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Tuesday, November 23, 2010

Birth Around the World: Birth at 37,000 feet

Earlier this month, a woman gave birth on a Korean Airlines flight headed for the Philippines. Talk about a birth around the world--literally! Fortunately, CPM Vicki Penwell was on the flight and lent her assistance.

I contacted Vicki to see if I could repost her story and feature her non-profit organization Mercy in Action. She graciously agreed. Here is more information about Mercy in Action:
Mercy in Action is a non-profit organization that focuses on the crisis in Maternal/Newborn/Child health care worldwide. We have been establishing and funding free birth centers for poor families in the Philippines since 1992, and to date more than 12,000 babies have been delivered free of charge for the poorest of the poor in Mercy In Action's Birth Centers, and literally tens of thousands of lives have been helped and healed in the medical outreaches.
Mercy in Action also trains midwives, nurses, medics, and support personnel, helping "provide compassionate health care throughout the developing world." As the Christmas season approaches, you might consider donating to Mercy in Action. I feel humbled at the incredible service this and other organizations (such as MamaBaby Haiti) are providing to women and babies around the world.

Here's Vicki's story of the birth at 37,000 feet:

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Korean Airlines Flight #12 on November 15, 2010 took off from LAX on time with Scott [Vicki's husband] and I on-board, en route to Manila to start a new charity maternity clinic for the poor. We scored the exit row seats in economy, so had plenty of leg room and slept for a few hours.

When I woke up about 6 hours into the flight, I noticed a flight attendant was bringing a woman to the jump seat in front of us, and she was sitting like she was in pain. My subconscious brain immediately recognized the unique type of squirming and sideways twisting that I had seen thousands of times...but my conscious brain said "no, people don't go into labor on airplanes except in the movies!" and anyway, in the dark I could not even tell if she was pregnant. But being medically trained in emergency and primary care as well as being a midwife, and being a generally helpful person, I got up and approached the scene to see if I could lend assistance.

A short history revealed that the woman (a Korean citizen named Jannie, who lived in Los Angles) had boarded the plane feeling fine but had been having stomach pains the past 4 hours, and had just gone to the bathroom and discovered she was bleeding. This was her third baby, due Jan 1. Her squirming had now turned into low moaning as well, and the steward looked terribly uncomfortable, unsure of what to do. He helpfully approached her with an oxygen mask, which is what you do for heart attacks, but was not much help for this situation. I told the steward we needed to get her to a private place, that she was going to deliver. He looked shocked and in denial and so did the woman. I insisted he think of a plan for a private place...perhaps clear out the back row of seats?

Finally making up his mind, the steward turned and led the way, so we walked forward, me supporting the laboring woman, all the way through the plane to the very front (the part I had never seen) where the first class passengers live in a world apart. It was like a small apartment, with wide seats that made into fully reclining beds, and very wide isles. We got the woman situated on a makeshift bed. By now she was really in hard labor. The steward in charge came up and demanded some medical ID from me, which Scott produced out of my handbag. It was pretty obvious the word "midwife" did not register with them. They were scared, understandably; they called on the intercom for any other medical assistance, and a Korean cardiologist came forward. However, since delivering babies was not in his scope of practice, he deferred to me and seemed very relieved at my answers to all his questions: "Had I done this before, because he had not"..."Yes," I said, "over 2,500 deliveries"..."Did I know how to resuscitate a baby?"..."Yes, I am trained in Neonatal Resuscitation"..."Did I know how to stop bleeding if she hemorrhaged?"..."Yes," ...and on and on.

The woman's water broke with a splash at this point, and discussion ceased. They all agreed I was in charge and they seemed very happy for it. The stewardesses tripped over each other each time I would ask for something, and rounded up every bit of medical supplies they had on the plane, though most were for heart attack emergencies. Since by dates the baby would be 6 weeks premature, I asked for lots of blankets, and told everyone we would be doing kangaroo care, with the baby skin to skin on the mother covered by blankets after birth. Since the doctor was worried that we had no anti-hemorrhage drugs, I told them all we would use breastfeeding and massage to contract the uterus. Since we had no resuscitation equipment or suction, I figured out a plan how to do that if necessary with what we had on hand.

At the time of the birth, there were about 6 stewardesses up there helping, holding the woman's hands, wiping her brow, giving her sips of water through a straw. it was like a homebirth and they were all her sisters! Scott was standing at my shoulder to hand me the improvised items I had found to use for emergencies should I need it. Fortunately I did not.

Ten hours after take-off, and with 4 hours left to go before landing, a nice baby boy was born, and with a little stimulation he cried and pinked right up. The stewardesses clapped and laughed and cried. The Apgar score was 9/9, meaning he transitioned well to extra-uterine life at 37,000 feet! By exam the baby was 38 weeks, meaning her dates had been a month off and he was really full-term. The placenta came after about 45 minutes, and the baby began to nurse like a champ. Airline policy actually forbids cutting the cord after an in-flight birth, so that was great; I just wrapped it up in a first class linen napkin and tucked it in the blankets, preventing any chance of infection.

For the rest of the plane ride into Seoul, Scott and I sat up in first class and I monitored the mother and baby. It was a very joyful atmosphere. The mother was so thankful and happy, and appreciative, and so were all the airline personnel. Scott took a short video using his laptop computer after everything was cleaned up and the mom and baby were relaxing. (Click the link to watch a few seconds of post-birth video.)



An ambulance crew came on and got the mother and baby when we landed, and Korean airlines officials guided Scott and I personally to our next gate on to Manila, and changed our tickets to business class. The pilot himself on the Manila leg came back and said thank you for my help. It was pretty great, even though I landed in Manila exhausted with that unique feeling all midwives know of having been up all night at a birth, with jet-lag on top!

The really interesting thing is, a few days ago I was wondering why we had decided to leave the states a week before Thanksgiving holiday, and was pondering if we had made a mistake...now I see that God had a plan that I was to be on that particular airplane on that night...nothing happens by chance when our lives are totally given over to God to be used for His good purposes in the world. In mysterious ways He leads and directs our every step, and puts us in position to be helpful to those in need.

12 comments:

  1. What an amazing story for everyone involved. I love the 'no cord cutting' policy. Why is it that an airline manages to have better evidence-based obstetrics policies than many hospitals? :)

    Congratulations to the mom and her sudden midwife.

    And Rixa, thanks for getting in touch with Vicki to get the whole story. I'd seen a blurb and wished there were more details. Love it!

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  2. Awesome story! I must be still too close to my last birth, because I teared up. (Or maybe that'll always happen...)

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  3. that actually teared me up. what an awesome story...

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  4. Goosebump inducing! Love it.

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  5. INcredible!! Beautiful story. Couldn't help but smile:) God is so good to us. And thanks!! That's two great birth stories in a row!

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  6. This story really made me smile. What a blessing to have such a peaceful birth at 37,000 feet and to have a wonderful midwife there to catch. :)

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  7. What a wonderful birth story! I love how God made it all work out so wonderfully. :)

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  8. Great story!
    I wonder if the cardiologist had to show a medical ID too?

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  9. Wow what an amazing story! Thank you for sharing!

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  10. I am tearing up too. Lucky baby.

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