They rejoiced at the appearance of new life, but reaped death. The dead fetus of one's own body is filled with such tragic symbolism that a person - even if he is not actually predisposed to this - simply cannot help but interpret it.
We all know that life is inextricably linked with death and that sooner or later death will still come to replace life - however, not a single fact, not a single truth is repressed by our consciousness like this. It can be noted that we fear death in a completely different way than, for example, religious Hindus or Buddhists, who are more conscious of death and, one might say, are on friendly terms with it. Anyone who views death as a necessary transitional stage, allowing one to gain freedom from the yoke of the body, even finds positive aspects in it, since he looks at life as a chain of events, during which one can gradually develop both upward and in breadth.
With us, things are completely different. When death comes where it was least expected, that is, at the very beginning of a new life, it turns into a particularly difficult test. At the same time, the painful lesson of this event is to figuratively let death into your life, bring it into the light and internally reconcile with it. If a woman gives birth to a stillborn child, she should admit that in life she carries something inanimate within herself that she herself does not notice, or that everything that she receives from life, she will have to give away one way or another.
Medicine tries to console parents with arguments that the death of the child was the best solution to the situation. As possible reasons These are the most severe developmental defects, such as heart defects or serious chromosomal abnormalities such as trisomy 18.
To be able to truly understand and accept the event of stillbirth, it is simply necessary to become familiar with the tenets of reincarnation therapy. If you ignore this opportunity, which gives incomparable liberation, then it is simply impossible to work through the death of a desired child and come to terms with it.
Nowhere in medicine is the theme of death more apparent than during childbirth, where we least expect to encounter it. In no other case are we given the opportunity to feel that fate is in the hands of God or in the hands of some majestic power. We cannot impose our will on the natural events of existence, and death in particular. No matter how many amniocentesis we do, sooner or later our life's tasks will overtake us, and we will not be able to constantly ignore the clues of fate.
Stillbirth is the birth of a stillborn fetus at >20 weeks of gestation. To determine the cause, examination of the mother and fetus is required. Management of the postpartum period is similar to that after the birth of a live fetus.
Working through child death
It is extremely difficult for orphaned parents to come to terms with the death of a child, since in the face of such a short, practically unlived life, finding meaning in death is even more difficult than in other cases. At the same time, the thought of severe developmental defects, which would still not give the child the opportunity for a “normal” life, can really have a comforting effect.
If we talk about specific actions, then in this case The most important thing is to really say goodbye to the child. Instead of giving the mother sedatives and sending the father home, doctors should have given them the opportunity to look at the child again in full consciousness and say goodbye to him, performing a series of mourning rituals. Father should have put a bed in Mother's room, because right now they really need each other.
Kahlil Gibran speaks about the lessons that parents should learn from such a situation in his “Prophet”: “Your children are not your children. They are the sons and daughters of life’s longing for itself.”
Awareness of one's own mortality can bring relief amid parental grief and despair. The memory of this makes a Westerner shudder internally. However, we should follow the example of all major religions, which claim that a person needs to understand and accept that death is invariably associated with life, is its natural opposite and accompanies us on different levels at every moment of life. Those who accept that facing death is only a matter of time and view time as an illusion find comfort more easily. Reading the Books of the Dead, written by adherents of various religions, such as Egyptian or, above all, Tibetan, can also help.
Self-help groups that deal with loss and grief can help in this regard. Women who have already gone through this test of fate understand how to help others better than professional consultants who mistakenly included the study of death topics in their list of services. If working in such groups does not bring relief, you should consider the possibility of psychotherapy and, first of all, reincarnation therapy. The often-given suggestion from doctors that there are genetic problems and that it is best for everyone is not only insufficient, but also ignores the depth and important dimension of the loss.
Causes of stillbirth
Fetal death on later pregnancy can be caused by pathology of the mother, placenta or fetus.
| Type | Examples |
|---|---|
| Maternal reasons | Diabetes (uncontrolled by treatment) Hereditary disorders of hemostasis Preeclampsia or eclampsia Sepsis Drug addiction Injury |
| Causes from the placenta | Placental abruption Chorioamnionitis Bleeding Feto-fetal transfusion syndrome Umbilical cord pathology (prolapse, nodes) Uteroplacental vascular insufficiency Vasa previa of the umbilical cord |
| Causes from the fetus | Alloimmune thrombocytopenia Chromosomal abnormalities Alloimmune or hereditary fetal anemia Infections Congenital malformations Nonimmune hydrops fetalis Genetic diseases |
Diagnosis of stillbirth
Investigations to identify causes include:
- determination of fetal karyotype and autopsy;
- clinical blood test;
- Kleihauer-Betke test;
- hemostasis studies (including factor V Leiden mutation; prothrombin G20210A mutation; protein C, S and Z levels; activated protein C resistance; fasting homocysteine level; antiphospholipid antibodies);
- Test for TORCH infections(toxoplasmosis (with IgG and IgM), other pathogens (for example, human parvovirus B 19, varicella zoster virus), rubella, cytomegalovirus, herpes simplex);
- determination of reagin antibodies in blood serum;
- examination of the placenta.
Often the cause cannot be determined.
Treatment of stillbirth
- Standard management of the postpartum period.
- Emotional support.
Management of the postpartum period is carried out in the same way as after the birth of a live fetus. If disseminated intravascular coagulation occurs, labor should be induced (eg, with oxytocin, sometimes after preparation of the cervix (effacement, opening) with prostaglandins. Any coagulopathy detected should be immediately and aggressively treated with blood replacement with whole blood or its components while preparations are made for delivery.
After delivery and delivery of the placenta, curettage may be required to remove any remaining placenta.
As an alternative, it is possible to resort to dilation and evacuation. In all cases, osmotic expanders should be used first. cervical canal, with or without misoprostol.
Parents typically experience grief and need emotional support and sometimes special counseling. The risks of subsequent pregnancies, taking into account the causes of stillbirth, should be discussed with the parents.
A delivery that ends with the birth of a dead fetus is called a stillbirth. There can be several causes of stillbirth death: placental, maternal, genetic, and also due to the anatomical structure of the fetus. But most common cause is precisely placental abruption.
Causes
- eclampsia;
- preeclampsia;
- sepsis;
- diabetes;
- substance abuse;
- thrombotic disorders.
Placental causes
- chorioamnionitis;
- transfusion between twins;
- damage to the umbilical canal;
- fetal and uterine bleeding;
- vasa previa;
- uteroplacental insufficiency.
Causes from the fetus
- monogenic disorders;
- chromosomal disorders;
- major malformations;
- fetal hydrocephalus;
- infections;
- alloimmune thrombocytopenia.
When the fetus dies closer to the due date and remains in the uterus for a long time, there is a risk of disseminated intravascular coagulation.
There are several types of tests to determine the reasons why a fetus was stillborn:
- maternal platelet count;
- Kleihauer-Betke test;
- anticardiolipin test;
- TORCH tests;
- thrombotic screening.
Unfortunately, very often the cause of a stillbirth cannot be determined. If a woman has symptoms of dead fetus syndrome, labor must be induced. Very often there is a need for curettage to remove fragments of the placenta. An alternative is fetal extraction and cervical dilatation. Osmotic dilators with misoprostol are used in all cases before abortion.
When a stillbirth occurs, any parents experience severe emotional stress and simply need advice and qualified support from specialists. Highly recommended in this difficult life situation consult a psychologist.
According to the reasons for the stillbirth of the child, the risks that may arise with the next pregnancy are minimized. During pregnancy, it is necessary to carefully avoid infection with certain types of diseases, including toxoplasmosis, salmonellosis, and listeriosis. In practice, many perinatal centers are ready to provide support to mothers who have lost their child in the past.
All pathologies associated with complications of childbirth must be diagnosed as early as possible and every possible effort must be made to eliminate them. Multiple pregnancy, post-term pregnancy, as well as fetal dystocia, as a rule, are well diagnosed.
Childbirth is an extremely unpredictable process and many pathological situations become obvious only during childbirth. In such situations, there is a need for prompt delivery, thanks to which the risks for the woman in labor can be minimized. There are often cases when serious complications begin after the birth itself, in the so-called postpartum period.
The death of a fetus in the early or late months of pregnancy is obviously the most difficult test for a woman. Miscarriage, which we call the loss of a fetus before the twenty-fourth week of pregnancy, is, of course, also difficult to experience, but the loss of a fully formed child during or after childbirth seems to be the most terrible outcome of pregnancy, and some of the readers will probably find this section difficult to read. However, many women who experience this tragic event often express regret that they were not prepared for it as they were for other aspects of pregnancy.
When do they talk about the birth of a stillborn fetus?
A stillbirth is said to occur when a child dies during childbirth or before birth after the twenty-fourth week. intrauterine development. The commonly used concept of “prenatal mortality” includes stillbirth and fetal death in the first week of life. This concept does not include the loss of a child in the second, third or fourth weeks of life, since in this case the causes of fetal death are considered to be less attributable to the course of pregnancy.
The prenatal mortality rate is calculated not only for statistical purposes, but also to study its causes, which may include the mother’s heredity, her past illnesses, educational level, and the management of pregnancy and childbirth. In order to understand the reasons and thereby prevent an unfavorable outcome of pregnancy after the 24th week, doctors count prenatal deaths per thousand births. The current prenatal mortality rate in England and Wales is approximately 9 per thousand.
You saw in the chart at the beginning of the book that prenatal mortality has fallen significantly over the past 40 years, largely due to improvements in public health. However, the recent decline in prenatal mortality can be attributed to some extent to improvements in obstetric care.
There are three main factors that can affect the outcome of pregnancy: the woman's age, number of children and social status. The number of children you have increases with age, but older or very young mothers are at greatest risk. A mother giving birth to her second or third child is at the lowest risk, regardless of her age. This may be due to the lack of prenatal care for very young mothers and the increased likelihood of illnesses or complications during pregnancy in older women.
A previous pregnancy can serve as a warning about what may happen in a subsequent pregnancy, and there is certainly a reproductive pattern. Some risk factors tend to recur and thus may affect the next pregnancy. They may be hereditary or acquired. The risk increases slightly in case of a previous miscarriage, ectopic pregnancy or the birth of a premature or stillborn baby.
All these factors can be taken into account at the beginning of pregnancy, so the course of pregnancy is carefully recorded, which allows the doctor to plan pregnancy management.
Why is a child born still?
There are many theories regarding unexpected fetal death. Often there is no obvious reason, and we can talk about several factors at the same time. The three main causes are: congenital disorders; prematurity; asphyxia due to lack of oxygen as a result of ineffective functioning of the placenta. Sometimes a complication may occur during the birth itself, resulting in the death of the child. In some cases, the reasons are known: premature placental abruption, Rh conflict, umbilical cord entanglement.
Unfortunately, there are cases where there is no obvious cause of death of a child, and such unexplained death fetus is one of the most distressing events that mothers and medical personnel have to come to terms with.
Intrauterine death of a child
With the death of the fetus, most of the sensations that accompany pregnancy disappear fairly quickly. One of the first things a woman may notice is a lack of fetal movement. The difficulty is that often the baby's movements can stop - or so it may seem to the woman - for several hours or even a whole day.
If on latest dates pregnancy, active and regular fetal movements are observed, and then a sudden change occurs, you should immediately inform your doctor. You will likely be asked to check for a fetal heartbeat using a regular stethoscope or through electronic monitoring or ultrasound. A woman may also notice a fairly rapid decrease in breast size, since the uterus in this case shrinks and the production of pregnancy hormones stops.
If the death of the fetus is confirmed, this will not cause any harm to the woman’s body. The doctor or midwife must decide how to tell the woman what happened and what to do next. The usual reaction of parents is to ask for the dead baby to be removed from the uterus as soon as possible, but there is no need to urgently induce labor if the parents prefer to wait a little to comprehend what has happened.
When the parents decide to remove the child, the woman is placed in one of the departments of the maternity hospital and labor is induced using gynecological balls containing the substance prostaglandin. Sometimes it is necessary to insert several of these balls at four-hour intervals in order for labor contractions to begin, since the uterus is not yet ready for childbirth and its contractions must be artificially stimulated. Fortunately, labor usually begins within a few hours.
Contractions begin or the membranes of the membranes may rupture, and sometimes help is needed in the form of an intravenous infusion of a substance that stimulates uterine contractions (syntocinon). If strong enough uterine contractions can be achieved, labor will usually follow quickly, and although the woman will have to work hard to push the baby out, she won't have to push for very long.
Sometimes, unfortunately, a child may die during a completely normal birth, usually due to insufficient oxygen supply to the baby from the placenta, and in some cases due to the umbilical cord being entangled around the baby's neck. Of course, it is impossible to say exactly to what extent these problems caused death, and often we can only speculate about what actually happened.
During childbirth, the uterus contracts regularly, and at the peak of each contraction, the blood supply to the placenta is interrupted. Healthy child tolerates this easily as it only lasts a few seconds every few minutes, however, if there is an additional factor that interferes with the blood supply to the placenta, it can be a big test for the fetus and cause development pathological condition. In some cases, the lack of oxygen during childbirth occurs because the uterus contracts strongly and quickly with too short intervals between contractions. Sometimes the causes may be sudden uterine bleeding due to abruption of a small fragment of the placenta, prolapse of the umbilical cord or, in very rare cases, obstructed labor.
Can a baby die as a result of a difficult birth?
It should be said that this is an extremely rare cause of death in a child. If the birth of a baby requires the use of forceps and is more difficult than usual, the baby may experience internal bleeding, which can cause problems.
In reality, this is unlikely, since the baby can withstand enormous pressure, and if the birth is expected to be difficult, a doctor experienced in the use of forceps and other aids is called in. This is one of the most difficult facts to understand because parents have every reason to believe that something happened during childbirth, and it is also quite understandable that they blame doctors or midwives for everything if they suspect that there was a mistake on their part. or they made the wrong decision.
Congenital disorders and defects
Of course, all parents experience a natural fear that their child may be abnormal. These fears cannot be dispelled, but perhaps parents will be reassured by the fact that 97% of all children are born normal, and of the 2.5% of children with disabilities, half have only minor defects, such as an extra finger, deformation of the auricle, birthmarks etc. Quite serious congenital disorders that can lead to intrauterine death occur in one case out of two hundred.
It is also consoling that many of the abnormalities that were very serious several decades ago can be completely eliminated by modern medicine.
Medicine has made such progress that many of these disorders can be detected even before birth using ultrasound, and appropriate measures can be taken: either termination of pregnancy if the parents want it, or delivery in a special department, which has all the conditions to correct some surgical violations.
After stillbirth
Whether a baby is stillborn, dies shortly after birth, or a few weeks later, parents have a hard time coming to terms with the loss.
They are often depressed and unable to explain to themselves what happened. How did it happen? Why did this happen? Was there any hope? Could the death have been prevented? The past and present seem so incomprehensible that it is impossible to even think about what to do next.
Many parents want to see the child or have a photograph of him. Often heartbroken the mother just doesn't know what to do. If a child has significant physical deformities, staff may be hesitant to show the child to parents. On the other hand, parents may want to see the child, since deformities may prove that death was rather a deliverance.
If the baby looks normal outwardly, parents can take comfort in the fact that they had a baby. beautiful child. Some mothers want to hold their baby after birth or a little later. The midwife usually wraps the baby before showing it to the mother, and the mother can take comfort in knowing that the baby appears quite normal. Seeing those parts that are formed normally in the child is very important both for the mother’s condition at the moment and for future pregnancy.
Some maternity hospitals make sure to take photographs of all deceased children, and if months or even years later parents want to have something to remember the child, these photographs can bring comfort. If parents want to take the photographs, they will be readily given them.
As difficult as it may be to make such a decision during a time of deep mourning, the parents will be asked for permission for an autopsy, which can provide important information, which can affect future pregnancy, and since mothers so often blame themselves for what happened, a post-mortem study can take that weight off their shoulders. Even if the cause of death cannot be determined, the examination can often confirm that the parents did not make any mistakes, and the information obtained from the post-mortem examination can help other children who are at risk of the same risk.
The child needs to be registered, which is often an unnecessary bitter reminder of what happened, and the hospital chaplain will serve the funeral service. There is no immediate need to make a difficult decision about whether or not to have a funeral or in what form it should take place.
Physiological changes after childbirth
No big difference between the birth of a living child and a dead one, as regards physiological changes, which occur when the body returns to normal. There may be painful sensations in the breasts associated with milk production, which can be stopped by taking special pills.
Before a woman is discharged from the maternity hospital, which, of course, will happen at any time convenient for her, she is usually prescribed a consultation with a doctor. This is a very important step and although it can be extremely difficult, during the conversation much can be done to make the parents feel better. If an autopsy was performed, the results will be discussed during the consultation.
It is often helpful to come back for a follow-up consultation a few weeks later if you have any additional questions that your doctor will be happy to answer. Two key points that should be addressed in this conversation are the mother's feeling that she may have done something wrong that led to the baby's death, the likelihood of the same outcome in the next pregnancy if the couple decided to conceive again, and what the time will be most suitable for this.
It is fair to say that there is no way a mother can cause such misfortune. Women often believe that they did not get enough rest before giving birth, that they were too active image life or did not monitor their diet enough. Women can be sure that these are natural questions that are often asked, but they have nothing to do with what happened.
In cases where the exact cause of fetal death has not been established, certain tests may be performed to detect rare viral diseases such as toxoplasmosis or cytomegalovirus. If a child was born with congenital disorders, consultation with a geneticist will help determine the likelihood of recurrence in a subsequent pregnancy.
From a physiological point of view, there is no reason that would not allow a couple to try to have a child again, approximately two months after the tragedy. Previously, it was believed that it was necessary to wait three to four months in order for the cycle to normalize, but in reality this does not matter much. If the couple prefers not to wait that long, there are no contraindications once all the examinations have been completed. Even if we are talking about complicated natural childbirth or a caesarean section, the couple does not need to wait more than a few months.
How to cope with grief for a woman who has lost a child?
Several factors force a woman to deeply hide her experiences from others. Outwardly, as a rule, a woman copes with her grief surprisingly easily. The birth of a child seems like an event that never happened, and the woman's main feeling may be shame. The feeling of inferiority and failure makes a woman want to hide from the eyes of others, and the offer of a separate room sometimes only worsens the matter. A woman feels guilty when she has nothing to reproach herself for, feels sick without being sick, and most of all feels a sense of emptiness and loss, without even having memories of the one she lost.
It is always difficult to find words of comfort in the event of a stillbirth. Friends and relatives have no memories, no words of affection and love about someone they have never seen. With the best of intentions, they may make comments such as, “There will be more children,” which can deeply hurt. Much more than consolation, a woman in this case needs sincere sympathy for her grief.
In conclusion, it should be said that subsequent pregnancy is a period of psychological stress, which increases the more more woman tries to convince himself that this time the pregnancy will end successfully, in the hope that with birth normal child everything will work out. Fortunately, repeat stillbirths from unknown causes are extremely rare, and most women can be confident that the outcome of their subsequent pregnancy will be happy.
Source Sanders P. All about pregnancy: day by day. - M.: Eksmo Publishing House, 2005.
My daughter was stillborn... Why?
Anxious phone call came from a deputy of the Talalaevsky district council Alexandra Kobyzha:“In our district hospital, a woman gave birth to a stillborn child. Perhaps it was the doctors' fault. I sent a parliamentary appeal to the district and regional prosecutors with a request to conduct an investigation. In my opinion, this tragic incident cannot go unnoticed."
We went to Talalaevka and listened to all the participants in this story. We tried to understand everyone. This material was in no way intended to glorify or, especially, blame doctors. After reading it, let everyone draw their own conclusions.
Difficult birth
Zaryana Negodko still cannot recover from grief, so her mother, Lidiya Vasilievna, mainly spoke:
- Robin really wanted this child! Although she knew that she would raise him alone (the guy she was dating drank, so her daughter left him). She registered at the Talalaevskaya hospital on time. Led her obstetrician-gynecologist Galina Ivanovna Obukh(I also gave birth to my children with her). Every two weeks Zaryanka went to get checked. I didn’t get sick and gained weight normally. On Saturday, March 6, we went to the hospital.
“On Sunday morning I started having contractions,” recalls Zaryana. — It lasted the whole day and the next day, March 8. Around six in the evening they began to prepare me for childbirth. They put me on a chair, where I stayed until 10:15 p.m. I couldn't give birth. Finally Galina Ivanovna She took off her gloves, threw them on the table and, with the words “She won’t give birth on her own,” ran out of the delivery room. Following her came the children's doctor Nikolai Szegeda, who was also there. A few minutes later, Galina Ivanovna came in and told the nurses to turn off the IV. Told me what I need to do C-section, for this she will call doctors from Pryluki. Everyone who was in the delivery room was very surprised. They helped me get up from the chair and took me to the room. Galina Ivanovna asked to call her mother.
Lidia Vasilievna I found a car with difficulty (no one wanted to go, because after the holiday everyone was drunk) and an hour later I was already standing under the doors of the delivery room.
- What pain Zaryanka had, how she suffered! Besides, it’s already the second day! It’s already midnight, and the first hour, and there are no Priluki doctors. I began to insist that they call again. Instead, Galina Ivanovna called me into the office: “The child’s heartbeat is so weak... I don’t know if they will undertake a caesarean section.” Then she said that she would have to pay for the ambulance call (for gasoline and doctors). I couldn’t stand it anymore: “You save Zaryana and the child! There will be money!”
“The Priluki doctors arrived at 2.10 and immediately put me on a chair and started listening to me,” continues Zaryana. — Galina Ivanovna advised everything:“Listen here, right here.” But they never heard the child's heartbeat. A doctor from Pryluky asked the Talalaev doctors if they had tools to take out the child piece by piece if something happened. Then she said to make an incision in the perineum. - Author), and 20 minutes later a girl was born. Dead... The Szeged doctor still tried to save her, but the gynecologist from Priluki said that when they arrived, the child’s heart was no longer beating. I was in shock...
“They didn’t let me see the child right away, but then I went in anyway.” The baby lies as if sleeping. 3850 g, 55 cm - good girl! She would already be a month old,” Lidia Vasilievna cries.
Why did the child die?
“Galina Ivanovna came to me in the morning and asked me when was the last time I felt a child. I say: “When they took me out of the chair.” Galina Ivanovna objected: “It can’t be. Your baby froze 10 hours before birth.” I don’t agree with this - after all, I felt it almost until the last! With every contraction, my chest was pushed so hard! And somewhere at one in the morning this feeling disappeared. I told the doctors about this. They replied that the child must have taken a comfortable position.
A day later, Galina Ivanovna gave a different version: they say that 10 days before the birth the child began to have problems with the liver and kidneys, and the girl would have died anyway.
When I came back ten days later to remove the stitches, they gave me a certificate of the child’s death to register with the registry office. The conclusion states that the child was strangled by the umbilical cord during birth. Which of these three versions is correct? I am convinced that doctors are to blame. More March 7 I complained of pain. The doctors replied: “It’s still early, let’s wait.” That's what we've been waiting for!
“If Galina Ivanovna had called me right away and said that there was a threat, we would have taken Zaryana to Srebnoye or Priluki ourselves. Maybe the child would have been saved,” Lidia Vasilievna laments. - Why, when Zaryana was on the chair, the doctor didn’t tell me that my daughter was giving birth to a stillborn child?
When we arrived, Galina Obukh was on sick leave, but was at work in the gynecology department and agreed to talk with us. She told me about everything in detail:
— Zaryana was registered with us at 12-13 weeks. She did not experience any pathologies during pregnancy. The time has come for childbirth. The patient came to the appointment with a postponement. Before this, I offered her hospitalization, but Zaryana refused, saying that she would stay at home for a while, and would come on the 6th herself. When she arrived at the hospital, the Chernigov ultrasound team worked out how to do it. Since Zaryana was carrying the baby, I asked to have an ultrasound scan. We didn't see any complications there. It was determined that pregnancy 40 weeks. I admitted Zaryana to the hospital. I decided to monitor her, and if she did not give birth within four to five days, to induce labor.
On March 7, I listened to her, everything was fine, and on the 8th at noon the midwife called me with the words: “I can’t hear the baby’s heartbeat.” I came and listened to her for a long time. It seemed to me that there was a heartbeat. Unfortunately, we don't have a heart monitor that can accurately determine this. I realized that the child froze. In this case, my task is to give birth to the woman naturally so as not to cut or maim her. Around two o'clock in the afternoon, Zaryana began having more or less regular contractions. Everything was going well, but about She's 19 The water began to break with the baby’s feces. This is very bad. Even if there is a heartbeat, but the waters are colored by these masses, this is a sign of hypoxia (oxygen deficiency) of the fetus. We decided to speed up labor. At 19.30 They connected the Zaryanekapelnitsa, and at about ten o'clock in the evening they examined it. The baby’s head was pressed to the entrance to the pelvis and remained there, not moving. Because of this, there was a threat of uterine rupture. I couldn't let this happen. The child has already died, why risk the woman? I called the air ambulance for help. It would take 4-5 hours to wait for her from Chernigov, so the call was transferred to Priluki. When the Priluki team arrived, Zaryana’s cervix was already fully dilated and the baby’s head had dropped. There was no need to operate on her. She only had an episiotomy (an incision in the perineum) to prevent a rupture due to the large head (we assumed that the child would be 3800 g).
The next day I took the girl for a pathological examination in Pryluki. An autopsy showed that the cause of death was the tight entanglement of the umbilical cord around the neck. According to the pathologist, the child was dead at least 12 hours before birth (changes were found in his internal organs).
“But Zaryana says that she heard movement almost until the last moment.
- Apparently, it seemed to her. I heard something too. Most likely, the woman in labor had muscle contraction abdominal cavity. This tragic incident could have been prevented if an ultrasound had shown that the fetus' neck was entwined with the umbilical cord. Then we would do a planned caesarean section. But the equipment showed nothing. The umbilical cord could wrap around the baby's neck when the uterus began to contract. Believe me, if I had known that Zaryana had complications, I would not have left her for surgery in the area.
The chief doctor of the Talalaevskaya Central District Hospital, Vasily Marchenko, says:
“Perhaps, with modern equipment, the child would have been saved.” But I don’t see Galina Ivanovna’s guilt either. Although I understand the grief of my mother and grandmother, I still ask for their forgiveness.
In the conversation, Vasily Marchenko also voiced the most important problem of his hospital - personnel:
— Galina Ivanovna is 63 years old, she has 37 years of experience. Due to health reasons, it is already difficult for her to work, and the doctor asks almost every day to let her retire. But I, as a leader, constantly persuade her to stay. If Galina Ivanovna writes a letter of resignation, I will need to raise the issue of closing the maternity ward, because there will be no one to work there. Three obstetricians-gynecologists are training for our hospital, but one has another year of internship left, the other two have two years each (gynecology internship is 3 years).
The girl was buried in the cemetery.
“The priest allowed it, he just said not to put up a cross.” “If you bury it at home,” he says, “you will only walk around the grave and cry.” And we cry endlessly...
Zaryana Negodko
Alina Dolinets, weekly “GART” No. 16 (2456)
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