# Stillbirth and subsequent pregnancies - stupid question



## khaoskat (May 11, 2006)

Ok, I was talking to someone, and they said that after I have had this stillbirth that from here on out all my subsequent pregnancies will automatically be treated high risk, and I will have to goto special high risk OB's, and no longer be able to use a Midwife (even if in the same group/office as an OB) or the Natural Birthing Center.

Does anyone know if this is true or not?

Melissa S.


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## dziejen (May 23, 2004)

Not a stupid question but one I don't entirely know the answer to. My daughter was also stillborn but she was delivered via emergency C-section in an attempt to save her. I don't think that I am considered high risk but I am not eligible to go to local CNM's because they do not do VBAC's and will not accept me. I have found a VBAC-friendly doctor (I hope!) that was recommended to me and her practice happens to be high risk but when I told my story over the phone I was told they would accept me as a new patient. So whatever that means. My first visit there is not until Monday so I don't know much more than that. I think it is very individual and depends on the situation, mom's current health and, unfortunately, age sometimes, as well as the health care provider and the policies of the birth place/hospital, etc. Much luck to you and I am very sorry about the loss of your baby.


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## HoosierDiaperinMama (Sep 23, 2003)

Melissa,

I don't know if it's true or not. It may depend on the circumstances surrounding your stillbirth. Was your health jeopardized? Do you have a reason as to why your DC was stillborn? Have you had more than one pregnancy loss?

I do think you are watched much closer after such a devastating pregnancy, but I don't think every person who has a stillbirth is automatically considered high risk.


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## midwifetx (Mar 16, 2005)

Some docs consider your emotional state to be high risk and put you in that catagory for that reason.

I personally feel that midwifery care is essential for a woman who has had a stillborn baby, because of the time a midwife gives her clients. Some women need Ob or Perinatology care in paralell with the midwifery care, but I do believe every woman deserves to be listened to the way a midwife does.


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## khaoskat (May 11, 2006)

Quote:


Originally Posted by *HoosierDiaperinMama* 
Melissa,

I don't know if it's true or not. It may depend on the circumstances surrounding your stillbirth. Was your health jeopardized? Do you have a reason as to why your DC was stillborn? Have you had more than one pregnancy loss?

I do think you are watched much closer after such a devastating pregnancy, but I don't think every person who has a stillbirth is automatically considered high risk.

I am not sure what the circumstances were -- but here is a quick history...

31 weeks - got my diagnostic US (was scheduled for 20 weeks, but cancelled due to insurance issues...then when the insurance problem got fixed, I wasn't sure I wanted to do it, then decided to go for it). There is one US pic with the following on it (specifically looking at the umbilical cord, because the tech was telling us everything she was examining and what was what) "2V CI". Her notes also said "2V CI". The question asking "3 Vessal Cord present" was answered either "No" or "2 vessal" - sorry cannot remember 100% but I believe it was 2 vessal. We couldn't get a clear view of left hand, just knuckles and themb.

32 weeks - (1 week after US) OB/Midwife office called - said they wanted to repeat the scan at 35 weeks because of the hand. No mention ever of anything to do with a 2 vessal cord or anything other than left hand. I even asked the nurse, as I didn't expect another "full US exam" just to see the left hand.

35 weeks - everything is fine with my apt. US again, the same things with the "2V CI". We saw the left hand, and counted all the fingers. Baby was heads down and cervix was either 3 cm or 33 mm (again cannot remember 100%).

37 weeks - baby is suddenly breech.

38 weeks - missed apt, due to an emergency that came up and the fact I couldn't find anything to wear that was fitting me as we were trying to run out the door because we were running so late. My apt. was at 10:30 and they don't take apts. after 11, because they close for the day at 11:30.

39 weeks - baby still breach, but couldn't determine for sure if the part that was down towards the pelvic bone was the head or the but. Midwife decided that 1) since both my other living children were born at 42 weeks + it was safe to wait; and 2) that since both my other living children went breech after 37 weeks and turned on their own again it was safe to wait. So, I was supposed to make my next apt. with the a specific OB in the office. When I went to make my apt, he was booked solid for the only day he was in the office the week of my 40 week visit. So, scheduled it out 10 days when they had an opening during the next week (had 39 week apt. on a tuesday, 40 week apt was on the next week Friday - they had to have a time slot to do both a Midwife apt and NST, since I would be seen after I hit the magic 40th week).

39 weeks 2 days - started having what I thought were BH contractions - was really happy, never had them this early with either of my other pregnancies.

40 weeks 1 day - was having contractions of 5 mins or less apart but the patterns only lasted 30-40 minutes then the contractions would stop. This was happening on and off all day. Around 11:30 p.m. I felt we - went to use the bathroom and I was bleeding (bright red blood, but only a little bit). Thought it might be bloody show, but didn't think it was, because there was no mucus or plug pieces. Got in the tub, as I had contractions 6 mins apart lasting 30 seconds. Called OB and was basically told I could wait till they were 5 mins apart or less - take a bath, relax...but if I really wanted to, I could come and be checked. After talking to him...they just jumped to 2-3 mins apart, lasting 30-40 second each. I packed and went in. 1:30 a.m. on Oct. 12, I arrived at birthing center. 1:35 nurse couldn't find HB, she continued to try for about 5 mins..then called in OB and US. No HB found and she was breech. She was born at 6:28 a.m. It is believed that the cause of death was a Grossly, True Umbilical Cord Knot. All I have right now is the preliminary autopsy report (and I had to get that on my own, they haven't even called me yet with that).

I have one previous pregnancy loss at somewhere between 7- 9 1/2 weeks (I know I didn't ovulate when I should in that cycle.

I have two other known pregnancies that ended in live births...

DS1 - 4/03
Miscarriage - 5/04
DS 2 - 3/05 (postitive hpt on 6/28/04)
DD1 - 10/06 (stillbirth)


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## khaoskat (May 11, 2006)

Quote:


Originally Posted by *midwifetx* 
Some docs consider your emotional state to be high risk and put you in that catagory for that reason.

I personally feel that midwifery care is essential for a woman who has had a stillborn baby, because of the time a midwife gives her clients. Some women need Ob or Perinatology care in paralell with the midwifery care, but I do believe every woman deserves to be listened to the way a midwife does.

If that is so true, you would not like the Midwife group I have been with with the last two pregnancies. My choices are slim to non around here, and if I want to use the birth center and water birth, it is 1 Midwife practice (2 midwifes) and their oversee'ing OB's and I think one other OB practice that does water birth.

I swear I saw my Midwifes for just long enough for them to measure my fundal height, ask the normal 2 or 3 questions (any contractions, how you feeling, lots of movement) and to listen to the HB. Then they were heading on their way out of the door.

I am not sure if it is because of the fact that I used them with my 3rd and 4th pregnancies, that it was this way or not.

I had two visits that we actually "talked" and that was the first visit, and then the visit after we finally got all the paperwork and verbal notice of me getting on our state's insurance, we talked for a bit longer than normal about resources in the community and how if you are not a certain "race" where I live, you are just ignored in the "welfare" system.

Melissa S.


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## ApplePieBaby (Jun 15, 2006)

I think because it was a knot in the cord, and not due to your heath or a recurring genetic problem, you won't necessarily be high risk.


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## HaveWool~Will Felt (Apr 26, 2004)

Quote:


Originally Posted by *dziejen* 
Not a stupid question but one I don't entirely know the answer to. My daughter was also stillborn but she was delivered via emergency C-section in an attempt to save her. I don't think that I am considered high risk.

I think it is very individual and depends on the situation, mom's current health and, unfortunately, age sometimes, as well as the health care provider and the policies of the birth place/hospital, etc. Much luck to you and I am very sorry about the loss of your baby.










This is my answer as well....
Follow your heart. Double check what your coverage is with your insurance and start interviewing providers....md's, cnm, lay midwives....


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## AllyRae (Dec 10, 2003)

When I was pregnant with the twins, I was not considered high risk (it was not known that I was carrying twins at the time) because my doctor said what happened with Ry could not have been determined or predicted during pregnancy...

Now, because of the circumstances surrounding the miscarriage of the twins, I would be considered extreme high risk if we ever got pregnant (I recently developed a blood condition that makes it nearly impossible to sustain a pregnancy).


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## coralsmom (Apr 1, 2005)

i wondered the same thing, and asked alot about this. my cnm said no, what happened did not dictate or predict what would happen in our next pregnancy. we had an unexplained stillbirth of our daughter, no conclusive reason for her death. i met with and pressed the maternal fetal medicine doctor about this issue, and he again said that my next pregnancy would not be considered high risk. most likely just complicated emotionally and probably pretty stressful, but not high risk. he suggested an induction at 39 wks, and he said the only reason for that was for my own state of mind.

each woman's individual circumstance is different and unique in an of itself, her history, her present physical state, so many factors can influence high-risk, including the woman's own perspective. i feel like i would be a high risk pregnancy (when that happens), but mostly that is because of my own fears, not because my body or ability to carry a healthy baby to term has changed at all.


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## HoosierDiaperinMama (Sep 23, 2003)

Melissa,

Thank you for sharing your history.







s I would totally agree with this:

Quote:


Originally Posted by *HaveWool~Will Felt* 
This is my answer as well....
Follow your heart. Double check what your coverage is with your insurance and start interviewing providers....md's, cnm, lay midwives....










Best of luck.







s


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## amydawnsmommy (Mar 13, 2005)

I was not considered high risk to my great shock!!!








I think it is because 'they' did not know what happened.

Because of this however I was able to go to the midwives for care.
I live in Ontario and the midwives here are not allowed to accept high risk patients or they must consult with a doctor depending on the circumstances.

Going to the midwives was very calming because they saw me weekly to hear the baby's heartbeat







because I started to panic as I approached the 22 week mark which was the week Amy Dawn died. The midwives were soooo good to me!!!









Their regular appointments are 45 minutes long and very informative. Having information and being able to make choices gave me a feeling of control which helped.

Also the midwives routinely test for many things including diabetes (if there are risk factors), Group B Strep, etc. It turned out I tested positive for Group B Strep at 35 weeks!!!! I panicked!!!!! I was given the recommendation to give birth in the hospital (the LAST place I wanted to be!!!) and to take shots before birth to protect the baby from GBS. AAAHHHHH!!! I didn't want to make those choices and yet I felt I had no choice!!!!

And yet Hope must have picked up on my intense feelings about not going to the hospital because my labour was very short and when the midwife came to check me I was 9 1/2 cm dilated!!!! She gave me the choice between going to the hospital (in the middle of winter, in an ambulance, on snow covered possibly icy bumpy roads) or giving birth at home. I picked home. I was scared but was not going to have my baby on the side of the road in an ambulance!!!

Hope had her way, she was born at home!















And she was fine!









Two midwives attended Hope's birth (there must be two by law) so that if there is a complication one can attend the mother and one can attend the baby.

It was so beautiful to finally hold my precious baby girl in my arms!








And yet so sad too knowing that Amy Dawn should have been here with us.







:


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## O_Mama (Jan 5, 2006)

Hi Melissa,

I am so very sorry for your loss.

I also had a stillborn baby in September 2003 due to a true knot in the umbilical cord. I was 40 weeks, 6 days.

I have since gone on to have 2 children afterwards and I am considered 'high risk'. I see my OB more often, especially from 32 weeks on - have Non Stress Tests twice per week - and am watched closely throughout.

I had a consultation with a Maternal Fetal Dr. with each pregnancy to have a Level 2 ultrasound and discuss my history.

With a true knot, they can examine the umbilical cord, but you can only see segments of it. They are unable to see it completely. You can the insertion point and other things as well.

Good luck to you and hope you are doing well.


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## philomom (Sep 12, 2004)

Yes, I was considered high risk after my loss, a almost term stillbirth. I let my team take very careful care of me during the next pregnancies and "negotiated" with my midwives for a hands off birth if everthing went well up to the labor point. It did and I had two amazing hospital but hands off births with my beloved midwife only checking the heartbeat and "catching" the babies.

So sorry for your loss. This part of my life did suck, but I'm glad I hung in there to see it get better. Take good care.


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## iris0110 (Aug 26, 2003)

I think with this question there are as many answers as there are women and Dr's dealing with it. It will depend on the woma, her comfort level, the cause of the loss and who she is seeing for care. I lost my daughter to chorioamnionitis. It is rare, and having it once does not make you more likely to have it again. So my next pregnancy was not considered high risk per se. I used the same CNM as I had for my first son and my daughter. We were a bit more cautious I think. Any time I was nervous I was encouraged to come in and any tests I wanted I could have. But I didn't want a medicalized pregnancy or birth. I had complications at delivery, but they were unforseeable and managed well by my midwife. My son was born healthy and quite large at 39 wks 1day. I had been offered an induction but did not want it. I did wind up with more interventions than I might have liked, but they were necessary and had nothing to do with my previous loss.

I think how your next pregnancy is managed will have more to do with how you feel than anything else, and of course on what care providers you can find to work with. Some are more cautious than others. There are two women on this board whom I know had unassisted births after their losses. One intentionally and one a planned midwife birth that came as a suprise a bit early. So it really is up to you.


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