Knowledge......ignorance is bliss?

[Fuschia]

Although I tend to be a bit liberal and not worry myself too much about what other people say, I do have two friends who both, awfully, lost a baby before birth. In both cases their daughters died in utero, this was discovered due to lack of movement. A scan confirmed their hearts had stopped. Both then had to be admitted, induced and give birth to their beautiful babies, knowing that there was no chance of 'resuscitation'. Both of them have described how painful it was to see a beautiful, perfect baby, not breathing, yet noone rushing to help, and coming to terms with the fact that their child would never draw breath.

That is what I associate with the phrase stillbirth and I hadn't previously heard it used any other way.

[Belle]

Oh Fuschia, that made me cry - how horribly sad for both your friends, how awful that anyone has to go through that.

[Fuschia]

I know, it makes me cry too. One of them has since had another daughter, but I know Ella will never be forgotten. The other baby was Polly, and it was only February that she died.

RIP beautiful Ella and Polly.

[let-them-eat-cake]

Thank you sillywoman.....it's kind of you to post about your thoughts too.....perhaps it's a little pedantic of me (although I don't think so), but this really worried me.

Smiler....I agree about everyone using personal experience and that it is subjective. But accuracy?...well, I think it's important.

Fuschia....yes, there are so many sad stories....it's not something I've personally been through, but have been on the 'outskirts' of, if that makes sense.

So.....sorry again if I've offended anyone and thank you to those who have seen this in the way that it was meant.

[EDmummy]

Reluctant to add to this as I am reluctant to add to any post about childbirth, home birth and Kings. One 'flat line' baby who barely had a Agbar score (is that the right name for it) who started out at home and two births where birth weight was dramatically under estimated nor appreciated by home midwives. Every birth is different! I envy those mothers who had dreamy deliveries in their own home but I greatly appreciate and respect the amazing professionalism I experienced at Kings.

I get your point but I feel that you may have given the OP a bit of short shrift. I still do not talk about my experiences because even after a number of years they are still raw. This forum feels like a place that things can be shared but perhaps others will feel that they will be judged if they do so.

[curlykaren]

thats odd, when I do a search for pradanic the only thing that comes up is this thread? But, let-them-eat-cake, if you did read that thread then you will also have seen the exert from the WHO, which, I'm afraid contradicts you. There is only a small section of the WHO advice in the thread with the original document describing the different possibilities for resuscitation of babies born dead (ie: stillborn).

[Saila]

I think it has a dash in the middle

If you go to the link in a previous post you can see she/he spells it prada-nic

Shall we let this thread naturally melt away?

It's really tragic and heartbreakingly sad ... mixed with misunderstanding / usual edf chat

Hope that makes sense

Night

[Fuschia]

Yes, have actually found some info about resuscitation in case of "unexpected apparent stillbirth" which I guess is another way of describing a baby who was Ok shortly prior to birth but who has no heartbeat/breathing when born. I think someone described this as a "flat" baby.

http://fn.bmj.com/content/78/2/F112.abstract

[let-them-eat-cake]

I think Saila is probably right and this thread sould be left....but, whilst I thank everyone for extra definitions, links to the prad-nic post (yup, it needs a hyphen)I think the registering of a baby makes sense of it all.

You can register a live birth or a stillbirth.

Not both for one baby.

If a baby is born (as Fuschia said) apparently (and I think the word apparently is important here) stillborn and then resuscitated, he/she wouldn't be called a stillbirth and would be registered as a live birth.

Looking at the old thread, Linzkg's experience sounds horrible and again, I have to say how impressed I so often am by midwives, doctors, paramedics etc......thank god for their skills.

That's it for me on this thread.....I hope the site of my name on others won't put people off!

Baking for the weekend now.....Cakey for Haiti went well, so I guess I can forgive the shameful cake sale name!

[curlykaren]

Basic Newborn Resuscitation: A Practical Guide - Revision (WHO; 1999; 33 pages)

Apparently stillborn fetus

If after delivery the fetus does not breathe and shows no other evidence of life (such as beating of the heart, pulsation of the umbilical cord, definite movement of voluntary muscles) or shows signs of maceration, it is considered stillborn. However, in a fresh stillborn newborn it is difficult to determine how long before birth the death occurred unless the fetal heartbeat has been checked frequently during the second phase of birth. The policy on when to initiate resuscitation will depend on the practice of monitoring fetal well-being. If the fetal heartbeat was heard shortly before birth, resuscitation should begin.

[let-them-eat-cake]

.............

yes.

And if the baby lives (well done to all those involved yet again....) then it would not be labelled as a stillbirth.

No arguments with the stuff from WHO......just about we would then refer to that particular baby!

Pancakes this morning.....

[buggie]

... but it doesn't go on to explain how effective that is.

Having been involved in stillborn resuscitation, (the ones I've been involved in were home births where the baby was then rushed to hospital) The monitoring had been intermittent so the dips in heart rate possibly weren't noticed (am sure the guide starts by explaining the fetal heart rate/patterns that occur with distress) and so resustiation initiated (at home and con't on way in).

It has very poor outcomes - either with us being unable to get spontaneous breathing/circulation back or with the baby having varying degrees of HIE (hypoxic ischemic encephalopathy).

Horrible situations for all involved, but important that the family know/see all has been done, especially as often everything will have been happening while mum is still on her way in (Mum can't be moved as quickly so a 2nd ambulance brings Mum while the 1st brings baby in asap).

[curlykaren]

*moan...lump appears on forehead from banging it against a brick wall*

the baby would be referred to as a baby who had been stillborn and then resuscitated.

[sillywoman]

. . . but in referring to the birth of the currently living baby it would surely be misleading and wrong to say that the baby was 'stillborn'? This implies a baby who is, and remains, dead. The baby was, as someone else has said - born 'flat'.

*holds spinning head in hands from going round in circles*

[The Nappy Lady]

I think we need someone medical ....Buggie? to advise on this and leave it at that as I can see the sense in both arguments.

I don't think L's original posts were wrong in context based on WHO given that she went on to explain that her little boy was successfully resuscitated, but......I do see the other side too, and the reasons for concern.

Maybe it is one of those misnomers where there isn't a right or wrong 'officially' though if it were me I'd prefer to use the term 'flat' I must admit.

M

[annaj]

Ok, well, since at least one person thinks it'll be useful, I'll add a medical perspective.

My intention here is simply to add clear and objective information, not to distress or criticise anyone and certainly not to fan the flames of an arguement. I'm going to be as clear as possible, if it slips over into overly simple or patronising, I'm sorry, that is not my intention either, but I've learnt at work that it's better not to assume that things are undrestood or go without saying.

The key here is the word apparent, or apparently, which, whilst it might seem like a minor linguistic point, marks the differnce between two entirely different situations.

The first is that which Fushia described, the foetus is found to have died in the womb before birth and delivered. This is medically termed inter-uterine death and normally referred to as stillbirth or a stillborn. In these cases no resuscitation is attempted.

The second is the apparent stillborn, where the baby is delivered and on delivery found not to be breathing and without signs of life. In this case there are two possiblities: that it is an inter-uterine death that was not picked up or that at some point during the delivery the baby became compromised. Which of these it is may be obvious if, for example, the baby was being monitored during deliver and so was known to have a heartbeat shortly before, or may not. Resuscitation is attempted, because there is a possibility the baby could survive if it only recently became compromised.

Resuscitation is part of my job. I lead a resuscitation attempt at least once a week, often more, admittedly usually with adult patients, but not always. Part of my role, as a resus team leader, is talking to families after failed and successful resuscitation attempts and so I know how varied, and often unrealistic, peoples' understanding and expectation of resuscitation can be.

Because of that insight I have to say (and this is my opinion now not objective fact, but it's an opinion informed by over a decade as a doctor most of it in Emergency Medicine)that I think LTEC was right and that using the right terms is really important to avoid misunderstanding. As users of a public forum I think we do have a responsibility to ensure that the information we're putting out there is accurate and to consider how it might affect those who read it.

[sillywoman]

Thankyou annaj. Your post has clarified both the appropriate terminology & it's importance very well.

[The Nappy Lady]

Seconded.

M

[let-them-eat-cake]

Phew.

Thank you annaj.

[buggie]

Been at wedding so sorry for posting and vanishing!! Annaj summed up everything

much better than I could have! (thank you annaj x)