Well, I’ve watched the GMA interview over and over again to see if my earlier questions would get answered. Here’s my final take on it (quoted portions come from the interview on Good Morning America).
The story begins with a narration by ABC news anchorwoman, Elizabeth Vargas telling viewers that Tracey Hermanstorfer’s “water broke at dawn on December 24, seven weeks before her due date”. After her husband quickly takes her to the hospital, the narration continues that “all was well until Tracey was overcome with exhaustion. She closed her eyes and suddenly…She went into cardiac arrest.” The narration continues to inform us that the staff tried to resuscitate her for the next 4 minutes under a code blue, but she was unresponsive. Once the doctors determined that she was dead, they decided to attempt to save the baby boy she was carrying by performing an emergency c-section right in the delivery room. The doctor performing the surgery is said to be Dr. Stephanie Martin, a maternal fetal medicine specialist at Memorial Central Hospital who had run in the room to assist in resuscitation when the code blue was called.
Dr. Martin delivered the baby, but he was not breathing either. It appears that just as the baby was delivered, Tracey’s pulse returned (one has to assume that she was still hooked up to the pulse monitor in the delivery room, which is normal protocol in most US hospitals). She was quickly transferred to the OR and within moments her son, Coltyn, took his first breath of life.
Thankfully, both Tracey and her son looked happy and healthy in the interview. I am thrilled for her and her family that their story had the best outcome anyone could have hoped for.
However, I wonder about her remarks that her son was 7lbs.4oz even at the reported gestational age of 33 weeks. (average weight at that time is somewhere between 4 and 5 lbs, this estimate comes from a table provided by Doublet PM, Benson CB, Nadel AS, et al: “Improved birth weight table for neonates developed from gestations dated by early ultrasonography.” Journal of Ultrasound Medicine. 16:241, 1997.) Tracey even seemed confused by Elizabeth Vargas’ statement that Coltyn was 7 weeks premature.
The next point was that she said after she got pitocin, she “felt a little wierd” and “the pains were just a lot harder than I could remember so we just decided to go ahead and do the epidural for the very first time”. Mike Hermanstorfer stated that Tracey was sitting up when she received the epidural, laid down after administration and then commented that “she was tired and that’s when the whole nightmare started”. He goes on to say that his wife did indicate that her legs went numb and she closed her eyes to take a nap because of the anticipated long day ahead of them, but then “she wasn’t waking up”. He noticed that as he was holding her hand it started to turn cold and he looked and noticed her fingertips turning blue. A nurse then noticed the color in her face had changed “she was grey as a ghost” her husband tells us.
Dr. Martin then takes her turn explaining what happened. When she heard the code blue, she ran to Tracey’s bedside, where” the anesthesiologist had already started breathing for Tracey” and preparations were being made to resuscitate her if her heart stopped, which it did within a few seconds of Dr. Martin’s arrival. She makes the comment that “unfortunately in most of these situations, despite the best efforts of the team, um, mom is often not able to be revived. And so we anticipated that possibility.” She indicates that the decision to perform the cesarean was only after they determined that the resuscitation efforts were ineffective and they wanted to deliver the baby to give him the best chance at survival. Amazingly, Tracey did respond once delivery occurred and she was able to be fully revived.
Although Elizabeth Vargas erroneously repeats twice that the cesarean was done “without anesthesia”, it is obvious that Tracey must have still been numb from the epidural that had been previously administered. This was a comforting thought to me because I just couldn’t imagine the pain she would have been feeling during the cesarean as she was beginning to come around. She reportedly had been without a heartbeat for somewhere between 4-5 minutes and stopped breathing a minute or two earlier.
Dr Martin concludes the interview by saying that while she doesn’t have “a great explanation”, but offers the theory that “primarily that emptying the uterus relieves the body of a responsibility to try and feed that baby in that uterus. And so perhaps that stress relief offered some, you know, um, ability for the heart to recover. And it also unblocks the obstruction to the blood flow to and from the heart because that uterus at term, or near term is quite large and can block the blood flow when they’re lying flat like that. But the reality is even that in those situations, most of the time, the mom does not have such an incredible turnaround. We may notice an improvement in their blood pressure, for example, or their response; but it’s very, very unusual to have this type of immediate recovery because as soon as she got her heart rate back, Tracey just continued to get better and better. By the time she was in the ICU about an hour and half later, she decided she didn’t care to be intubated anymore, removed her tubes…” she was able to talk after that and even made sure they knew the name she’d chosen for her newborn son.
Tracey Hermanstorfer has 2 older children and indicated that their births had been unmedicated.
Again, I congratulate the family and share their relief in Tracey and Coltyn’s healthiness, but I wonder if the outcome had been different, would it have been newsworthy? How many of the 569 maternal deaths in 2006 or how many of the 18,989 infants under 28 days old who died also were deemed to “inconclusive” and how many of those were even reported on by the media? (stats from U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau)
Clearly, with the US having the “second worst newborn death rate in the modern world” according to an article on CNN at http://www.cnn.com/2006/HEALTH/parenting/05/08/mothers.index/ and ranking an appalling 41st out of 171 countries for maternal mortality as reported by IPS at http://ipsnews.net/news.asp?idnews=39642 , something is terribly wrong with the way we handle pregnancy and childbirth in this country.
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