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February 26, 1982

One caution in pneumatic antishock garment use

JAMA. 1982;247(8):1112. doi:10.1001/jama.1982.03320330012005

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A set of unusual circumstances surrounding a home birth in California in which the mother ultimately died has caused a forensic pathologist to issue a warning to emergency room physicians and paramedical personnel about the use of the pneumatic anti-shock garment in similar cases.

According to Claus Speth, MD, one of the forensic pathologists for the coroner of San Bernardino County, California, the natural home childbirth—a term pregnancy—was attended by an unlicensed midwife and an assistant. The birth was normal but the placenta was not delivered, and hemorrhage began. The midwife and assistant were unable to help, and the husband became worried and started cardiopulmonary resuscitation. Finally he called emergency medical technicians (EMTs), who arrived about an hour after the birth.

The woman by then had lost a moderate amount of blood, according to witnesses, and was in shock. All vital signs were present for some time, and during the