friends troubled birth, advice needed

[midorimum]

my friend split from her boyfriend and i was her birthing partner, the birth was not entirely trouble free and wonder if any of you would be good enough to read through this and give me your thoughts, its long and as well as i can remember it,

her waters broke at approx 9.20pm on thursday 21st febuary, due date given was 1st march but there was some confusion over dates.

hospital was phoned and we were told to come straight up, showed to a delivery room and midwife started taking details, blood pressure etc, hooked her up to a monitor to get a trace of the heartbeat, possibly had an internal exam?,

her pad was inspected and seen to have meconium stained liqor (kind of lime greenish colour) midwife said the meconium looked very diluted and baby probably wouldnt have inhaled any but said because of the staining she wouldnt be allowed back home.

said that the ward was very busy and she might be slotted in but may have to wait till the morning to "get started"
told to keep active to encourage contractions, she hadnt had very many so far.
around 4am were finally told that it would be first thing in the morning before they would get labour started so got a few hours sleep

after breakfast obs were done and an internal, found to be 1-2 cm dilated? although this might have been what they said the night before i just cant rightly recall,
syntocin drip was started around 1030am?, contractions started slowly and soon progressed to regular and powerful ones needing gas and air around 1245pm?,

midwife could feel the head but thought there was a lip of cervix so asked in another (midwife?) for a second opinion, she felt and said there wasnt, that it was something else (unheard) and left, monitor was showing heartbeat dipping right down with contractions

after several pushes the midwife said the cord was round the neck, not sure if this was while head was still inside or not but when head appeared it was very dark blue/grey and seemed to get "stuck" for what seemed like ages although was probably only a few minutes no more than 5, during which midwife was sticking a finger in and pulling the cord away from the babys neck which made his mouth open and "bubble" told me to press button for help and another midwife came in,

the monitor was switched off at some point and the baby was delivered at 1.27pm, his head was quite cone shaped and face was still really blue /grey and body white/normal from the neck down, quickly unwrapped and cut cord and got him over to the resuscitaid table rubbing him and trying to get him going and they had the oxygen nozzle near his nose, his chest was rising and falling but he didnt cry and appeared to be "grunting" his colour evened out after maybe 5/10 mins, another more superior nurse? came in and checked him over, i have no idea what the apgar scores were, midwives said he was just a bit "shocked"

they brung in an incubator and put him in it for an hour to observe him, we noticed his leg was very twitchy but after an hour or so they said he seemed ok and we got him out and dressed him and i noticed his left eye had bloodshot marks on it.

he had his first feed but was sick afterwards, during the night he had to be woken for his feed and wasnt really keeping anything down, when i went up to collect them around 11.30 am on saturday morning, they had just told her she wasnt getting home as planned as they wanted to keep an eye on the baby as he was still very twitchy and his face a bit jaundiced, still being sick, they also took some blood samples. he is also arching sometimes when being held,

she was on lithium for depression during the pregnancy and asked the night before the birth if she should take her tablets and was told yes, since looking it up most advice seems to suggest stopping it 24-48 hours before a planned labour due to the risk of thyroid and kidney toxicity, cyanosis, cardiac arrhythmias and hypertonicity in the newborn.

due to this and the cord round the neck and his colour at birth should i be prompting her to ask questions or would i be worrying her needlessly, surely the doctors would tell her if any of this was a problem?

my own son was born at 26 weeks so i have no idea what a full term labour should be like and how common it is for the cord to be round the neck etc

Oh God, poor wee mite, it sounds very traumatic for all concerned.

It is common for the cord to be around the neck. I am not sure about your other questions but bumping as there will be advice forthcoming from more educated people.

Wishing your friend and her son well x

your poor freind.
don't wish to be glomy. but can i suggest. you get your freind to write down everything that happened. aslo to get hold a copy of her notes from the hospital before they "disapear" hopefully she might never need them but I have found out to my cost how your memory fades when you are sitting talking to a solicitor in years to come.

oh I'm sorry. your poor friend.

My ds2 had meconium in the waters when they were broken about 15 minutes before his birth (I had had a fast labour and was fully dilated etc., but my waters don't seem to go on their own, they were broken for ds1 too). He also had the cord round his neck twice when he was delivered by ventouse, but had a fairly normal colour and his Apgars were 9/10/10.

I feel after seeing a meocnium stained pad it wasn't really a good idea to let her go so long. IÄm sorry not to be more positive, but it might give you a perspective on the range of experiences with mecinium in waters/cord round neck.

All best wishes to your friend and her little boy.

Oh poor little thing, babies can be very tough & come through even the most traumatic of births OK.
But if your friend & the nurses are concerned she must insist he is assessed fully by a specialist, unfortunately the DR's don't always tell you what they are thinking & sometimes you do need to be tough & demand more.

Agree abut getting a copy of the notes.

The 'grunting' isn't too much of a worry in itself ime (ds2 grunted for the first day on and off- and is fine).

Poor little mite

I also agree with requesting a copy of your friends notes.

I personally think that they should have enduce her straight away, given the fact that there was meconium in her waters.

The heartbeat dipping down with contractions is also common, so long as it goes back to normal between contractions.

The babys head being cone shape i think is down to length of time he spent in the birth canal.

The bloodshot marks on her eyes are probably due the the pressure of contractions. Both my DDs had red marks on there eye lids (MIL called them stork marks) at birth, DD1s disappeared after a couple of weeks. But with DD2 it took almost 12 mths.

I would be concerned about the lithiam, was a planned induction ever mensioned to her, so that she could stop takeing them.

Sounds similar to ds' delivery (his was a ventouse delivery adn he had cord around his neck) - he was grey but pinked up fairly quickly, needed no extra help apart from a burst on resuscitaire. Do ask for Apgar scores, ds' were actually ok despite appearances although longer term he has got some motor coordination issues which may have been associated . Sickiness isn't uncommon - dd had it for a few days and it was mainly fluid she'd ingested in womb - and both were jaundiced. If she has concerns tell her to ask paed before they are discharged.

This is a bit scary, I'm sorry if it's irrelevant but it seems to indicate that the arching back thing coupled with jaundice can be serious. Is there any way you could talk with the doctors?

thanks all for your messages, last night he was up all night screaming and being sick, but today he is a lot more settled and not being sick.

i did a bit of research and it seems she shouldnt have been told it was ok to take the lithium on thursday night as it should really be stopped 24-48 hours prior to delivery as the body deals with it differently during labour and it can cause thyroid and kidney toxicity, cardiac arrhythmias, cyanosis and hypertonicity, spoke to the paediatrician about my concerns and she checked him over and said he seemed okay now, much better than yesterday, the twitches have pretty much stopped except when he gets startled etc, she then spoke to her boss and they decided to keep him in overnight again and have the registrar check him in the morning, but they expect everything to be fine.
so hopefully he should be home by tomorrow night...fingers crossed!

midorimum, sorry to be a bit gloomy, but sometimes in these cases the effects only really show in the months/years to come. There may be absolutely nothing wrong with the baby, so many babies have had difficult births and are doing great, they are really resilient little souls, but this is not always the case.
"They expect everything to be fine", that is not good enough.
Totally agree with 2shoes, your friend should collect all the documents she can get hold of and keep a close eye on the baby's development.

Do get her to get a copy of her notes. Something that was 'different' about ds1 at birth was that he startled very easily. I have no way of knowing whether that was remotely relevant (birth wasn't really traumatic for him according to his heart traces) but have read some stuff about the startle reflex since that makes me wonder.

Good that all looks well though. Hopefully it'll quickly just become a bad memory.

Definately get a copy of the notes. Personally I think the baby should have been delivered earlier (with the meconium stain).
Is the baby still jittery? I don't want to spread doom and gloom, but my DS2 was, mainly in his left leg, but this sometimes extended to the right one if he got really upset. He has got CP (brain damage), and apparently this is a good indicator. Are the babies feet OK - do they turn in when upset or they are tickled? (It looks quite painful to us when they do it, but the baby doesn't mind). Also arching of the back can be a sign of CP as well. Do they know how long the cord was wrapped around the neck for? Did it cut off the oxygen supply at all?
Definately get the notes and go and see PALS. They will give good, impartial advice.
Good luck