My name is Andrea Shea and I’m a registered nurse. I’m the on-site nurse here at Michigan Cerebral Palsy Attorneys. I currently review medical records. When I receive the medical records, it takes me weeks, sometimes months, to go through, review, and look for potential mistakes that may have occurred in the labor and/or delivery period.
Something that occurs in labor that can be potentially very dangerous to babies is called tachysystole. Tachysystole is when there are too many contractions. The uterus is an organ that the baby lives in during pregnancy. It’s essentially a large muscle that’s designed to grow with the baby as the baby grows and also to help deliver the baby at the time of birth. During labor the muscles start to contract, and they contract in a regular pattern. That pattern of contraction helps to bring the baby into the birth canal. As the baby enters the birth canal, along with those contractions, pressure from the baby’s head is placed in the cervix. As that pressure gets stronger, the cervix starts to open or dilate and then those contractions help to actually deliver the baby.
Oxytocin, sometimes called Pitocin, is a high-alert medication. It’s commonly used in labor and delivery. Doctors utilize it for stimulation of labor contractions, to help things along, but it’s also used in labor induction to start labor. It is a high-alert medication. Nurses that administer this medication are required to go through specific training on the safety and how to administer it properly. Hospital units have specific rules or protocols or standards that are involved in the administration of the oxytocin. There’s specifically way that it’s supposed to be initiated and how it’s supposed to be maintained, and nurses are also trained to watch for signs that the medication is having a negative effect on the baby.
If nurses aren’t trained properly, if there’s a medication error that occurs with Pitocin, it can have devastating, lifelong consequences. It can cause permanent brain injury or death. During a contraction the blood flow is temporarily cut off. As that muscle gets tight and it contracts, the blood flow stops and then once that uterus relaxes and that muscle relaxes, the blood flow goes back to the baby. As I mentioned before, in a naturally occurring labor, those contractions typically happen every 3-4 minutes and that’s safe. Contractions that occur every 3-4 minutes are safe for babies; that allows the baby time to catch their breath and to get oxygen again. A way to think about contractions and oxygenation, if you think about swimming. When we swim in a lake or a pool and we’re about to go under water we take a big, deep breath and we hold it for a period of time and when we need more air, we come back up out of the water and we take another deep breath. The baby can tolerate temporarily not receiving oxygen, as long as it can have a period of rest where it can get oxygen.
If contractions are occurring more often than every 3-4 minutes, if a person is having more than 5 contractions, let’s say, in 10 minutes, that is too much. The baby can’t tolerate that amount of oxygen deprivation and nurses that are administering oxytocin are trained to watch for this. They’re trained to watch for tachysystole and they’re required to do things to stop it and to help that baby recover. If a baby is experiencing tachysystole for a period of time and they’re not getting enough oxygen, the nurse isn’t watching properly, that baby can suffer a preventable birth injury.
When babies don’t get enough oxygen, they can suffer from what’s called HIE, or hypoxic ischemic encephalopathy. This type of birth injury is preventable and if nurses are not monitoring a patient properly, sometimes they’re not monitoring the contractions properly, and they’re not seeing contractions and maybe they’re not paying attention to a patient because they have an epidural and that epidural is making the patient comfortable, so the mom is not complaining of pain. Then the baby can have a period where they’re not getting enough oxygen and as a result they suffer from a permanent brain injury. And, unfortunately, that’s one of the things that I seem to come across in this job, as I’m reviewing medical records and I’m reviewing fetal monitor strips. Improper monitoring of contractions is a very significant cause of preventable birth injury.
If you think that possibly you had too many contractions during your labor or that your baby did not get enough oxygen, please contact us and we can do a free case review. We can look at your medical records. We can look at your fetal monitoring strips and assess if there was potentially an injury that occurred.