Is there more to the Christmas “miracle” mom & baby “mystery?”

In what’s being called a Christmas “miracle,” a mother suffered cardiac arrest and died while in labor on Christmas eve 2009, her lifeless baby was born after an emergency cesarean section, and then “inexplicably, astonishingly” both suddenly came back to life. At least, that is the picture that was first painted by ABC News.


Photo credit: ABC News

Tracy Hermanstorfer of Colorado was without a heartbeat for four to five minutes while her husband Mike undoubtedly stood by in shock. “‘Half of my family was lying there right in front of me — there’s no other way to say it — dead,’ Mike Hermanstorfer told ABC News’ Colorado affiliate KRDO. ‘I lost all feeling. Once her heartbeat stopped, I felt like mine did too.’”

First I must say that I’m so very thankful that Tracy and her son Coltyn were revived and both are doing very well. I can’t imagine what her husband Mike must have gone through in those moments. I wish the Hermanstorfer family a happy, healthy and uneventful new year.

While the story of a Christmas miracle such as this warms one’s heart, many people, myself included, thought there must be more to the story than the media was reporting. Dr. Stephanie Martin, the doctor who responded to the Code Blue and performed the emergency c-section, said she cannot explain the mother’s cardiac arrest or the recovery. “We did a thorough evaluation and can’t find anything that explains why this happened,” she said. In the video linked above Diane Sawyer says, “To Tracy’s doctors, the events are still a complete mystery.” A complete mystery? Really?

If you watch the ABC News interview (below) with Tracy and Mike Hermanstorfer and Dr. Stephanie Martin it looks like the “mystery” may have been solved after all and there could be a very valid explanation for why Tracy went into cardiac arrest – the epidural. Cardiac arrest is a very rare, but very real possible complication of epidurals.

Tracy was pregnant with her third child and had given birth to the previous two without an epidural. However, after her membranes ruptured (water broke), she went to Memorial Hospital in Colorado Springs and was given pitocin to speed up her labor. She found the contractions were “a lot harder” than she remembered so she opted for the epidural. It was not long after she received the epidural that Mike noticed Tracy’s hand was cold, her fingertips were blue and a nurse noticed the color in Tracy’s face was completely gone.

Henci Goer, “an acknowledged expert on evidence-based maternity care” and blogger at Science and Sensibility, transcribed the relevant parts of the ABC interview.

ABC: Code Blue was declared, a scary thing in any hospital. [Dr. Martin arrives in response.]

Dr. Martin: . . . When I ran into the room, the anesthesiologist had already started breathing for Tracy. There were preparations already being made to start a resuscitation should her heart stop. About 35 to 40 seconds after I got in the room, her heart did stop and we started making preparations to do an emergency cesarean delivery right there in the room in the event that we were not successful in bringing Tracy back. Unfortunately, in most of these situations, despite the best efforts of the team, Mom is often not able to be revived, so we anticipated that possibility and when it became clear that Tracy was not responding to all the work that the team was doing on her, we had to make that difficult decision to do the cesarean section, primarily in an effort to give Coltyn the best chance at a normal survival and also hoping that it would allow us to do a more effective resuscitation on Tracy, and fortunately, she cooperated and we got a heartbeat back immediately after delivering Coltyn.

Henci explains her assessment of the situation:

So, according to Dr. Martin, Tracy is an example of how things can go suddenly and horribly wrong for no discernible reason in a healthy woman having a normal labor. All I can say is that Dr. Martin must have slept through the class on epidural complications. Tracy’s story is the classic sequence that follows what anesthesiologists term an “unexpectedly high blockade,” meaning the anesthesiologist injected the epidural anesthetic into the wrong space and it migrated upward, paralyzing breathing muscles and in some cases, stopping the heart. High blockade happens rarely… It does happen, though, and I am willing to bet that high blockade and its sequelae happened to Tracy.

The moral of the print version would be: have your baby in a hospital where you can be saved should this happen to you. The video interview, however, reveals a different picture. The real moral of the tale is that the safest and healthiest births will be achieved by avoiding medical intervention whenever possible.

Danielle from Momotics asks, “Why was there a need for pitocin? Because no one wants to be sitting around waiting to deliver a baby on Christmas eve?” She also wants to know why the possible correlation between the epidural and the cardiac arrest isn’t being talked about in the media. “Why is the mainstream media not reporting these things? Mass hysteria? Loss of money for the pharmaceutical companies that make pitocin and these anesthesia drugs?”

Jasmine who writes for The Examiner offered up her own take on the situation:

Knowing the side effects of both pitocin and the epidural, Hermanstorfer’s history of having unmedicated births, she probably experienced a dropped heartrate from the pitocin which may have caused her cardiac arrest upon administering the epidural. We all like the story of hearing “miracles” and they do happen, however, we have to know a little more about modern medicine and the side effects and dangers of modern drugs.

Nicole from It’s Your Birth Right speculates a few possibilities of what may have gone wrong. She admits that there is no way for her to say for sure what happened in Tracy’s case, but she wants people to know that having an epidural does carry risks.:

I just want it to be clear that Epidurals can indeed cause cardiac problems and can also stop a woman’s breathing immediately after administration. Does it always happen? NO. Does it usually happen? NO. Can it happen? YES. And did the media completely ignore the possibility of the epidural having anything to do with the cardiac arrest? YES.

Nicole adds:

Often when I tell people I don’t want an epidural they don’t understand why. THIS is why. The risks in my humble opinion are high for a procedure that is considered elective.

Often when I tell people epidurals carry risks that are not discussed with women resulting in misinformed consent for a procedure they know little about, I am considered an extremist. PLEASE if you want an epidural, that’s your choice but get INFORMED!!!

Here are the reported side effects of epidurals on both mother and baby.

Conspiracy theories aside, I think one of the reasons the possible cause of Tracy’s cardiac arrest wasn’t reported by the media is because it diminishes the feel-good Christmas miracle aspect of it. I think the media sensationalized the story to draw as much attention to it as possible. They succeeded.

The truth is we may never know what caused Tracy Hermanstorfer’s heart to stop beating, but it seems likely that the sequence of events – pitocin, epidural, lying on her back (which can cause “problems with backaches, breathing, digestive system, hemorrhoids, low blood pressure and decrease in circulation to your heart and your baby. This is a result of your abdomen resting on your intestines and major blood vessels (the aorta and vena cava).”) may have had something to do with it. While this story had a very happy ending, most like it do not. What can we learn from this? Educate yourself, learn about the risks of common interventions, and hire a doula.

Once again, I wish Tracy and Mike Hermanstorfer and their family all the best. :)

Cross-posted on BlogHer

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31 thoughts on “Is there more to the Christmas “miracle” mom & baby “mystery?”

  1. My cohost and I read this on our Birth Junkie Radio show the other night and I was really stunned that there seemed to be no explanation at all by the doc or the reporter about the cause of the arrest. I agree that the media chose to tell a story about a holiday “miracle” and not report the facts in this matter. I’m craving more info: was this the test dose? Did they do a test dose? How quickly did the breathing stop after admin of the epidural? It’s frustrating, really, that no effort whatsoever was taken to get to the bottom of the arrest.

    Now, I should decide, when teaching, do I mention this story when I come to the interventions class and we discuss epidurals?

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  3. To leanne: absolutely you should mention it because not only does it illustrate the potential risks, it also demonstrates why these risks are not well known. For those who do think natural birth educators are being “extremists” this is a game-changing story that really depicts it being swept under the rug.

  4. this is really interesting to me. i am high risk due to a blood clotting disease. i have to be induced to make sure they can monitor everything and we don’t lose another child through birth, so i am grateful they can do this. i also went code blue and we didn’t get the miracle that they did, our daughter passed away.

    saying that though, i really HATE how much people take for granted the process of going into labor and enjoying birth when they have no risk but just want to get it done quickly. the use of the medicine is over used and over requested. my sister in law was induced 2 weeks early for no reason and than after 8 hours of labor with no progress they decided c-section cause they didn’t think she would ever get to a 10! SERIOUSLY, go home wait, labor it out, you had no medical emergency.

    okay soapbox over

    i find the lying on your back thing pretty interesting also and cant understand why they can get some kind of information on this.

    to ashly: i think to even consider natural birth educators extremist is insane, yes we have a choice but its not extreme at all,some might have no desire to do it, but to listen and learn is important in all areas. to know what you are doing to your body is by far a great thing than extreme.

  5. Just one more reason for me to avoid pitocin and an epidural. It really seems that the pitocin leads to further interventions, and I just hope that my baby decides to make his appearance before 41 weeks when protocol of my doctor’s office calls for induction. I’ll save my energy for that fight, I’m sure.

    What about the doctors involved here? The media is reporting what the doctors found, and it’s obviously irresponsible for them to say there’s no explanation. If I was this woman, I’d want to know why my heart stopped!!! How scary… if it’s really unexplained, couldn’t it happen again? Are they planning to give her a pace maker? Or put her on heart medication? Or did they just send her home on her merry way because they think it won’t happen again? If I was her, I’d push for answers.

  6. I definitely wish I was more informed about the dangerous side of an epidural before I had my son. When I was given one both mine and Wesley’s heartbeat instantly dropped. I was soooo out of it and had no idea the severity of the situation until much later. Thank goodness it was a happy ending, but I definitely steered clear of the needle when I had my daughter.

  7. There’s no way for any of us to know the real reason, but I think it’s important to open up discussion about the very real, if rare, risks that epidurals can bring. Too many people think they are riskless simple because they are so routine. The fact is no medication is without risk.

  8. I am glad this woman and her baby are fine as well you and your babe Wendy. Many women recover well from epidurals and their babies are fine but for the few cases where there are severe complications like this I think the discussion needs to be better recognized in the media. Actually the realities of the epidural process need to be recognized in reality, it is not a happy drug that will make everything easy, it courses through your body and makes some people shaky, plays with heart rates, etc. It is amazing to me how few expecting mothers know this at all.

  9. It would be nice if hospitals “banned” epidurals as easily as they do VBAC after one such incident. Our local hospital has done that after a “VBAC gone wrong” years ago. The funny thing is that it was an induced, intervention laced VBAC attempt that if left alone would have probably been successful.

    It will be interesting to see if this family sues. If more litigation was initiated for unnecessary interventions and procedures maybe the overuse of such procedures would fall.

    *off my soapbox

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  11. The words “informed consent” seem to be missing in too many OB/Gyn’s vocabularies.

    If it were not for my doula, there is much I wouldn’t have known going in. I will refrain from clogging up your comments with my own horrid birth story – but there’s an irony to the fact that I knew right away about the possibility of cardiac arrest and epidurals. I knew because I had to have my epi 1 disc up from the norm (L5/S1) because of issues with my disk there. This required my being fully informed of the risks, having the written consent of the head of anesthesiology, and he chose to administer it himself and stayed to monitor as well as being present when all hell broke loose. Very good man.

    There is, in the U.S. medical profession a weird attitude that pregnancy and childbirth are “unnatural” states – so the mother is often treated more like an illness than a functional person with a brain.

    Quite happy that the mom made it through that. Someone ought to have a chat with her OB though about the risks of epidurals.

  12. I also had an improperly placed epidural with my second child, although my side effects weren’t nearly as serious as in this case. Not only did I not get any pain relief, but the epidural caused me to shake so violently after contractions that my husband had to hold me down so I didn’t fall off the bed. We’re done having kids, but if we had planned for me, it would be no epidural all the way. I’m not surprised the hospital hasn’t identified the cause of the cardiac arrest, they’d probably be opening themselves to a lawsuit with the admission.

  13. Thank you all for your comments.

    Courtney – I’m so glad you are OK, but so very sorry for your loss.

    Abbie – You raise a great point. It is irresponsible for the doctor to say there’s no explanation. I don’t buy it. I also think the media should do some investigating of their own. There are too many flags raised on this.

    Wendy – I’m so glad everything worked out OK for you and your baby.

    Lucretia – I remember your birth story well. I think you hit the nail on the head when you said: “There is, in the U.S. medical profession a weird attitude that pregnancy and childbirth are “unnatural” states – so the mother is often treated more like an illness than a functional person with a brain.” It’s so unfortunate.

    BTW, I’ve emailed ABCNews and the Colorado Springs Gazette as well as contacted some other local news sources on Twitter to see if anyone plans to do more investigating. I’ll keep you posted.

  14. It had to have happened fairly quickly after the epidural itself if the doctor who administered the epidural is the one who was “already doing breathing” according to the news reports.

    That’s within just a few minutes. Most of the time the epidural is given and the doctor watches for awhile to gauge a reaction, but it’s not like 45 minutes or anything like that. The reaction had to have been fairly soon.

    Angela <

  15. I hadn’t heard about this story, and I wanted to say thank you for covering it. I really appreciate your summary posts of an issue in the media or blogosphere, Amy. They are so easy to read and rich with information. So, thank you!!

  16. Both my husband and I were wondering what could have caused this problem for her, but hadn’t given it another thought until I saw your article. Nice recap of all the follow-up articles that have been posted by others. I’ll be sure to help get the word out about this one!

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  18. Thank you for this! I was induced at 41 weeks and refused to have an epidural inspite of it. It truly was the most painful day of my life, but I would do it again (and will do this coming birth without an epidural!). I’ve said it before and I will say it again; Epidurals scare me so much more than natural childbirth and pain.

  19. once again totally boggled by how much intervention is done in US hospitals..and how the dangers are SOOO glossed over.
    Does nobody notice how attentive the anesthetic dudes are to you with an epi? FOR A REASON!!!

    It is actually amazing that this doesn’t happen more often.

  20. As soon as I saw this story, I said to my husband, “I wonder what intervention caused that?” Yes, this sort of reaction is rare (although obviously very serious). Many people don’t know, however, the much more common issues associated with epidurals–labor slowing, then needing Pitocin, another epidural because the Pitocin contractions are more painful, ending with failure to progress OR baby in distress, and an ‘emergency’ csection. ALL of the risks associated with medication during birth needs to be further publicized.

  21. i just want to reiterate what stacy said thanking you for doing such a wonderful job or writing about this situation. it is a gift you have for gathering and sharing facts and perspectives. i remember you asked awhile back what your blog should be and this post speaks to me of what a talented blogger you are!

  22. First, as a doctor and a mommy I have to say, if your doctor isn’t giving you sufficient information FIND ANOTHER DOC! I delivered with a collegue and friend who kept me informed and put every decision to me and my husband. As woman, and I see this from patients everyday, as soon as that doctor walks into the room we let ourselves get pushed and try to be “nice girls.” F**k nice. Stand up for yourself.

    Second, stop being so hard on each other! I try my best to facilitate the healthiest and naturalists birth I can, but there are choices we all have to make in the moment. On this blog and many other mommy blogs I see moms tearing each other to pieces over natural child birth. I’ve seen woman who loved their natural births, I’ve seen woman who hated them. I’ve seen woman who love their epidurals and woman who hated them. Sometimes all a woman needs is positive reinforcement and encouragement to have a successful natural birth. Sometimes a woman needs to be told its okay to think about your comfort and get the damn epidural! The natural childbirth has become the newest battle in the mommy wars and what saddens me is that woman can’t stop beating each other up.

  23. You know this makes a lot of sense to me.

    With my 1st child, I was pressured into getting an epidural by the nurse. Again it was the pitocin which was ridiculously painful!

    My son came out blue and not breathing!

    He was OK, but peds people had to rush in immediately and take him to the ICU.

    After that I have had 3 more children, all of them naturally.

    I will not do the epidural because I was so scared by what happened the 1st time. He had the cord wrapped around his neck. The epidural made me too relaxed and sped up labor to much (or so I can gather in retrospect).

    At any rate, his heart rate was dropping, and this would make sense with this story.

    Thanks for the info & awareness.

    Megan

  24. I am a health care provider. Yes, epidurals come with certain risks. Hate to tell you this, but so does natural birth. This woman could have been at home and having a hospital-free birth and still thrown an amniotic fluid emoblism with a similar outcome. I’m not saying one option is better than the other. It’s a personal choice and THAT is the most important thing. All I’m saying is let’s not pretend that the alternative to the epidural does not also have significant risks. Freaky, scary, and completely unpredictable things can and do happen all the time in healthcare. History will show that lots of women have lost their lives, both naturally AND those who had medical care available. No matter what we do, natural or not, bad things can and do unfortunately happen. Please lay off the judgment of other women’s birthing choices. This could have happened to anyone.

  25. I hadn’t heard this story before. Thank you for sharing it, along with the commentary. I too had a routine epidural that turned into an “unexpectedly high spinal blockade” that paralyzed me and stopped my lung function. I was intubated, although my heart didn’t stop. My son was delivered by emergency C-section while I was under general anesthesia. He was actually cut by the doctor in her rush to get him out and will have a scar on his face his whole life (not that I begrudge her speed, but it’s just an unpleasant reminder to me every time I look at him). Thankfully, we are both fine now.

    It happened several hours after receiving the epidural, so the theory is that the needle migrated. I’ve been told it was listed as a risk on the consent paperwork, but I had never heard of this happening before it happened to me. I do wish more people knew about it and really considered the risk of it before getting an epidural.

  26. Concerned nurse is missing the point that an epidural is an unnecessary elective procedure, which poses risks of which most women are completely unaware. I don’t judge anyone’s birth choices. However, I do judge a lack of knowledge and research when making those choices.

  27. Nope, not missing the point at all. Not necessary for YOU doesn’t mean it’s not necessary for someone else. If we accept that every birth experience is truly individual, then we must accept that for some women, an epidural is absolutely, 100% necessary, whether we agree with it or think it’s “best” or not. A well-informed patient choice is never wrong, no matter what, and yes, plenty of well-informed mothers do opt for epidurals. And yes, I agree that some women are not aware or not made aware of the risks. It’s an unfortunate part of healthcare. Not all practitioners are created equal, and not all women have equal access to informative resources or prenatal care.

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