Labor Chart (1st baby) Postpartum Hemmorhage.

Since the birth center I had the baby at mysteriously deleted my labor flow chart a few days after the birth (I had taken screen shots before it was deleted-because I had a feeling it might disappear) I have decided to retype my labor flow chart onto this post, because the internet lives forever and if nothing went wrong, why was it deleted? I still have the screenshots but I have condensed it into a more readable format and converted the military time to AM/PM. This was written by the midwife who delivered the baby so- as for exact, accurate times I’m not 100% but she was on the Ipad everytime she checked on me (checked blood pressure with her hands). This will also give a good idea how often I was checked, etc. I will write it EXACTLY as is (excluding temperature), with whatever information she includes ONLY, and I will make comments or disagreements in Italics.

*Warning: Graphic, real labor.

7:05PM Early/Prodromal labor. Will stay and try to rest here, because distance from home.
BP: 140/90 – Contractions: 30-45 seconds at 3-4 minutes – Mild – Fetal Position: ROA Dilated: 3cm
7:15PM Chelsie would like to get into tub to relax. Offered dipenhydramine for relaxation/sleep.
8:20PM Relaxing, using essential oils, Not in water.
BP: 123/82 Contractions: 45 seconds at 3-4 minutes – Mild
9:15PM Sitting, in water. More bloody show.
BP: 114/64 Contractions: 60 seconds at 3 minutes – Moderate
9:57PM On hands and knees, not in water.
Contractions:60 seconds at 2-3 minutes – Moderate
10:10PM BP: 125/80 Contractions:60-75 seconds at 3-4 minutes – Moderate
12:05 Has been in tub, John sleeping. Chelsie states contractions have spaced out but feel stronger. Says she’s been pushing some with contractions and it relieves some pain. Encouraged to try to breathe through contractions without pushing to avoid cervical swelling. Encouraged to rest/sleep now and conserve energy for more active labor.
This is the point where I cannot take anymore and am freaking out inside- cannot rest, cannot lay comfortably, cannot get comfortable period. I get pissed and determined to get the baby out as fast and soon as possible.
BP: 118/67 Dilated: 4cm
12:45AM Rupture of membranes: spontaneous
12:55AM Sitting on toilet, not in water. Says she felt a pop in the tub and contractions are stronger, more painful.
Contractions: 75-90 seconds at 2-3 minutes – Strong
1:22AM Kneeling, not in water
Contractions: 90-100 seconds at 2 minutes – Strong
1:50AM Assistant, MA, arrival at birth center.
1:55AM Semi- reclining not in water.
Fetal position: LOA
2:06AM Back to tub, sitting in water, pushing involuntarily.
Contractions: 90 seconds at 2-3 minutes – Strong
2:20AM Encouraged to blow through contractions.
2:26AM Rectal pressure, “Feels like I have to poop.”
2:41AM Semi-reclining in water. Encouraged to continue blowing through contractions.
Fetal position: LOA
2:55AM 10cm dilated
3:09AM Head visible with contractions.
3:20 Head visible with contractions.
3:34 Crown
3:35AM Birth: NSVD of viable, vigorous female in LOA presentation. Baby brought out of water in mom’s chest immediately.
Mom’s position: semi-reclining in water. Fetal: Flexed Cephalic Position of presenting part: Anterior.
3:35AM Resuscitation: Stimulation, Dried with warm linen.
3:36 Apgar score- 1 minute: 10
3:40 Apgar score- 5 minutes: 10
3:45 Cord cut/clamped – 10 minutes after birth
3:55 BP: 115/63
4:05AM Cord avulsion with gentle traction, bleeding scant.
4:25AM BP:148/81
4:31AM BP:151/91
4:50AM Attempt to locate placenta/manually remove in vagina unsuccessful. Bleeding scant. Mom stable, alert and oriented. BPP 148/81 at 4:25, squatted in attempt to deliver placenta unsuccessful. Additional attempt at manual removal. 911/EMS activated and mom transported. Dad accompanied mom, baby with assistant, MA.
5:10 Records delivered to nursing staff L&D by Karen. Chelsie alert, stable and oriented. Dr. on call. Karen return to birth center for newborn care. John will call birth center when they know the plan for Chelsie care and make arrangements to come get baby.
6:35AM TC from Dr. requesting info and history on Chelsie. Manual removal done bedside. Chelsie on IV abx was given two units of blood, will be staying for observation for a couple of days.
6:45AM TC to John, Chelsie stable and ready to see her baby. He will call back/or come pick up baby within ten minutes.
7:15AM Discharge note: Baby discharged to dad in car seat. Car seat safety reviewed. Taking baby to hospital to see mom. Will call with updates. Told him we’d visit to follow up.
7:30AM Departure from birth center: Karen, LM.

Baby’s position was checked a grand total of 3 times during labor.
According to the labor flow chart that Karen wrote herself, which has been deleted:
30 minute duration from the time of birth to the time of attempting to deliver placenta.
45 minute duration from the time of placenta separation to arrival at the hospital. And I was right next door.
20 minute duration from the time I arrived at the hospital to the time Karen delivered the records. (No idea if anything about the time was changed or why it took this long since we were right next door, nurses scrambling to figure out what happened.)

65 minute duration is the grand total of time it took from the time the placenta separated (beginning of emergency) to the time I was in the hospital and the records were delivered so that I could be treated. Is that an acceptable time?!?!?!

2 hours 30 minute duration from the time of placenta separation to the time my info and history was requested by the on call doctor. (Wait- shouldn’t most of my history have been already given? Maybe this is why I accidentally received Kell positive blood? What’s going on here?!)
7 hours 30 minute total time Karen was at the birth center. Must be nice for the birth center to be paid upwards of 10,000 for not doing much of anything except watching TV, to be transported next door where they could actually do something in an emergency.

Birth center: Just over 10,000$
Emergency transport: (about 20 feet) 550$
Hospital emergency: 38,000$
Mistrust in my care providers, being forgotten about, going next door to the hospital alone, bad communication between the three midwives, and having all actions justified: Priceless.