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Nola's Story

by Amrita Lal-Paterson

Supporting: What If We Had Known . . . ? for Group B Strep International

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This was written by my husband just a couple of days after our daughter, Nola, passed away from Group B Strep.

Early Tuesday morning,May 6, 2008, about 1:00 a.m., Amrita started having a lot of back pain and not long after started having contractions. I brought her to the hospital at about 8:30 and for most of the day she of course struggled with the contractions and everything associated with early labor. Everything was fine according to the doctors, and they were respectful of our wishes to try and have a natural childbirth unless we requested otherwise or events should dictate otherwise. They did have a fetal monitor set up, and about 4:30 pm nearly the entire wing of the hospital came in like gangbusters into the room, as the baby's heart rate dipped to a very low level. About 10 medical personnel entered at once and started all kinds of new tubes and monitors, rushing around madly as our doula and I looked on. Fortunately the heart rate went back up after Amrita changed positions and after several minutes of monitoring. But the doctors recommended that Amrita get an epidural because if it dropped again there was the possibility of an emergency C-section, and if she didn't have the epidural set up already then they would have to give her general anaesthesia and she wouldn't even be awake for the birth of our baby, not to mention the risks involved with general anesthesia to both mother and baby. 

After they gave her the epidural they encouraged her to sleep for a bit, which she started to do. They also broke her water for her, which along with getting Amrita to relax with the epidural, they thought would help further labor along. Since I thought I now had a few minutes I left Amrita with our doula to make a couple quick phone calls letting family know the baby's progress and went down to the cafeteria to eat a quick bite. Just as I started to place something on the tray, our doula called me and said I needed to get back up to the room, they were going to do an emergency C-section because the baby's heart rate dropped again. After dressing in scrubs I got in to the surgery suite in time to hold her hand as the operating staff were jerking Amrita's body around underneath the surgical canopy that separated her and I from the trauma they were putting her body through, in an effort to get the baby out as quickly as possible.


Amrita was in obvious agony and fear, tears fell down her cheeks. Within 5 minutes, they had the baby out. I knew something was wrong very quickly; I heard someone say "start CPR", followed by "bring in the crash cart" and I looked over at the small incubator our daughter was in; I could see very little but I could see the top of her chest and someone's fingers pressing up and down to manually pump her heart. I tried to tell myself that since she was born through C-section, that they probably had to do CPR to expel the fluid from her lungs, that she should be OK. They kept giving her injections of epinephrine to try to stimulate her heart; Amrita was below the canopy and couldn't see anything and asked me what was wrong. "Why don't I hear her crying?" I could only tell her I didn't know; I felt utterly helpless. Below the surgical canopy the surgical team was working to put her body back together; and just out of arm's reach a virtual army of staff struggled to save my daughter's life. For a moment both our hearts lightened as we heard a slight gasp and wheeze that a baby would make, but then silence as the staff all continued to work frantically around her. Amrita kept asking me "Why don't I hear her crying? What is going on?" and I could only tell her again that I didn't know, that it was a girl, and that I thought she had fluid in her lungs and didn't want to say anymore that might upset her further. It was then that one of the nurses came over to me and told me then what I was beginning to suspect: the baby's heart wasn't pumping and they were trying frantically to start it. The anesthesiologist was right next to me and told me then he was going to give Amrita an extra shot to let her sleep so she wouldn't have to watch this; I nodded OK.

At one point I heard someone say "Heart Rate 27", which while low still gave me hope that they might be achieving results. The nurse came over to me to tell me again though that they still hadn't been able to get any response. At that point my heart sank and my vision blurred from the tears that began welling up; I felt as though I would faint. My mental state felt as though I had entered a movie set or had fallen into a dream. Amrita kept dozing and waking; she asked me again what was happening and why she didn't she hear Nola, and even with the surgical mask on I'm sure the tears told her the story. Fortunately she dozed again and didn't have to witness any more of this. Then the neonatologist called me aside to talk to me. I had to get up and leave Amrita while we talked at the other end of the room. She told me they had tried to get Nola's heart beating for about 30 minutes without success, and at this point brain damage was imminent, and that they recommended desisting. So in the space of less than an hour I had gone from waiting expectantly for this baby we had prepared the last 9 months for to having to decide whether to terminate her life. 


Thirty minutes later as Amrita came out of her sedation I had to break the news to her. She told me later that she fell asleep when I left and thought I had gone to be with Nola when they took her to the nursery. The look on her face when I told her the news will haunt me the rest of my life. In the space of 30 minutes two of the most gut wrenching tasks of my life were put before me. 

Maybe I have given too much info here, more than you wanted or needed, I don't know. I only know I lost my daughter. She was 7 pounds, 7 ounces, 19 3/4 inches long and beautiful, with Amrita's beautiful eyes and a pretty head of hair that was a mix of blonde and brown, with soft eyebrows that take after her father, softly complected, with a small mouth with pretty petite lips. I'm sure her father would have had a hard time with the boys chasing her when she became a teenager. The hospital was nice enough to dress her in some clothes and take pictures; when you see them you think she is simply sleeping...

At first the doctors were mystified by what happened; they didn't have an answer. After a few days of testing it showed "a massive infection with GBS". We are still waiting for the results of the autopsy and some other tests, but it has become clear to us that Group B Strep was Nola's killer. The OB/GYN has said that it must have happened less than 24 hours before Amrita started labor. The day before she was in the OB/GYN's office, where they did a digital exam and listened to her heart; everything was fine, but they did want to schedule an induction because she was 5 days late. The next day when we arrived at labor and delivery the same OB/GYN said that "she must have stirred the pot" when she had the exam less than 24 hours before. We are absolutely convinced this is what caused the infection.  Since it seems that all OB/GYN's do this and we were told that it is necessary and that ultrasounds can't reveal as much as the digital exam.



About

  What if we had known how to help protect our babies from GBS?




As a tribute to all babies who have been infected by group B strep (GBS), let's make sure the next parents know how to help protect their babies! Help GBSI help parents and providers around the globe close the gap in GBS care. Sometimes something as simple as making sure the hospital knows a woman's GBS status is all it takes to make a difference in a baby's life.

You can make a difference for families worldwide by learning, contributing, and sharing about GBS!

Here's how to make a difference for families worldwide:

    1) Learn about GBS at www.groupbstrepinternational.org


    2) Contribute to the cause by making a donation                                  

    The first $25,000 raised ~ GBSI plans to exhibit and/or present at two important international conferences, such as FIGO 2018 and ISPID-ISA 2018, and the American College of Nurse-Midwives 63rd Annual Meeting & Exhibition as well as cover our routine printing and shipping of GBS info to parents and perinatal providers.

    The next $5,000 raised~ Have our website and all of our GBS materials fully translated into Spanish and then print and ship Spanish-language GBS info to the many requests we've had over the years.

    The next $40,000 raised~ Will provide funding to implement statewide distribution of GBS info through two US State Departments of Health and one smaller country's Department of Health. Funding would include staffing, printing, and distribution of materials. (See what GBS mom, Bevin Tomlin did with the State of Alabama!) AND work with those Departments of Health to ensure that babies' death certificates are being updated when pathology tests results are available so that GBS infections are counted! (We learned that this isn't happening as it should - even in the US - when we were at a perinatal conference in Uruguay last year.)


 3) Share our posts through your social media

     Share ways to promote July as International GBS Awareness Month by clicking HERE

     If you are a GBS parent and haven't already, share your story for GBSI's website by clicking HERE 


Let’s make this the best July so far for GBS awareness!


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