? about fetus that died in womb

mturner88 · Apr 30, 2006

I'm not so sure if that would be considered unethical. My personal experience with the same situation is that my baby was at 15wks gestation when I found out that she had no heartbeat. They did an ultrasound to make sure that she just wasn't laying in a weird position and on the monitor we found out that she was no longer alive. I was extremely upset and they told me that they could induce my labor but all I did is want to go home. I went back to the hospital (next day) where they put these sticks in my cervix and it hurt like hell, to cause me to have contractions. I was supposed to later go back to get some medication to induce my labor but that night I went into labor on my own and my water broke. I got to the hospital where they delivered my baby (May 9, 2001 - Destiny Renee) and found out that the cause of her death was because she had wrapped her tiny leg so many times around her umbilical cord that it cut off her life supply. In addition to that, the cord had cut right threw the skin on her leg where the bone was exposed. God knows that I miss her much and she was so tiny but all of her bones and veins were there. It was a very sad time for me and now I have a beautiful boy (August 16, 2003 - Xavier Marcell) that I love dearly.

But not to get off the subject at hand, I think it's really up to the mother and what it is that she wants to do. Of course the staff isn't going to allow her to keep the baby in the womb until it makes her physically ill. If she decided to wait unil the next day, they don't have a problem with that but you have to come in to get that procedure done.

mysticalwaters1 · Apr 30, 2006

I'm not so sure if that would be considered unethical. My personal experience with the same situation is that my baby was at 15wks gestation when I found out that she had no heartbeat. They did an ultrasound to make sure that she just wasn't laying in a weird position and on the monitor we found out that she was no longer alive. I was extremely upset and they told me that they could induce my labor but all I did is want to go home. I went back to the hospital (next day) where they put these sticks in my cervix and it hurt like hell, to cause me to have contractions. I was supposed to later go back to get some medication to induce my labor but that night I went into labor on my own and my water broke. I got to the hospital where they delivered my baby (May 9, 2001 - Destiny Renee) and found out that the cause of her death was because she had wrapped her tiny leg so many times around her umbilical cord that it cut off her life supply. In addition to that, the cord had cut right threw the skin on her leg where the bone was exposed. God knows that I miss her much and she was so tiny but all of her bones and veins were there. It was a very sad time for me and now I have a beautiful boy (August 16, 2003 - Xavier Marcell) that I love dearly.
But not to get off the subject at hand, I think it's really up to the mother and what it is that she wants to do. Of course the staff isn't going to allow her to keep the baby in the womb until it makes her physically ill. If she decided to wait unil the next day, they don't have a problem with that but you have to come in to get that procedure done.

Oh I'm sorry to hear about that! Sounds absoulutey horrible and glad you care for your little boy now :)

I don't know if my coworker's friend wanted it done right away. But he gave me the impression she would have if they decided to do it that day but scheduled for the next day and that's what upset him.

l&drocks · Apr 30, 2006

In the institution I work in, mother's are usually given a choice whether to remove the fetus or let nature take its course. Most of the patients that I work with if they are less than 16 weeks or so they will opt for a D&C. If the fetus is full term, labor will be induced.

tinyscrafts · Apr 30, 2006

Some moms prefer to wait it out as long as there are no signs of infection. It gives some moms time to process the loss and plan for momentos/memorial services etc... Doing it faster is not necessarilly better. It won't speed the healing. IMO more ethical to inform the parents of all the options and give them time to think about them.

JessicRN · Apr 30, 2006

We had a mother who was 14 weeks gestation with an interuterine death and she had to wait 3 days to have it removed. Not her choice, they wanted it out now. She was told if she developed N/V or fever she was to return to the ED. I had missed abortions and the thought of leaving it any part in me for greater then 24 hours would sicken me. I would be a raving maniac. I luckly only had to wait a couple of hours to go from the MD's office to the ED (NH does Dilation and extractions for first trimester deaths in the ED's).

ljds · Apr 30, 2006

We usually encouraged people to wait. Oftentimes they need time to process the death, make arrangements for a service or funeral, and gather a support network. I work in an out of hospital environment (independent birth center), so if they want to have the baby immediately, then we need time to make arrangements with someone for a D&C, since we can't do that here.

We also spend alot of time discussing their birth and arrangements for the baby. We share some of the experiences that others have had; it is such a hard time, we really want to enable them to make it as meaningful and healing as possible. It takes alot of time and intensive support, something that a traditional doctor's office doesn't have the intimate ability to offer. We are also lucky enough to be able to offer home, birth center, or hospital birth to these mamas.

There are risks with a D&C, and it is not something entered into lightly. We do labwork to watch the mother's WBC and DDimer values; usually nature will takes it's course, sometimes we use cytotec. I have been there four + years; I have never seen a mama who wants an immediate birth. I have also never seen a mama develop complications from waiting. We don't have the traditional mamas, though; our mothers are already doing something outside of the mainstream, by having an out of hospital birth, so that probably skews our experiences. We have had mamas wait almost two weeks; we have had mamas choose cytotec within 24 hours of discovering the death. Many mamas have chosen to take their babies home; it was important to them to have a memory of their infant in their house, and to have time to say goodbye. We've had parents leave their infants at the birth center, and we have taken care of arrangements. My experience is with infants between 12 weeks and 28 weeks gestation.

I'm sorry about your friend's loss. She's lucky to have such a supportive friend.

SmilingBluEyes · Apr 30, 2006

I am sorry about your friend's loss. What a tragedy.

Where I work, they would be admitted and hopefully, nature allowed to take course. If nothing happened after a day or so, cervical ripening or pitocin would be started to get labor going. This is the safest way to go in most cases----the body should be allowed to do what it can to labor and deliver the expired baby itself. It seems horribly cruel, to be sure, but these folks, do need time to process and grieve, and this is a part of that process.

Again, so very sorry to read of your friend's loss. How very sad for her and her loved ones.

luvmy2angels · Apr 30, 2006

I had a similar situation as well and was given the choice wether I wanted a D&C that day or wanted to wait. They said I could wait and nature would "take it course" but I opted for the D&C that day. I agree with the others though that some women just need time to process the whole thing, this can be a very traumatic experience for women and they should be supported in whatever decision they make. Did your friend voice her thoughts on wanting to have it done that day?? I think that would be a hard posititon to be in as a nurse, and I disagree that the nurse should have "acted as her advocate" and demanded the fetus be removed. If the pt felt so strongly about having the fetus removed she should confront the Dr herself and not expect the nurse to do that, especially for such a person decision as this was. Just my opinion.

fergus51 · Apr 30, 2006

Some moms prefer to wait it out as long as there are no signs of infection. It gives some moms time to process the loss and plan for momentos/memorial services etc... Doing it faster is not necessarilly better. It won't speed the healing. IMO more ethical to inform the parents of all the options and give them time to think about them.

Amen to that. My friend needed some time before being induced for her daughter that had died. She waited about a week. She said it gave her a chance to say goodbye in her own way and to prepare for the actual delivery.

Your coworker should refrain from making comments like this unless he was there because he really doesn't know what went on otherwise.

nurse_wannabe · Apr 30, 2006

A one-day wait isn't going to make much difference physically. It's the emotional trauma that I would be concerned about, and the mother should have been told all of her options regarding the birth or removal of the baby.

I have personal experience with this. My baby was full-term and I went to the hospital d/t lack of movement. An US was performed - no heartbeat. Doctor was called immediately. Since I had already had something to drink that morning, I had to wait 4 hours before he would do the cesarean (I was already scheduled for a cesarean d/t a prior one).

It was the hardest 4 hours of my life. It did not give me any time to "process" and grieve for the loss, b/c a part of me believed it was all some horrible mistake and I didn't completely believe he was dead until I woke up from anesthesia and asked the doctor. That's when my grieving began.

In short, barring any contraindications, the mother's wishes should have been followed. If they were not, she should find a new OB.

fergus51 · Apr 30, 2006

Also, it may be important to look at the practicalities here. Was the woman's so available right then, is this a bigger hospital that could provide for her care on a moment's notice, etc. I worked at a rural hospital briefly and they didn't even have anesthesia in house 24 hours a day. If he was busy on a case or the only OB/GYN in town was busy and a woman came in with a deceased baby, waiting would have been necessary for her safety.