Monday, December 14, 2009

Emergency deliveries

Here's a roundup of recent "emergency deliveries." It happens in planes! In living rooms! In bathrooms! Via Blackberries! I've included highlights from each story. Bolding is mine. Feel free to laugh, cry, or roll your eyes.

My commentary:
  • what's with the hullabaloo over clamping/cutting the umbilical cord?
  • good thing a doctor can go to medical school, not deliver a baby since the 1970s, and get all credit for doing nothing more than tying a knot in a shoelace
  • How come the dads get all the glory for doing simple things like using a Blackberry or being on the phone with an emergency responder? Isn't it the mom who's doing all the work here? Give her some credit!

Baby Boy Delivered 30,000 Feet Over Colorado aka "Magic Doctor Does The Honors"
A Southwest Airlines flight from Chicago to Salt Lake City diverted to Denver on Friday after a woman gave birth to a healthy baby boy at 30,000 feet. A suburban Chicago doctor who hadn't delivered a baby since the mid 1970's did the honors in the sky over Colorado. When it was determined that the woman was not only in labor but wouldn't make it to either the intended destination or any other, she was moved to the rear of the aircraft where the doctor did his magic, tying the umbilical cord with his shoestring.
Baby Starts Birth in Hospital Toilet aka "It's an emergency if you're not in bed--even in a hospital"
A British woman said she started giving birth to her son in a bathroom after seven medical workers told her she was not in labor. Janet Clark, 38, said she was 25 weeks pregnant when she went into the Pilgrim Hospital in Boston, England, with a great deal of pain and was sent home after talking to a doctor and four midwives, The Sun reported Monday. Clark said she returned to the hospital the next day and went into the bathroom after being told by two more medical workers that she was not in labor and had nothing to worry about. However, Clark said her son, Zac, began to arrive while she was on the toilet. "A pregnant woman shouldn't have to plead with medical staff," Clark said after giving birth to Zac, who hospital staff said needed special care at first but is now doing well.
Young woman delivers her own baby at home in Mackay, aka "Wow! You mean delivering babies isn't just something doctors do?"
JANE Santacaterina never wanted a homebirth but nobody told her baby. Little Braithe Williams arrived in such a hurry on Sunday afternoon, his mother did not even make it to the car. "My partner and I live at Dysart (in central Queensland) and I'd come to stay with my Mum at Andergrove for the last two weeks of my pregnancy, so I'd be closer to Mackay Hospital," said Jane, 20, yesterday. "When the labour pains started I went to get into the car and landed on the loungeroom floor. That's where I stayed."

With her contractions coming every two minutes, mother Ruth Santacaterina rang through to Queensland Ambulance Service emergency medical dispatcher Leighton Smith in Rockhampton. "He was brilliant, so calm. He told me what to do and I did it," Mrs Santacaterina said.
Fast-Tracked: Home birth quite a surprise for couple aka "Good thing dad was an EMT"
Maria and Michael Hernandez of Modesto never planned a home birth for their second child. It just happened that way and it went remarkably well. "It was like something on TV or a reality show," Maria said Tuesday, holding her daughter, Brianna. "I'm just glad my husband was there to calm me."...

Friday, her husband took her to Kaiser Modesto Medical Center for what they thought would be a routine birth, but after more than four hours, hospital staff sent them home to wait for Maria's contractions to get stronger. At 8:40 that evening, Maria's labor pains were getting worse and became intolerable by 9 p.m. As they prepared to return to the hospital, Maria went into the bathroom and her water broke. Soon after Michael ran to assist her, the baby's head was crowning, he said.

Michael said his training as an emergency medical technician kicked in. He spread towels on the floor in the bedroom and helped his wife to lie down. "As soon as she was on the floor, the baby was coming by herself," he said. "The majority of her head was coming out."

His mother, Maxine Mosqueda, was on the phone with a 911 dispatcher and they could hear the sirens of emergency vehicles responding to the call. The baby's head emerged, and the baby let out a cry. With another contraction, her shoulders pushed through and Michael pulled her out. He was clamping the umbilical cord when Modesto firefighters came into the room. Brianna Addison Hernandez was born at 9:17 p.m. Friday. She weighed 7 pounds, 1 ounce, and was 21 inches long.

As emergency personnel took mother and child to the ambulance, the parents passed through a sea of neighbors gathered outside the home. The baby appeared healthy and began to nurse during the ambulance ride to the hospital, the parents said....

Hernandez said the birth certificate, giving their home as the place of birth and noting the father delivered the baby, is something they will treasure. Maria was able to give birth without all the intravenous lines and noisy medical equipment. "It was scary, but now I think it was the most natural thing that could have happened," she said.
Dad's web guide to delivering tot aka "Blackberry Birth"
Desperate dad Leroy Smith resorted to Google with the request "how to deliver a baby" when his wife went into labour. He was so clueless when wife Emma suddenly started to give birth at home he opted to use the internet.

Mr Smith called a midwife for advice but before she arrived Emma, 25, began having powerful contractions. So the 29-year-old grabbed hold of his BlackBerry, accessed the internet and sought help from search engine Google for step-by-step instructions. And after following the detailed guide on the internet's wikiHow Emma safely gave birth to daughter 6lb 11oz Mahalia Merita Angela Smith....

"The BlackBerry told me that when I saw the head, I had to support it. And when the baby actually comes out, I had to place her on Emma's chest, then covered them both with a blanket and make sure they were both comfortable and relaxed. It was amazing. It was just us two in the house because the other kids were with their grandma - Emma's mum. The midwife arrived about five minutes after the birth and told me I'd done good. She clamped the umbilical cord and I cut it."

Mr Smith, a security guard, added: "I couldn't believe I had done it and Emma was such a soldier, no pain relief or anything. I knew the midwife was on her way but Emma went into labour very quickly, the whole thing only took about 40 minutes."...

Proud mum-of-four Emma, of Leytonstone, East London, said: "It's incredible that Leroy delivered our first daughter. The other three are boys. "I said to him 'you're Leroy Smith, you can do anything'. I had wanted a home birth anyway. And thank God for the BlackBerry, I'm never going to moan at Leroy about being on the phone again."


  1. Haha! This reminded me of Heather Cushman-Dowdee's recent comic, "Not News to Me!"

  2. Not only did the doctor get all the credit in the airplane delivery, the two nurses who initially assisted the mom got squat credit (as usual). Anyway, the mom deserves ALL the credit!

  3. Well, if they don't make a big deal about whoever "delivers" the baby besides the mom it's like admitting that women can give birth unassisted without the sky falling.

  4. Haha, Kate makes a good point. We can't have people think birth is EASY or that they can accomplish it WITHOUT DRUGS or NOT IN A HOSPITAL. They just wouldn't know what to do with that kind of crazy! ;)

  5. My google alert for "birth" has been kicking up a lot of those stories and I agree the umbilical cord clamping is a weirdly prominent feature. I've been thinking about quizzing people not birth-educated about what function they think cord clamping serves, and when it needs to happen. I'm kind of fascinated with how the clamping/cutting has embedded itself to be such a crucial part of birth, and I'd like to know what pieces of its medical context have embedded with it. The panic over clamping - in one story, a woman delivered in a convenience store parking lot and her mother ran into the store asking for something to clamp the cord with - is fascinating and makes me suspect that people will "know" you need to clamp the cord quickly but not be sure why.

  6. And that's how the media presents birth- birth is something that happens to women, not something they do themselves. And if birth 'happens' to you, you'd better hope there's someone around with a blackberry, or shoes with laces.....Oh dear.

  7. This round-up is awesome.

    We were waxing philosophical on Birth Activist about the media's cord cutting fetish and someone commented that every birth has to have a hero.

    It was kind of deep.

  8. I think the point about the UK story (baby born in hospital toilet) was that the woman was dissatisfied with her care and ended up giving birth in an unsafe place, given that she was 25 weeks.

    In her case, she wasn't listened to when she told 'hostpial workers' (probably midwives) that she was in labour. If you want to save a baby born at 25 weeks, you've got a better chance if the birth takes place in the vicinity of resuscitation equipment and a neonatal team. Sorry, I think you are way off base including this story with the others, because preterm birth at 25 weeks IS an "emergency" (or at least require urgent action).

  9. Gag.

    That's what I think when I read these kinds of stories.

    And you know what? After my UC, the #1 question I was asked was, "What did you do about the cord?".


    I never really know how to reply without coming off like some kind of biology professor. I am tempted to say "I ate it". Ha.

  10. I am viewing it from a different perspective. I gave birth to my daughter in February in the back of an ambulance. My labor progressed very quickly at home and then my water broke and my husband could see her head. My body WANTED to was incredible. But I was forced (my midwife, doula and dispatcher on the phone with my husband) to hold it in until the ambulance got there. My birth experience would have been so much more calm if I hadn't been trained to think that I had to give birth at a hospital! I gave birth in the ambulance during the 14 minute drive from my home to the hospital. My husband was driving our car following the ambulance. I feel that I was blessed with a quick birth experience...but I am also much more aware now of what my body is capable of and I plan to have a homebirth for future babies!

  11. A reality show? Gee I missed out! Where was my camera crew, my panel of dubious experts expounding on the birth, where were the midwives getting into hair-pulling brawls as I push?!

    My fame, my fortune...

  12. Rebecca - That sounds like a research project I would love to read about! I think you are right, people would "know for certain" that the cord must be clamped, and I bet that their answers to "why?" would be both sad and hilarious. It's like people are afraid once a baby is born, a bunch of toxic chemicals start coming through the cord!

  13. I mentioned to my midwife the story about the doctor who used his shoelaces to tie the cord on the airplane baby, and he was horrified. It hadn't occurred to me that our shoes carry all kinds of nasty germs, and the cord should never be clamped or cut with anything unsterilized. A doctor should know this.

  14. I'll admit it! I'm one of those people who thinks the cord must be clamped but has no idea when or why. Do tell.

    The saddest part about these "emergency" situations is they take a moment that should be calm where everything is fine and turn it into a terrifying crisis.

  15. I just had to post a comment! I'm reading 'Birth as an American Rite of Passage' by Robbie Davis-Floyd and just today I read this in Chapter 2:

    'Said one obstetrician, "I could never attend a home birth. I wouldn't know what to do."'

    This is exactly the problem. The people (OBs) attending the vast majority of births in this country believe there's something they have to do. Most of the time there's nothing to do except wait for the baby to come.


  16. I'm a Bradley teacher, and in one of our classes are included instructions on "emergency childbirth." I always like to highlight that the "don'ts" included (this is an old government publication) are nearly all what doctors do (don't pull on the baby, don't administer medication, don't pull the cord, don't clamp the cord).

  17. The thing that makes me roll my eyes whenever there's an "emergency" birth story is the idea that you have to make the mother lie down. Because otherwise the baby might fall out???

  18. Ah, it's such good evening news, though.

  19. My homebirth midwife gave us instructions on what to do and not do if she couldn't make to the birth on time. Of course we already had most of the supplies needed for the birth, so we didn't have to scramble for towels, etc. It would be nice if OBs would give their patients tips for staying calm if mom has a fast labor instead of turning it into an emergency.

  20. The doctor used his shoelace??!! Gross. Guess he missed the med school class covering the function of Wharton's jelly in *clamping* the cord. Or do they cover that in med school...

  21. Just thought of something regarding the doc using a shoelace to tie the cord. I hope they didn't wrap the baby in one of those airplane blankets. I don't think those get washed very often.

  22. You just *know* the panicked thoughts that were going through that doctor's head went something like this: "OH NO, OH NO, I haven't birthed a baby in 40 years, this is so scary, WHERE IS THE NEAREST EMERGENCY ROOM?, ok she's laying down WHEW that's a relief, this is something I can deal with...ooooh no I have nothing to clamp the cord with! SOMEONE GET A DOCTOR OVER HERE!"

  23. LOL Rixa!!!

    And, mmm, Yehudit, from what I can read, the UK woman went to the hospital exactly because she thought she was having a baby and she was told she wasn't and sent home.
    So not only is she showing that she knows better than a doctor (she spoke to at least one doctor according to the article) that she is in labor, she is also showing that this premie did not need a high intervention birth. The premie was lucky with such a persistent mom who did not go home.

  24. Maria,

    My point was that actually, unlike some of the other stories Rixa showcases here, the premature birth of a 25 weeker is indeed truly an emergency. Therefore the OMG!!! tone of the reporting is, in some sense, justified and the jokey "It's an emergency if you're not in bed--even in a hospital" is not really justified.

    As a general rule, I'm completely happy for women who have their babies in hospital toilets - or in the bathroom at home. I'm not happy that a woman in preterm labour at 25 weeks had her baby in a hospital toilet. Babies born at 25 weeks do need massive intervention in order to survive, and that intervention starts at the moment of birth. I'm all for natural, but in the case of preterm labour at 25 weeks, natural = death for the baby.

    It's not always an easy thing to diagnose preterm labour either. Abdominal pain in pregnancy is commonplace and the midwives and doctors presumably had some basis for thinking this was not labour. In fact, the incentive is to be "too cautious" in our response to complaints of abdo pain in pregnancy - to operate on the principle of "just in case". Isn't this part of the problem of modern maternity care? If we admitted every
    ?preterm labour even after assessment found no grounds for admission, then we would have no space in our antenatal wards for women with severe pre-eclampsia, grade IV placenta praevia at term etc...

    Yes, there are some times when we will get it wrong. And yes, we should listen to women (which is why the "OMG" is justifiable in this case). But please tell me where to buy X-ray eyes, a crystal ball and a retrospectoscope.

  25. Yehudit is right -- this one, though fitting with the overall theme, is or can be considered a true emergency, unlike the others which appear to be "normal" births. I don't think anyone should consider a birth at 25 weeks to be normal. Just a little over half of the babies born at this gestation survive.

    However, the tone of the article is that the shocking thing is that the baby was born in the toilet, rather than that the baby was born at 25 weeks. I'd be curious to know how the mother was assessed and labor was ruled out -- it seems like there must have been *some* dilation evident, which should not be the case at 25 weeks.


  26. I agree, the baby at 25 weeks would qualify as an emergency.

    What about THIS story, from our Arizona paper? I wonder if there was a true emergency that necessitated air lifting this woman out? And to think I hate labor in a CAR with my first (hospital-born) baby!

  27. I definitely agree that the 25 week part *is* an was all the fuss over the baby starting to be born in a hospital toilet--rather than the fact that the baby was so premature--that made me include the story. I think we all know that a 25-26 week baby will need a lot of assistance at first.

  28. @ Muffin Cake

    I was able to find a bit more info here:
    "the town in the Havasupai Reservation is one of the few places in the United States without motor vehicles. Most outsiders arrive there after a 10-plus-mile hike. Just after 6 a.m. this morning, the 33-year-old woman developed an unspecified medical emergency while in active labor. Her doctor decided she needed to be flown out as soon as possible. No medical transport choppers were available, so the DPS came to the rescue with its own helicopter."

    So the helicopter was due to the remote location, and no automobiles. Wonder what the "complication" was?


  29. I think we all know that a 25-26 week baby will need a lot of assistance at first.


    Which is why it IS a problem to have the risk of that baby being born in a toilet. (Not literally down the toilet, but in the bathroom). I don't know how familiar you are with UK hospitals, but the bathrooms are usually pretty small and my guess would be that this woman was on an antenatal ward, not the labour ward (I could be wrong). The immediate care required can be given effectively with the woman and baby in the bathroom.

    I have cared for women in preterm labour who have mobilised throughout labour and given birth on all fours. So, I don't have a problem with any of that, BUT I want them to be in a setting where moving directly to theatre is an option (preterm babies sometimes need caesarean section, if they don't tolerate labour well), where there is excellent lighting for the paed to visualise the cords for intubation etc..., where there is a resuscitaire and space for the team that will transfer the baby direct to NICU. None of these are true of a bathroom.

    I don't regard it as scandalous that the woman wasn't judged to be in labour (everyone makes mistakes and misjudgments - and the prospect of putting everyone on bedrest 'just in case' is pretty horrendous). But I can see that from her point of view the fact of almost giving birth in a toilet was very distressing. Hence the shock! horror! newspaper story (which must come from her, the hospital won't be trumpeting it).

    If someone presents with ?labour at 25 weeks, they will be fully assessed including CTG monitoring (which monitors contractions as well as fetal heart) and speculum examination. Some units use fetal fibronectin tests, but not all (I suspect this one doesn't, but it probably does now!) Obviously, it's a tabloid type of story, and we don't get told the type of assessment that was done, so there is no way of knowing what the picture looked like to the clinicians at the time. Women in preterm labour can progress very quickly.

  30. ooops, that should have been

    "the immediate care CANNOT be given effectively in the bathroom"

  31. Gotcha, Yehudit. I too was just reading the giving birth in the toilet part and the part where the doctor told her the woman she was not in labor. It is of course a true emergency to be born that early and I am glad the woman was in fact still at the hospital.

  32. I'm guessing the cord obsession is because, as others have suggested, it is something that someone else can actively do. There's almost a mainstream assumption that the cord starts pumping poison into the baby the second the baby is out or something. Since we can't give the mom much credit since she was dumb enough to go into labor outside of a hospital bed, than praise be the hero who dealt with the poisonous cord. Amen.

  33. I think you should put the title in quotes because we all know 99% of these deliveries are no more than normal, average, everyday BIRTH days.

  34. Add one more to the list:

    See the sidebar with the video about the kids all born on the same day.



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