Lincoln's Birth: The Doctors' Story

     We told you we would explain more about Link's delivery once we were able to speak to the doctors who were actually there helping Savvy and Link.

     Like we've talked about, Savanna and I arrived at the Hospital around 8AM on July 16. Everything began as planned. Savanna began her pitocin medication to begin contracting. Labor progressed slowly throughout the day with no change in dilation from when she started the day (2 cm). Her cervix continued to efface up to 100% by the afternoon. The contractions and baby's heart beat were monitored all day. Our nurse began to notice a decrease in Lincoln's heart beat around 5:30/5:45PM and asked the doctor if she could break Savanna's bag of water so the nurse could put in an internal monitor to more accurately track the fetal heart beat.

     During the doctor shift change, Savanna's new doctor came in to break her water around 6pm, which she did. The rupture first produced the normal, clear fluid. The nurse, planning on inserting the monitor, continued to notice a significant decrease in fetal blood pressure, as well as, more than a normal amount of blood coming from Savanna. The nurse quickly called for an emergency team to attend to Savanna and Link. They tried different things to find Baby's heartbeat, but it was still untraceable for a few minutes. Any reading that they did get was about half as fast (60-90 bpm) as what they expect for babies (120-150 bpm).

     The doctors moved Savanna into the OR ten minutes after they broke the bag of water. While in the OR, they tried another few things to find Baby's heartbeat. Still untraceable. The reason why Savanna was rushed into the OR was for an emergency C-section. Savanna had obviously been losing blood, and the doctors had suspicions about Link's blood loss, because of his lack of heartbeat.

     Savanna hadn't received an epidural, so the anesthesiologist put her completely under; it was the quickest way to get the Baby delivered. From the time Savanna was put under to Link's delivery was about 60 seconds. In total, from the time Savvy's water broke to the time Lincoln was born was 16 minutes. Emergency FAST!

     Lincoln was delivered at 6:25pm, 7 lbs. 1.5 oz., 20.25 in. He came out not breathing, pale, and his umbilical cord looking empty (not full of blood). The delivery doctors, cut the cord and quickly passed him directly through the window to the NICU. They then closed up Savanna with little complications.

     When Lincoln was passed through the window to the NICU pediatricians (Stiers, Patel, Bernali and others), they immediately cleaned him off and began chest compressions. During chest compressions, they also began him on a ventilator, since he wasn't breathing on his own. His APGAR score (a score that is a universal standard of relative baby health; high score is 10) was zero at 1 minute, 5 minutes, and 10 minutes; meaning, Link wasn't doing anything on his own, but the machines he was hooked to were doing all the work. The doctors rushed about with a number of things in a very short amount of time: placing lines in his umbilical cord to give him medication (epinephrine, prostaglandin), fluid, and blood, continuing chest compressions for 12 or 13 minutes, and giving him oxygen. At 15 minutes, Link's APGAR score was 7. His heart began beating around 12 or 13 minutes after delivery; his lungs began breathing at the same time.

     The doctors were very concerned about Lincoln's loss of blood and lack of oxygen to his organs (hypoxia). They were worried about his brain, heart, kidneys, and liver. He continued breathing with oxygen, but still had a low amount of blood. They first gave him an IV with sugar water to give him more volume, and within about 25 minutes of life, he was given emergency blood. Within 30 minutes, the doctors began a cooling procedure for the hypoxia. The cooling slows the organs down to prevent any further damage, but does not reverse any initial damage. (Kind of like putting ice on a bruise.) He will be cooled for 72 hours.

     The doctors were curious about why this traumatic event happened. All three doctors (Edmunds, Conway, and Manuck) who delivered Lincoln explained to us the problem and drew us pictures. What had happened was the umbilical cord inserted into the membranes surrounding the placenta, then branched out and traveled to the placenta. This is called a villamentous insertion. Normally, the umbilical cord should enter into the placenta somewhere in the middle of the placenta. Obviously Link was receiving nutrients throughout his time in the uterus, but with the rupturing of the bag of water, one of the vessels branching from the umbilical to the placenta was compromised. This most likely happened because the blood vessel was too close to the cervix (this is called vasa previa); therefore, the vessel was disrupted with the rupture of the membranes near the cervix. The disrupted vessel then caused the significant loss of blood pressure to Link, and the emergency C-section.

This umbilical cord defect is very rare. It happens 1 in 3,000+ births. If Savanna would have been home when her water broke Lincoln would not be with us. Even at the hospital with all the staff working quickly he barely made it in time.  Doctors are optimist that this was a one time thing for our family. Other pregnancies and births won't be at risk because of this abnormality. 

     All of this (from breaking Savanna's water, to Link's semi-stable state) took about 25 minutes. The doctors are optimistic about Lincoln's progress and signs of growth. Link is continuously monitored one-to-one; the nurses have been so helpful answering all our questions. Though the doctors are very optimistic about Link's progress and future development, they know he isn't finished with his cooling and his upcoming surgery. He's already been through a lot and he continues to be a trooper through it all.

     We are so grateful for the many wonderful doctors, nurses, assistants, and staff who helped Savanna and Lincoln. We are grateful for our family and friends. We appreciate and feel the great faith and prayers of so many people.

     We are so happy our baby boy is happy and safe right now.