No Stone Unturned: The Need for Nonstress Tests for Preventing Umbilical Cord Accidents

stonesOctober is Pregnancy and Infant Loss Awareness Month, which is intended to increase awareness about the tragic causes of infant death.

I served in the United States Army for nine and a half years. I was deployed twice to Afghanistan and once to Africa. I served first as an intelligence analyst and then as combat camera working with an infantry unit when I was injured and medevac’d out.

I never imagined that the greatest challenge I would face in my life would be at home.

After my service, when I was 31 and my husband was 35, I became pregnant with my first child. Everything was wonderful. I got pregnant right away and my son was perfect, growing just as he should have been. The routine checkups and genetic tests all showed a perfectly normal pregnancy.

I had never heard about people having stillbirths.

One day at the 28 week mark, I felt like the baby was moving less than normal. I called my mom, a nurse, who tried to calm my fears by suggesting it was a normal gestational phase, but to call the obstetrician if I was concerned. The doctor did an ultrasound and told me they couldn’t find a heartbeat. I didn’t believe them. I made them repeat the test on three different ultrasound machines. How could anything possibly be wrong with my perfect baby? Nothing had seemed wrong throughout my entire pregnancy.

Both my husband and my obstetrician were out of town. The doctor I met with told me I could go to the hospital immediately and be induced or we could wait until my doctor was back. I opted to wait until my husband could get home and we went to the hospital together. They did another ultrasound and the results came back the same. Twelve hours later, I gave birth to my baby boy who had the umbilical cord wrapped around him five times.

I didn’t know that the umbilical cord – a source of life – could be an issue. I later learned that this was called an umbilical cord accident (UCA), which represents 10 percent of stillbirths[1] and result in the deaths of one in every thousand babies[2]. It seems unbelievable to me that we live in a society with modern advancements and technologies, yet these numbers are so significant. Still birth rates in the U.S. have not changed significantly over the last 30 years, and while it is painful to share my personal experience, I believe there is more that can be done to lower this number and that it needs to be discussed.

The need for nonstress tests (NST)

After a great deal of searching, I uncovered research from Dr. Jason Collins, the preeminent expert on UCAs. Dr. Collins’ research aims to reduce the number of stillbirths by one half through the expanded use of nonstress tests (NST) to monitor fetal heartbeats at home. He calls for adding an additional ultrasound at the 28 week mark and to specifically check the umbilical cord attachments to placenta and fetus. If a problem is seen or there is a chance of higher risk, adding NSTs and fetal heart rate monitoring offer opportunities to catch issues before they become fatal.

Stillbirths – and UCAs in particular – are an issue that requires more attention. There has to be more that can be done so that no other mother has to go through this type of loss, and nonstress tests are a simple, efficient solution to get closer to making this a reality. Many doctors know very little about stillbirths, and even fewer parents do. Don’t be afraid to ask questions, do research, and push your doctor for nonstress tests. Moving forward, we need to take advantage of every option, every resource, every test that is available to help prevent other parents from facing a similar tragedy.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3428685/

[2] http://www.pregnancyandbaby.com/pregnancy/articles/944197/untangling-the-mystery-of-umbilical-cord-accidents

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