Heard a sad, scary story from my preceptor today

NurseGuy_in_06 · Nov 22, 2004

Today I had a preceptor with about 17 years exp. She was quizzing me on what complications may occur with the patient we had. It was a big baby, and we got talking about shoulder distocia (sp?). She shared with me a story, and I was wondering if any of you have ever heard of this happening, or had it happen.
The pt was to deliver lady partslly, and the head was delivered, but the shoulders wouldn't come. Apparently they tried everything (trying to put the head back in, cut the cervix, broke the clavicle, did the manuevers to get the shoulders through, etc. Not in that order I'm sure). She said they tried for over 20 minutes and could not get anywhere. The head was out and the baby was stuck. They (well the attending) had to decapitate the baby.
She said the resident left the room vomiting and she doesn't like to think about it to this day. I don't know how long ago it was.
What a horrible thing! I can't get it off my mind. Anyone know anything about this sort of situation?

Ever heard of a C-section? If the head was out and the shoulders were stuck how did cutting the head off help? Ever heard of Urban Legend? :rotfl:

gauge14iv, MSN, APRN, NP · Nov 22, 2004

I have heard this story too.....

but the baby was supposedly breech, it was in the middle of nowhere and there was no anesthesia to be called in.

Dunno if it's true or not, but I have heard of some pretty strange things - it's possible I guess

DutchgirlRN, ASN, RN · Nov 22, 2004

I have heard this story too.....
but the baby was supposedly breech, it was in the middle of nowhere and there was no anesthesia to be called in.
Dunno if it's true or not, but I have heard of some pretty strange things - it's possible I guess

I absolutely don't believe this is true !! Maybe in Africa, the rice paddies of Asia, outer Mongolia, maybe even Russia, but not here in America. I did L&D from 1982-1994 and I can tell you it did not happen whether that baby was vertex or breech. It makes absolutely no sense what-so-ever. I think I'd be asking for another preceptor. Whether she believes this crazy story or not she should never have told you. That would be one fast way to run off a newbie!

Baby Catcher · Nov 22, 2004

I knew a nurse who told a variation of this urban legend. She was a real nut case. I hope J.W. is not your preceptor. If she is RUN!

pebbles1977 · Nov 22, 2004

She's not my regular preceptor, but other than that story, I found my experience with her today wonderful. It's nice to hear that that may not be true.

Her explanation to the c/s was that they were not able to get the head back in.

That story, or no preceptor, is going to scare me away from L&D. I love it too much. I know that there are bad things that can happen, but I think that almost fear keeps you on your toes. Or at least for me it does.

Thanks!

Oh, and it was a first hand story from her. Just wanted to add that if it wasn't clear.

stevierae · Nov 22, 2004

There actually is an instrument called "decapitation scissors." We use it in the operating room for various things--NOT decapitation!!!

I think there is always a grain of truth to any urban legend. I SUSPECT that what actually happened--probably many, many years ago; perhaps in the '30s, '40s or '50s is that this baby (subject of the urban legend) was ALREADY dead--that is, a fetal demise---and that for whatever reason his intact head and body could not be delivered lady partslly and also for whatever reason a C-section was not an option--Attempts to allow nature to take its course and expel it naturally were unsuccessful, and, hence, use of the decapitation scissors to separate the overly large head from the body WHILE IT WAS STILL HIGH UP IN THE lady parts--NOT out. Hence, the decapitation of an already DEAD baby. I am only speculating; please do NOT quote me.

However, decapitating a LIVE baby due to cephalo-pelvic disproportion? NO WAY. I am certain that this has never happened, at least in MY lifetime, and I have been around since the '70s and did OB way back then, when our only tool to diagnose CPD was pelvimetry. CPD that would not allow safe lady partsl delivery progressed immediately to C-section.

pebbles1977 · Nov 22, 2004

Gotcha! So could there ever be an instance where I guess it wasn't realized that the shoulders couldn't be delivered until too late? Would there be a time ever when you couldn't get the head back up to do the c/s? Is this a possibility, or not at all feasible?

Now that you guys are giving me so much help, I have my professional curiosity peaked!

gauge14iv, MSN, APRN, NP · Nov 22, 2004

In the version of the story I was told - the baby had already died - not that that makes it any better or more true....and I would bet based on the age of the person and the age of the person who supposedly told her, that this story was probably around in the 40's so who knows

smk1, LPN · Nov 22, 2004

ok it's late and i am not a nurse yet so maybe i just don't get it but, if the SHOULDERS are stuck then how does cutting off the HEAD help? (it's already out) Am i just being an airhead and not seeing the obvious here....

pebbles1977 · Nov 22, 2004

smkoe-

From what I understand, the shoulders can get stuck with a big baby at the pelvic bones (or that's my understanding - I'm new to this too, and have been out of nursing school for a bit!). The nurse that precepted me today prepared me for this by explaining some techniques to get the baby out if that happens. She said that there have been times the baby's clavicles have had to be broken to get it out. Basically, the head comes down and out, but the shoulders are too wide for the lady's bones, so either you use certain techniques to get the shoulders through, or you resort to other measures.

I don't look forward to the day that this happens to me. As sick as is sounds, I would have preferred the distocia (sp? again) to have happened today with an experienced nurse precepting me, than seeing it on my own in a few weeks! Not that I'd ever want to see it, but I just want to know how to treat my pt in the best way possible.

palesarah · Nov 22, 2004

There actually is an instrument called "decapitation scissors." We use it in the operating room for various things--NOT decapitation!!!
I think there is always a grain of truth to any urban legend. I SUSPECT that what actually happened--probably many, many years ago; perhaps in the '30s, '40s or '50s is that this baby (subject of the urban legend) was ALREADY dead--that is, a fetal demise---and that for whatever reason his intact head and body could not be delivered lady partslly and also for whatever reason a C-section was not an option--Attempts to allow nature to take its course and expel it naturally were unsuccessful, and, hence, use of the decapitation scissors to separate the overly large head from the body WHILE IT WAS STILL HIGH UP IN THE lady parts--NOT out. Hence, the decapitation of an already DEAD baby. I am only speculating; please do NOT quote me.
However, decapitating a LIVE baby due to cephalo-pelvic disproportion? NO WAY. I am certain that this has never happened, at least in MY lifetime, and I have been around since the '70s and did OB way back then, when our only tool to diagnose CPD was pelvimetry. CPD that would not allow safe lady partsl delivery progressed immediately to C-section.

Several of my coworkers and I have gotten into collecting old OB nursing texts (pre-1900's to 1940's), and decapitation is mentioned in some of the books as a "last resort" pretty much exactly as you speculated.