Heard a sad, scary story from my preceptor today

stevierae · Nov 22, 2004

well i may not know alot but here goes.......the babys head circumference by
design is to max out the opening for the shoulders and rest of the body to pass.
so it would make more sense to hack off an arm and shoulder....child would at least live that way.....but mostly i think its a bunch of hooooeeey.

Again, I know of no cases reported in the literature in which a LIVE baby was decapitated. It was only done way back when in the case of severe cephalo-pelvic disproportion (in the '30s, '40s and '50s when pelvimetry was not readily available) AND WHEN THE BABY WAS ALREADY DEAD. Before amniocentesis, I am certain there must have been a fair number of babies born dead with multiple anomalies, including severe hydrocephalus that made a normal VERTEX lady partsl delivery of the grossly oversized head difficult if not impossible. (They called these babies "monsters" back then--that's how severe and bizarre some of their deformities were, and they likely had severe accompanying mental deficiencies that made any quality of life impossible. Most were born dead. The ones that survived were often the "freaks" presented in traveling roadshows.)

Shoulder dystocia may not have even been a problem or a consideration--the grossly oversized HEAD in an already dead baby was the obstacle they were dealing with. In those days, rural births far from hospitals were common; poverty--especially during the depression--was widespread, and who knows how accessible C-sections were?

I am sure breech presentations back then presented their own complex set of problems.

palesarah · Nov 22, 2004

Again, I know of no cases reported in the literature in which a LIVE baby was decapitated. It was only done way back when in the case of severe cephalo-pelvic disproportion (in the '30s, '40s and '50s when pelvimetry was not readily available) AND WHEN THE BABY WAS ALREADY DEAD. Before amniocentesis, I am certain there must have been a fair number of babies born dead with multiple anomalies, including severe hydrocephalus that made a normal VERTEX lady partsl delivery of the grossly oversized head difficult if not impossible. (They called these babies "monsters" back then--that's how severe and bizarre some of their deformities were, and they likely had severe accompanying mental deficiencies that made any quality of life impossible. Most were born dead. The ones that survived were often the "freaks" presented in traveling roadshows.)
Shoulder dystocia may not have even been a problem or a consideration--the grossly oversized HEAD in an already dead baby was the obstacle they were dealing with. In those days, rural births far from hospitals were common; poverty--especially during the depression--was widespread, and who knows how accessible C-sections were?
I am sure breech presentations back then presented their own complex set of problems.

Exactly. My old OB texts actually refer to decapitation being used not for CPD or dystocia but for high transverse presentation where the baby had already died, labor was prolonged and imprending uterine rupture was feared, as well as conjoined twins and "monstrosities" (deformities) that could not be delivered intact. As childbirth moved from home to the hospital and c-sections became less dangerous due to the appearance of antibiotics and other medical advances, these situations could be resolved with c-section.

smk1, LPN · Nov 23, 2004

If You Remove The Head, The Shoulders Remain Same Size

this was my thought as well....maybe A&P really is frying my brain because i still don't get it... :imbar

are they removng the head of a deceased baby to be able to perform c-section to get the rest out? I'm just lost perhaps i need to stay out of this thread...

itsmiranda · Dec 7, 2004

I couldn't imagine. Seems odd....almost third world if you would....I just couldn't imagine.......you have left me speechless....I have never heard of such a thing....maybe your preceptor is a stroyteller......maybe.....but yuck..if it did happen. The shoulders are the same size, even if the head is removed....and since alot of cases of babies with shoudler dystocia clavicles break their shoulders would therefore be smaller than their heads.....just doesn't sound right to me. If there was a bone caught or something I can see them opening the mother up and dislogding the bone...I could even see breaking the pelvis to a degree......but never decapitation...

ladyhustler21 · Dec 8, 2004

I was still in nursing school, when this happened to me. The mom was kindof on the big size and she was going to have a big baby. As the doctor was delivering the baby, she got stuck(the baby), and the doctor decided to break one of the babies arm/clavicle in order to get the baby out. She told the mom it was either break her arm or have the baby suffer from more complicated problems such as brain disorder. Also I saw on babies special delivery that a mom was had diabetes was going to deliver a big baby, same thing happen to her, the babies head got stuck, no matter how hard she pushed they could not get the baby out. One of the nurse got on the bed and helped push from the top, to help push the baby out. She was stuck for 3 minutes, she was not breathing. Once they got the baby out they gave her epi and oxygen, she was rushed to NICU, of course the baby lived. It was pretty scary.

If they ( your story) know the baby was so big, why did they not do a C-section? That is why they have ultrasounds to see if they are going to have any complications, also they can tell when they are checking the mother.

Your story is very sad, and I feel very sorry for that mother and family. :crying2:

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?

celticqueen · Dec 8, 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?

NO WAY!!!!! can't see it myself. I reckon she's having you on - it's a bit sick though isn't it. Besides, if it was the shoulders that were stuck, what was the point of lopping the head off?????

Emma

Farkinott, RN · Dec 8, 2004

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:

Even if it is urban legend it is still a really crappy thing to do to an innocent newby. I say boo!

itsmiranda · Dec 8, 2004

Even though she was a big lady...it doesn't mean that her pelvis was big enough to pass the baby. It was probably that the lady was giving birth to the babies head and shoulders at the same time...this is called shoulder dystocia...the doctor sometimes tends to break the clavicle if he/she is unable to manipulate the babies body in order to prevent the break and still deliver the baby. Also you have to put into perspective...how much care did she get?....was it a one time prenatal check...was it multiple times?...was she on vacation and she went into labor somewhere else?....in order to know why things happened the way they did, you really have to know all of the aspects of the situation.

been there · Dec 9, 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.

Reminds me of the story about the teenagers parking in a lonely spot, the girl hears something, the boy didn't then when he drove her home and went to open her door he saw a hook (like Captain Hook's) caught in the door handle!!

Lapa · Dec 9, 2004

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!

Please leave Russia out of this.

Hairstylingnurse · Dec 9, 2004

Hey guy's, I can totally tell u where this came from. I haven't read all the posts here, so someone may have already said it. This story was in a book that I bought at a thrift store. I believe it was published in the late 80s or early 90s. It is called something like 48 hr. rotation or something to that affect. It was showing what life is like for residents. I have it packed away somewhere, but I will dig to find it and hopefully be able to give u all the title. I couldn't read anymore of it after that story.

I honestly don't know if it was fiction or not. The cover of the paperback book is white with an ambulance on it and a resident in his teal scrubs is pictured looking stressed lightly over the ambulance. I will do my best to find this book.

NurseGuy_in_06 · Dec 9, 2004

Even if it is urban legend it is still a really crappy thing to do to an innocent newby. I say boo!

I agree. It is akin to snipe hunting.