There is something missing in the story I’ve shared about Eleni Laura Hauser, my baby girl. In 2015, after a healthy pregnancy, I was eagerly anticipating her birth. Like you, I was completely shocked when that joyous event turned tragic.

What happened? What exactly went so terribly wrong?

In the traumatic aftermath of her birth, that story was too painful, too confusing. Soon it became a matter I should not discuss publicly. Common sense and a little research revealed that we had not been cared for properly. At a different hospital, with a different nurse or doctor, I’d have brought home a healthy baby that day.

Seven years ago we began pursuing legal action, a lawsuit for medical negligence. We needed to speak up so that this wouldn’t happen again to another baby, and we also feared we’d drown under the costs of Eleni’s intensive medical needs. At long, long last we brought Eleni’s case to trial in 2022.

Now I can speak. This is a story I need to tell.

The story begins with a mother who had given birth before: two healthy and legal home births under the care of midwives. A healthy third pregnancy, multiple ultrasounds, and labor that began at home spontaneously, with a familiar, strong contraction pattern. Then after 4 hours, the contractions gradually ebbed away.

The story starts with a midwife. The day after that false labor I expressed that Eleni wasn’t as active as usual, so my midwife came again to check on us at home. Using her hand held doppler, she noted an elevated fetal heart rate with low variability. She sent us to the hospital for an official “non stress test”, essentially listening to the baby’s heart again, but with a continuous electronic fetal monitor.

The non stress test was “non-reassuring.” This mean that, via the test, they could not confirm that baby was in good health. Instead her heart rate was slightly elevated (tachycardia) and lacking variability, just as my midwife had reported. But I didn’t understand that. I was simply told, by the doctor who took over my case: You need to have your baby. It’s time to have your baby, and you are no longer a candidate for home birth.

What does low-to-absent variability indicate when it comes to baby’s heart rate? It means her heart rate is not bouncing around making a zigzag tracing on the fetal monitor strip. Instead, it’s nearly flat. A healthy baby has accelerations, where her heart rate bumps up when she hears a sound, makes a movement, etc. Low variability indicates fetal distress.

What they should have said, what the could have said is “We don’t know if your baby is getting enough oxygen. You reported decreased fetal movement and in combination with these findings, we recommend an immediate c-section.” If only they had appeared concerned or even mentioned the word “concern.”

The mother trusts birth. The mother trusts caregivers. The mother trusts.

This is a story of a baby who was full term (38 weeks) and ready to be born. The baby’s mother was asked to choose without being well-informed. Do you want a c-section or another test? If the test is successful, you can give birth naturally in the hospital. I faltered, surprised and confused. I said, “I guess I would choose the test, the trial of labor, because if a c-section is not necessary a vaginal birth is usually best for the baby.”

No further clarification and no advice was offered. We proceeded to a stress test.

In retrospect, this story is irrational. Eleni failed a non-stress test, though I didn’t realize that at a the time. And so, we proceeded to a stress test?

The doctor explained it this way: We’ll give you Pitocin to make you have contractions. We will monitor you closely to make sure baby is tolerating this. If she is still tolerating labor when you have three contractions during a 10 minute period, we’ll know she can tolerate a natural birth. Then you can continue laboring until you give birth.

The word “stress” is in the name of the test because contractions stress even a healthy baby. The squeezing of the uterus often temporarily interrupts blood and oxygen flow to baby. A healthy baby can handle this, but even so the stress often shows up as slight heart rate dips or decelerations on the electronic fetal monitor. A baby who is sick or weak will have frequent and/or big decelerations during labor. This tips off caregivers to take action to increase oxygen getting to baby and/or order a c-section.

This is the story of a nurse who was there from the beginning, during the initial non-stress test. A nurse who never had a discussion with us to clarify what was happening in lay-terms. She was now to monitor the stress test, and that she did.

The nurse’s charting shows that once I started having 2-3 contractions per 15 minutes, Eleni had one or multiple heart rate decelerations consistently. The nurse charted in 15 minute intervals. During what turned out to be 12 hours of labor, she only marked 2 boxes as free from decelerations. She charted both variable and late decelerations.

Eleni failed the non-stress test and then she failed the stress-test. Did the nurse realize that? Did the doctor? I don't know. I was laboring without pain relief, so I was a little occupied. I was well-aware of when I reached that threshold of 3 contractions within a 10 minute period, the level of a valid stress test, per the doctor. No one came to give me the results, so I asked.

When I asked the nurse if I had passed the test, she said, I think the plan is that we’re just going to keep going until you have this baby!

It sounded like good news, but it wasn’t.

When we arrived at the hospital Eleni had tachycardia. The high heart rate was a sign of distress, but the lack of variability in her heart rate and heart rate decelerations were even more telling. Electronic fetal monitoring is a screening tool, really the only one, used during labor to monitor the health of baby.

The nurse came in to my laboring room frequently to adjust the electronic fetal monitor belt on my abdomen. As a natural labor patient I was shifting around in bed a lot and also getting up to the bathroom since I was on extra fluids. As a result most of the strip (the graph of the fetal monitor results) is hard to read. Baby’s heart rate showed up pretty well, but most of the time the graph didn’t show my contractions.

This is the story of a nurse who failed to act. She was charting all these heart rate dips from baby, and she had no real record of my contraction timing. Without that info, she couldn’t know how many of these decelerations were “late decels” which are the most concerning type. It is key to know the timing of baby’s decelerations in relation to mother’s contractions.

My water broke at 2 am. She could have advocated for an internal fetal monitor, which would have solved the problem, providing the info they needed to easily see that baby was in distress. She didn’t.

Eleni remained distressed throughout my labor, but only briefly was that distress jump-out spectacular. Around 3 am Eleni had four big heart rate decals within a 16 minute period. The nurse spoke to the doctor at that time, but the result was “no new orders.” No c-section advice and no internal fetal monitor. Just no action at all.

That nurse filled in her last charting box at 6:15. Her shift was over at 7, but she admits she may have left early.

At 7 am there was a shift change. My new nurse charted for the first time at 7:45. I don’t think that she liked what she saw. I was dilating very slowly, slower than normal for me and for the average mom. I was only 6 centimeters dilated after 11 hours of Pitocin, and baby had been having tachycardia and decelerations all night long.

At 8:17 am the new nurse had the doctor in the room advising an internal electronic fetal monitor, because they couldn’t see when my contractions were happening. They needed more info, they said. Finally, some action. At 8:30 the device was placed. The internal fetal monitor showed my contraction pattern clearly and quickly confirmed that Eleni was having late decals with every contraction. Around 9 am they calmly and without urgency recommend a c-section, and we consented.

Because we followed their advice the whole damn night.

And where was the doctor? They called him into my labor and delivery room, where I was still waiting to be prepped for the c-section at 9:30. Eleni was born then vaginally, because my body dilated quickly in an intuitive effort to save her. This happens sometimes with babies in distress and mothers who have birthed before.

He caught her, the man who asked me to choose between “a test that could lead to a natural delivery” and a c-section 12 hours earlier. Who had promised that we would be closely monitored. Who had not noticed when she failed the stress test that he ordered. The doctor who I had not seen all night, not seen again until the new nurse brought him in at 8:17 am the next day.

This is the story of a doctor who didn’t give advice, who was never very involved and certainly never seemed concerned. No surprise then that he didn’t take responsibility for the results either. He caught my gray-blue baby girl, who was born limp and unresponsive. Eleni didn’t even attempt to breath for herself until she was 20 minutes old. He caught my afterbirth, and he left. I never saw him again or heard a word from him until our trial.

Oh, except for the bill. I received the bill for his labor and delivery services. And I paid it.

What follows is everything terrible. Eleni experienced both a prolonged period of oxygen deprivation and a severe period of oxygen deprivation, as indicated by later MRI imaging. This caused severe, global brain damage. You can find the story of Eleni’s short and difficult life here. Scroll to the bottom to read from the beginning. Now you know how it started, and how confused and shocked and angry we would have been.

Her birth was not a birth, but more of a death. I had seen her on ultrasounds inside my womb, opening and closing her hands, kicking, wiggling, happy. Once born she was trapped in a body that could not move, could not see, or hear or eat. It was a body that actually could not even breathe. All of this because I trusted the caregivers. We were vulnerable, she was so vulnerable and they did not act to save her.

Next up, the trial and its outcome. I just thought that you needed to hear this story first.

the Missing Story of Eleni's Birth

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