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As a physician, my opinion regarding this incident has been asked by my friends over and over again. However, I cannot really make a conclusion on this case simply because not much facts were revealed. If I were to study the case efficiently, I’d want to see the medical chart of the patient and the monitoring sheet used by the attending nurses. I would need to know the setup of the hospital where this incident occurred. Of course, I would have to ask statements from all the involved hospital personnel.
But, here, only the news article is available to me. And so I’m just going to draw my conclusions based on this material only. I’m afraid, though, that I’ll be raising more questions than answers in this post.
First comment I’ve to give is that the application of the diaper, in this case, is unusual. I don’t say that it is improper. However, the use of adult diapers is usually AFTER delivery of the baby. It is worn by the mother because of the bloody vaginal discharges that is expected after a vaginal delivery of a baby. What is usually used during labor is a rubber sheet or a folded linen placed underneath the pregnant woman in labor, so as not to stain the bedsheets with vaginal discharges that is to be expected during labor, too. Some may use diapers during the latent stage of labor or the early stages when the contractions were not that strong that some women may not even notice it at all. The latent stage of labor usually lasts for about 6-8 hours for primigravids and for a shorter period of time for the multiparas (women who had borne children before).
It is also important to know the status of the labor at the time that the diaper was placed. I’m sure any average, competent doctor wouldn’t place a diaper on a pregnant woman in active labor. If I understand it correctly, the mother in this case was a primigravid, a first-time pregnant woman. For a first-time pregnant woman, the early stage of labor may last to about 6-8 hours, as I’ve said. But this is difficult to asses because the woman may not even notice the weak contractions. So, I think, it is rather difficult to pinpoint the time the actual labor started. As a doctor, I would rather base my decisions on the dilatation of the cervix. If the cervix of the laboring pregnant woman is at 4 cm and the contractions are getting stronger, she is in active stage of labor already. The length of this stage may take about 4 hours to 6 hours and may be shorter for those who are multiparas. The reason for not putting a diaper on the laboring patient at this stage is that the condition may progress faster than expected. Moreso, during the second stage of labor, or the delivery of the baby, which could take only several minutes or may be close to an hour. So, when this diaper was placed on the patient in this case, I guess, the doctor was thinking that she wouldn’t be giving birth anytime soon. Perhaps the patient’s cervix was only dilated 3cm or less. But I could only speculate.
I have to make a comment on what was written on the article regarding Valium. Valium (Generic: Diazepam) belongs to a class of drug called benzodiazepines. It affects chemicals in the brain that are responsible for seizures, anxiety, and muscle spasms. And so, this drug is often used as a sedative. And the reason this drug was given to the patient in this case is for her to be able to rest while she is not still in active labor and also to avoid undue energy expenditures in her part. The patient needed to reserve her energy for the more important part of her labor: the delivery of the baby. I’d like to correct, though, that Valium will not cause anyone to lose consciousness, if given in proper dosage. It is only sedating. The article cited that the patient said she was given Valium and lost consciousness. Perhaps, it was the choice of words that was wrong. Unless, of course, she wa really given Valium at a dosage that could cause her to lose consciousness.
She may have become too sedated that she failed to noticed that she has already given birth. Thus, I can only speculate at to what time she must have delivered the baby. However, was she really that much sedated that she didn’t notice that there is already something in between her thighs, though it may not be moving or making sounds?
And then, based on this news article, there was a long interval between the last time she was checked by the doctor (midnight , when she was given Valium) and the time that the lifeless baby was discovered, which is at around 7 am. That is seven hours? Does this article tell me that no internal examinations were done during those time to check if the cervix is already fully dilated? Usually, when monitoring an actively laboring patient, IEs (internal examinations) may be done every 2 hours, or more frequent if the cervix is near to full dilatation.
As I’ve said, there are so many questions to be answered. Much as I want to be following this case as it unfolds, I’m afraid I’ll be just limited to snippets of anecdotes from grieving parents and relatives. The doctor, I presume, will keep her thoughts to herself and her lawyer. And that is, for her own good. So, don’t be surprised if the doctor involved isn’t making any press statements. She reserving all the bullets that she may gather (or appear to gather from thin air) for her defense.
May there be fair justice for everyone involved. And may the truth be uncovered, though elusive it may be.
