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My name is Amy Gates (also known on the ‘net as amygeekgrl or the Crunchy Domestic Goddess). I live in Colorado with my husband Jody (yes, he’s a guy...
 
 
 
 

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Mom and Baby Die and Come Back to Life -- Because of an Epidural?

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In what's being called a Christmas "miracle," a mother suffered cardiac arrest and died while in labor on Christmas eve 2009, her lifeless baby was born after an emergency cesarean section, and then "inexplicably, astonishingly" both suddenly came back to life. At least, that is the picture that was first painted by ABC News.


Photo credit: ABC News

Tracy Hermanstorfer of Colorado was without a heartbeat for four to five minutes while her husband Mike undoubtedly stood by in shock. "'Half of my family was lying there right in front of me -- there's no other way to say it -- dead,' Mike Hermanstorfer told ABC News' Colorado affiliate KRDO. 'I lost all feeling. Once her heartbeat stopped, I felt like mine did too.'"

First I must say that I'm so very thankful that Tracy and her son Coltyn were revived and both are doing very well. I can't imagine what her husband Mike must have gone through in those moments. I wish the Hermanstorfer family a happy, healthy and uneventful new year.

While the story of a Christmas miracle such as this warms one's heart, many people, myself included, thought there must be more to the story than the media was reporting. Dr. Stephanie Martin, the doctor who responded to the Code Blue and performed the emergency c-section, said she cannot explain the mother's cardiac arrest or the recovery. "We did a thorough evaluation and can't find anything that explains why this happened," she said. In the video linked above Diane Sawyer says, "To Tracy's doctors, the events are still a complete mystery." A complete mystery? Really?

If you watch the ABC News interview (below) with Tracy and Mike Hermanstorfer and Dr. Stephanie Martin it looks like the "mystery" may have been solved after all and there could be a very valid explanation for why Tracy went into cardiac arrest - the epidural. Cardiac arrest is a very rare, but very real possible complication of epidurals.

Tracy was pregnant with her third child and had given birth to the previous two without an epidural. However, after her membranes ruptured (water broke), she went to Memorial Hospital in Colorado Springs and was given pitocin to speed up her labor. She found the contractions were "a lot harder" than she remembered so she opted for the epidural. It was not long after she received the epidural that Mike noticed Tracy's hand was cold, her fingertips were blue and a nurse noticed the color in Tracy's face was completely gone.

Henci Goer, "an acknowledged expert on evidence-based maternity care" and blogger at Science and Sensibility, transcribed the relevant parts of the ABC interview.

ABC: Code Blue was declared, a scary thing in any hospital. [Dr. Martin arrives in response.]

Dr. Martin: . . . When I ran into the room, the anesthesiologist had already started breathing for Tracy. There were preparations already being made to start a resuscitation should her heart stop. About 35 to 40 seconds after I got in the room, her heart did stop and we started making preparations to do an emergency cesarean delivery right there in the room in the event that we were not successful in bringing Tracy back. Unfortunately, in most of these situations, despite the best efforts of the team, Mom is often not able to be revived, so we anticipated that possibility and when it became clear that Tracy was not responding to all the work that the team was doing on her, we had to make that difficult decision to do the cesarean section, primarily in an effort to give Coltyn the best chance at a normal survival and also hoping that it would allow us to do a more effective resuscitation on Tracy, and fortunately, she cooperated and we got a heartbeat back immediately after delivering Coltyn.

Henci explains her assessment of the situation:

So, according to Dr. Martin, Tracy is an example of how things can go suddenly and horribly wrong for no discernible reason in a healthy woman having a normal labor. All I can say is that Dr. Martin must have slept through the class on epidural complications. Tracy’s story is the classic sequence that follows what anesthesiologists term an “unexpectedly high blockade,” meaning the anesthesiologist injected the epidural anesthetic into the wrong space and it migrated upward, paralyzing breathing muscles and in some cases, stopping

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paapeseed 5 pts

This just happened to my coworker. Unfortunately, she didn't make it.

FirstTimeMomIn2009 5 pts

I didn't know that you could experience a Code Blue due to an epidural until it happened to me the night I gave birth to my daughter. One minute we were talking about my daughter's arrival and the next thing I remember is having the breathing tube removed as I was regaining consciousness. Due to the spinal sac being punctured and fluid leaking out (at least this is how the ob explained it to me later that night) the medication went in the wrong direction and told my brain to stop my breathing. It seems I was the first mother to experience this in the history of the hospital where we gave birth. We ended up with an emergency c section to deliver my daughter (who is a healthy one year old now). Just thought I would share as someone who did experience something during childbirth that was not the norm.

fogelbaby 5 pts

Dr Chukwuma Onyeije and I reviewed this case in an evidence based fashion and discussed the role of media these types of situations in a recent blog post.  Your readers may be interested in the analysis.

While you are right that an epidural was a potential reason for the problem experienced by Mr Hermastorfer, there are a number of reasons that this is unlikely.

Link: http://academicobgyn.com/2010/01/10/an-obstetrical...

 Nicholas Fogelson, MD

amygeekgrl 5 pts

Thank you.

I've heard time and time again of women who weren't told what the risks of an epidural were before they got one and I think this is truly unfortunate. How can one make an informed choice without all of the information? If the medical community isn't going to educate us, we must educate ourselves.

Amy
Crunchy Domestic Goddess ( http://crunchydomesticgoddess.com )
BlogHers Act contributing editor ( http://www.blogher.com/special-events/bloghers-act )

JennaHatfield 10 pts

I had been discussing this with a friend of mine, questioning why it wasn't being talked about in the media. Thank you for giving voice to it.

@FireMom ( http://twitter.com ) from Stop, Drop and Blog ( http://stopdropandblog.com ) and The Chronicles of Munchkin Land ( http://thechroniclesofmunchkinland.com )

Beverly Flaxington 5 pts

Thank you so much for this. I think overall it's such a good reminder that we take medicine and the "solutions" for granted thinking everything is safe. We're lulled into such a false sense of security. I used midwives for all three of my children (and ended up with 2 c-sections and a 10.5 lb vbac anyway!) but the midwives were so resourceful and educated me so much during the process. It was scary to find how little the regular docs sometimes tell us. We also probably don't ask enough questions because we just trust that it's fine if our doctor tells us it's so!

Beverly Flaxington

Blog: Dealing with Difficult People ( http://dealingdifficultpeople.blogspot.com/ )

Book: Understanding Other People: The Five Secrets ( http://www.understandingotherpeople.com/ )