Breech baby delivered with umbilical cord complications
As EMS workers, we often times get “Woman in labor” calls. However, most times when we arrive the patient has already found a ride to the hospital or after our initial exam it is obvious that she will not be delivering any time soon. Maybe this is their first pregnancy or perhaps it was a family member that panicked and thought that the patient might deliver at any second. In any case, most of these calls continue on without any real urgency, and we can have the patient at the hospital safely with hours to go before the baby is delivered.
On a hot September morning at about 3 am, I was awakened from sleep at our station from the dispatch tones with information of “Woman in labor”. Of course we got moving as quickly as possible, but we also knew in our minds that this run is probably going to turn out like the majority of others similar to this. Dispatch information was that this patient was in a home that was located about 25 miles from our station, so we had the local volunteer fire department also enroute.
About 10 minutes from the scene I received a phone call on our cell phone from one of the firemen at the scene. I knew instantly that there was a problem by the absolutely frightened tone in his voice. I still remember his words, as if it were only yesterday. “Jamey, all I see is feet!!” Having a good idea what he meant, but trying to lighten the situation a bit, as well as make sure I heard him right, I replied “Who’s feet? Mine, the patients, yours, the neighbor next door, can you be a bit more specific?” He quickly replied, “The baby’s, and he is still not delivered!” This was the point at which I became wide awake.
My driver and I arrived on the scene a few minutes later to find several firemen outside the house. They all pointed us to a very small bedroom inside the rural home. I will never forget what I saw when I entered the bedroom. What stands out the most was the cowboy hat. The young woman was lying on her back, and the volunteer fireman was at her feet. He was wearing a large wide brimmed cowboy hat, and it struck me as a very funny scene.
My exam of the patient revealed a 16 year old patient at full term pregnancy. She had been hiding this fact from her parents, and had tried to deliver the baby by herself during the night, while her parents slept. The baby was coming breach, and upon my first exam, I could see the infant’s lower legs to about the knee joints. A quick phone call to our local ER doc, and I had permission to finish the delivery there, in the home.
Delivering the baby up until the neck area went very smoothly. The patient, although young and small build, handled the delivery very well. However, upon seeing the baby’s neck, I noticed the umbilical cord wrapped around the neck. Since I still had the ER doc on the phone, I was able to take his advice on how to move the cord, which I did and continued the delivery. The rest of the delivery went smoothly, and we were presented with a very healthy baby girl.
During the ride into the hospital, the mother seemed very distant. Knowing that she was young and scared, my female partner tried to comfort her, to no avail. The father of the child was also present and was very much interested in holding and crying over his new daughter. We later found out that this young mother had given her baby to the father, and wished to not have contact with them any further. As it turns out, she did not want the child from the beginning, and had broken up with her boyfriend long before.
As a greenhorn Paramedic, this was one of my first runs and I will always remember it. I was scared but with the help of a great partner, calm and collective ER doc in my ear, and an outstanding Paramedic education, I managed to get through the situation.