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this post was submitted on 06 Feb 2024
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Surgical tech here. Can't really comment on the clinical justification for what's going on here cuz 1) I'm just a tech; and 2) I wasn't there; but I’ve done a metric fuck-ton of c-sections, so figured I'd chime in with some behind-the-scenes insight. C-sections can be brutal as hell. Never been in on a vaginal delivery, cuz that’s not OR territory, but c-sections are the kind of case you’re on high alert for the entire time cuz shit can go south really fast for both mother and baby. The amount of force I’ve seen (and contributed to) applied to get a baby out could definitely be in dismemberment territory if there was some defect at play that could make the bones/muscles weaker than normal... article doesn't say anything about that being the case, but point is that we tend to think of handling babies as being an exceptionally gentle process, and that is 100% not the case when it comes to getting them out of the mother.
Some of the most horrific things I’ve seen in the OR have been in the c-section room. But they’re the kind of thing that if you don’t do, it’s basically a death sentence for the mom or the baby... like, do you leave a baby stuck in the birth canal with its umbilical cord wrapped around its neck; or do you pull a little harder to get it out? You're weighing certain death against possible death, but the latter being an exceptionally shocking worse-case scenario.
Can't emphasize enough: wasn't there, can't justify squat, but I have been in situations where the the surgeon weighed a risk like that, and the only reason you didn't read about that case in the news was that the risk paid off and we got the desired outcome. Luck.
The ruling on this one of homicide as opposed to murder or even involuntary manslaughter is a point of interest. Homicide is the killing of another human, but isn't typically a charge in and of itself... illegal and intentional homicide is murder; legal and justifiable homicide could be something like self defense... but just "homicide" only tells us that the baby was killed, and yeah no shit.
Anyway, based on my own experience, I’d give the doc and delivery team the benefit of the doubt in terms of the operation: extreme circumstances can call for an extreme response, and when that doesn’t work, the result is also extreme. This is a case that will haunt the staff involved all the way to the grave - really hope the hospital hooks them all up with top-notch therapy after that shit. The absence of murder/manslaughter charge leads me to believe their investigation found some merit in the doc's decision to pull extra hard.
Thad said, state law is a weird animal, so "homicide" in Georgia legally speaking could be equatable to "murder" everywhere else. /shrug.
But even assuming the best-case-scenario clinically, the lack of transparency after the fact though is 100% inexcusable, but also unsurprising coming from a private hospital. Their decisions are driven by money and PR. Ethics are a tie breaker at best.
The bit that makes me not want to give the benefit of the doubt is the fact that they had lost fetal heart tones an hour before going to C-section. For a delivery like this with a couple known complications going into it, the threshold to go to the OR should be much lower. Also, as barbaric as it is, something like an episiotomy could have averted this death.
Wow
Like I said, it's kind of barbaric, but it can be used as an intermediate measure if there's something like shoulder dystocia but the mother is against or hesitant about going to C-Section. These days, the episiotomy incision is made at a very specific angle so as to preserve function of the pelvic floor muscles, and it can also be used as an intervention or prophylaxis against perineal tearing which is more likely to damage the pelvic floor muscles and lead to complications.
At least asking the husband if he wants the doctor to "tighten her up a bit" by stitching the perineum up further than nomal has fallen out of fashion.
LOL, wait till you see your wife get cut in real time. Jesus. All I saw was a flash of steel.
"Uh, what was that? Oh hell no..."
C-sections can be done to recover the corpse of a fetus. It's not common - I've only seen it once, it was easily the single most fucked up thing I've witnessed. An hour isn't an unreasonable amount of time to staff and setup a c-section. It's not a STAT, for sure, but with the fetus already dead, the only urgency would be on behalf of the mother, so if her life wasn't in danger at that time, things were likely slowing back down at that point.
I'm saying that they should have gone to C-Section or episiotomy long before it got to that point. This was already known to be a higher risk delivery, and the first sign of shoulder dystocia or other complication should have been the time to elevate the level of care....not several hours later.
I don't have the expertise or experience to comment on what they should have done - 100% of my experience with OB is c-sections; I've just seen how shit can go from bad to haunt-you-for-the-rest-of-your-life in less time than it takes to process and act on wtf just happened in that room.
Sounds like you do have that experience/expertise, so I'll take what you're saying at face value; my only goal here was to caution folks against going straight for the torches and pitchforks considering the high likelyhood of contributing factors that either weren't reported or are outside of our normal scope of thinking.