RHOC star Kara Keough’s baby dies after homebirth

Baby Tombstone

It’s difficult to imagine anything more soul searing for a mother than the thought that her baby died as a result of her choice.

People Magazine reported:

Kara Keough Bosworth and her husband Kyle Bosworth are mourning the loss of their newborn son, McCoy Casey.

In an emotional Instagram post on Tuesday, the daughter of Real Housewives of Orange County star Jeana Keough revealed the tragic news that her son had died after experiencing “shoulder dystocia and a compressed umbilical cord” during the course of his birth.

What they didn’t mention was that his death was very likely preventable. It happened because Keough chose homebirth.

Low risk is never no risk.

As she explained to members of a shoulder dystocia Facebook group:

This has been the worst and hardest time of my life, and I can’t even wrap my brain around how we missed an 11 lb+ baby … I’m experiencing a lot of sell-blame and guilt. How did I not know? Would the outcome have been different in a hospital? Would he have been saved?

Why did Keough choose to risk her baby’s life in this way?

Once hospital rules changed and I learned my doula wouldn’t be allowed to attend and there were rumors that husbands might not even be allowed by the time I delivered due to COVID-19, I made the decision to switch to a home birth with a certified nurse midwife, her student midwife assistant and my doula.

After all, she had a completely normal pregnancy and had had a previous vaginal birth. She believed she was low risk. She was told her baby was “on the bigger side of the normal range.”

But low risk is never no risk and when emergencies happen at home babies die for lack of access to high tech medical care.

Crowning hurt but head came out in 2 effective pushes. I expected the body to slither out from there … But instead …midwife told me to get on all fours and I knew instantly – shoulder dystocia.

… [W]e did McRoberts, Gaskin maneuver, standing, supra public pressure, running start, Wood’s screw maneuver, she attempted to release the anterior shoulder, posterior shoulder, reach an arm/hand and break a clavicle. We ran through the maneuvers about 3 times each.

And during that entire time, Keough’s baby was deprived of oxygen. Once the head is born, the umbilical cord is trapped between the baby and the pelvis until the rest of the body is born.

It took so long to release the baby that EMTs had time to arrive and enter the house.

Baby McCoy had no heartbeat.

[H]e was immediately “bagged” to help him breathe and they were doing chest compressions. My husband followed him to the hospital – 4 blocks away (another reason we felt safe making the decision to birth at home) and they did manual compressions for 45 minutes – and they got him back with 3 shots of epinephrine… [He] was 11 lbs 4 oz.

They got his heart restarted, but his brain had suffered massive injury.

After 72 hours of cooling blanket and an MRI we were given the devastating news that our son’s brain was severely damaged from severe HIE (hypoxic ischemic encephalopathy)…

We had to make the decision to withdraw care and let his body join his soul after 6 days and we held him as he made the transition to heaven.

There are a variety of reasons that the outcome would almost certainly have been different in a hospital. Most importantly, there would have been physicians more experienced in managing shoulder dystocia and neonatologists who could have intubated the baby immediately. A Zavanelli maneuver (pushing the baby back up and performing and immediate C-section) might have been possible.

Another possibility is that an ultrasound might have revealed that the baby was extremely large and Keough might have been offered a C-section. Had that happened, baby McCoy would have survived and Keough would be mourning the loss of a vaginal birth, not the loss of her son.

Yet despite everything she has endured and lost, Keough is thinking about avoiding a C-section for her next baby.

My brain can’t help but jump ahead to my next pregnancy and the PTSD and how I would totally WANT a natural vaginal birth again … but I would no longer be a good candidate for a home birth (despite the fact that I really loved every minute until he was stuck)…

It’s shocking. It was her concern for her experience that cost her son his life; yet he hasn’t been dead for a week and she’s already worried about her future experiences.