I'm on duty tonight at the station, covering for a friend who's sick. It's been fairly busy here tonight, car accidents and injuries across the county - just enough to keep us hopping and make getting something for dinner almost more of a challenge than it's worth. But something happened tonight that once again gives me that little kick that reminds me why I do this.
We got dispatched at about half past 9 o'clock tonight for a sickness call - nothing unusual there - but the additional dispatch information was a bit odd - "woman bleeding, 39 weeks pregnant, contractions one minute apart." EEEEK! It was initially a bit strange that this was dispatched as a sickness, not as an OB, and that there was a medic added to the call in addition to the ambulance, but it turned out for the best in the end.
The initial scene was a bit chaotic, as these things often are - Mom is laying on the hallway floor, in active labor, Dad is standing behind her, looking distraught, still holding the phone, and there are six strangers all carrying bags suddenly in the entryway. We had her hooked up to the monitors within the first two minutes we were on scene, and as soon as we verified that her contractions were indeed only about a minute apart (the longest was a minute and 10 seconds), we knew that it was time to hunker down and get ready to catch a baby - it's not a good idea to start moving the mother when contractions are that close together. Mom was MOST unhappy with our decision, since we had no pain meds to give her, and I felt terrible, but we explained that it was the safest option for her and her baby, and she acquiesced, albeit a tad grumpily. I ended up at Mom's head holding her hand and monitoring her breathing, while my crew fetched her cool towels and ice chips and the boys on the medic unit hunkered down to catch her boy.
Mom said that her water had broken about 9:30, and almost as soon as we had her settled on the blankets we put down on the carpet she said that she needed to push - YOWZA! I took a moment in my own head to sympathize with this woman who was lying on her living room floor, naked from the waist down, with a half a dozen strangers watching her writhe in pain. I must have reassured her a hundred times that she was in good hands and that we wouldn't let anything happen to her or her baby, and I felt for her embarrassment - her whisper that she had to go to the bathroom, her worry that she was making a mess. I am glad for her sake that there were two females on crew tonight - I cannot imagine one of the guys holding her hand, stroking her forehead and reassuring her that it would all be OK. She was in a pretty decent amount of pain - her abdomen was rock hard, she was sweating profusely, and she had a death grip on her husband with her right hand and on me with her left. Her husband was trying to reassure her to the best of his ability, but I think he was just as terrified. I don't normally offer effusive compassion to my patients, but as I was kneeling on this woman's living room floor, my numb fingers bloodless in her grip, looking directly into her eyes as she whispered to me that she was scared - I would have promised her anything she wanted to hear to alleviate her fear. I am incredibly thankful that the birth was textbook perfect, and that there were nothing but good things to convey - I had a crew with me that was experienced, that was cohesive, and all of us played our parts to perfection - even the universe, since every single moment of the birth went smoothly.
I will say that I am not a fan of delivering children - it is a messy, chaotic process that had enormous potential to go wrong. There is enormous responsibility conferred and great vigilance required during a birth - even a perfect one - as you have not one but two patients, both fragile in their symbiosis and achingly vulnerable to even the slightest danger. However, I have been present at more than a few, and every time I am awed.
A poet named William MacNeile Dixon once said: "Birth is the sudden opening of a window, through which you look out upon a stupendous prospect. For what has happened? A miracle. You have exchanged nothing for the possibility of everything." The incredible thing about being present at a birth is that you can feel the miracle. There is an intimacy that happens, even when you have bright lights shining in your eyes, equipment strewn everywhere, and a dozen people around you performing menial tasks - everyone's focus is on the arrival of new life - your hands may be busy, your mouth may be moving, but your ears are listening, straining to hear that first wavering cry. For every moment that the silence grows, your shoulders tense and your neck tightens, until the first mewling cry sounds out, and every one gives a silent sigh of relief and goes about their tasks with a somewhat lighter heart.
I lived all of those things tonight - Mom was only in labor for 18 minutes, but it seemed an eternity to those of us kneeling on the beige carpet in the hallway. We bit our lips in sympathy every time she cried out with a contraction, we formed assembly lines to maneuver around the scene debris to get her cold washcloths and ice chips, we all leaned just a bit forward when Bob announced that she was crowning, and we, every one of us, held our breaths as his head and shoulders cleared the birth canal. He was born in a rush, amniotic fluid gushing out behind him, and though he was born face down, he began to cry the moment Bob turned his face up to the light. He was loud for a little guy, and his cry was strong and disgruntled, which is a more positive sign than you might think. If you were suddenly thrust from somewhere warm and comfortable and safe into an environment that was loud and bright and cold - don't you think you'd be a little torqued off? That's why disgruntled babies are good - cry away, little man, it lets us know you're healthy.
I think I got baby responsibility by virtue of being the closest person to Bob, but I don't mind. I have a slew of nieces and nephews, and Baby Charlie, at 8lbs 2oz, was actually almost twice as big as my last nephew when he was born. I always forget how small they are, and how perfect. Charlie came out with a full head of dark hair, tiny stubbly eyelashes, ten tiny fingers with slightly blue nails, and perfect little feet that he immediately tried to tuck up for warmth. We got him bundled up in a blanket and put a stocking cap on his head, while he stuck his fingers in his mouth and sucked on his thumb or his fingers all the way to the hospital.
It's pretty critical to keep babies warm after birth, and since it was fairly chilly out tonight, we broke out our hypothermia reflective blanket, and wrapped it around the bunting we had initially put Charlie in. The reflective blankets are a space age polymer that looks like really flexible aluminum foil - it's a bright shiny silver and crackles when you move it. The boys joked about the reflective blanket being necessary to ward off my death rays (which thus far are limited to technology), but he really looked like a little mini burrito wrapped in foil - one Charlie Chipotle, coming up!
So we kept Charlie warm, and got Mom bundled up, and delivered Mom and baby to the hospital with no problems whatsoever. I started to relax at this point, thinking it's all over, and I realize what a good job we've all done, and how well things have really gone. They are here in the hospital, there are nurses and doctors taking over, and our job is pretty much done. I've turned Charlie over to a nurse who cleans him up and puts him under a warming lamp, and I've helped the nurses get Mom into a gown and situated on the bed. And then the coolest moment of the whole event happens: I'm standing there in the Birthing Center, holding Mom's hand as the nurses try to deliver the afterbirth, and I look over at Dad, standing by the incubator, just inside the circle of light cast by the warming lamp. He's just standing there, hands in his pockets, completely still, but there's this look on his face that's incredible. He had explained to us before that he was in Iraq when his daughter was born, and that he had missed much of the experience of being a father by being away at war. I looked over at him, contemplating his son, and you could see in his face how moved he was - how awed he was by the miracle of this tiny person who had emerged from the chaos of this evening and was sleeping, perfectly content and at peace, as if all was right with the world.
I'm not a very religious person, and I'm not inclined to sentiment, but it's been said that a child is God's opinion that life should go on, and tonight I'm inclined to agree.
Welcome to world, Charlie. May your life be as beautiful as your birth.
Mel,
This is the most beautiful story. Your descriptions and details painted the chaotic scene. I'm so happy that all is well with patients and crew. How wonderful for you to have experienced life's beginning instead of so many of life's complications you are called to "clean" up. You are a better woman for these experiences. Keep up the good work. You are truely an angel that is completing work set before you! Miss running with you. You were the best crew mate I had!
Danielle
Posted by: Danielle Wood | February 19, 2009 at 13:55