Having just finished another month in the newborn nursery, I thought I’d share one of the more exciting deliveries I attended. As the pediatrician on call, we are called to attend the high-risk deliveries. These include any preterm births, C-sections, deliveries requiring the use of forceps or vacuum, deliveries where meconium is present in the amniotic fluid, and essentially any delivery where there are signs of fetal distress. While the OB doctors handle the actual delivering of the baby, we quickly take over to resuscitate the newborn infant when necessary. This can include anything from simply bulb suctioning, drying, and stimulating the infant, to intubating, deep suctioning, and/or performing chest compressions. You never know what is going to happen until it actually happens.

One particular night I was on call, I could tell from looking at the list of women on the Labor & Delivery service that it was going to be a potentially very busy night. There were several women in the unit, and any one of them would be at risk for a very precipitous delivery, resulting in an urgent page during the night. When we get the urgent page to come to a delivery, it means, “Now!!” and we literally run. It doesn’t help that the pediatric resident call room is one flight of stairs up and down a very long hallway from the delivery rooms. I had a feeling that this would be a “sleep in my tennis shoes” kind of night, which is seriously what I have to do when I’m expecting emergencies (no time to lace up your shoes!).

Sure enough, the night turned out to be quite busy, and I finally laid my head down on my pillow to catch a quick nap around 4 o’clock in the morning, with tennis shoes on under the covers, of course, even though I didn’t anticipate any more deliveries to attend for the rest of the night. Well, it was a good thing I kept those shoes on, because at 4:20 a.m. I got the most urgent of the urgent pages, so I jumped out of bed and took off running. It was chaos for a minute as I quickly grabbed my mask, cap, shoe covers, and gloves by Labor & Delivery, asking the bustling people around me what the situation was.

Incredulously, I heard that one of the mothers in labor had “coded,” meaning that she had gone into cardiac arrest and stopped breathing completely. They needed to get the baby out immediately! I quickly gowned up and was then told that there was no time to move the mother into the back operating room where the C-sections and risky deliveries are normally performed. They were doing an emergent C-section delivery in her very labor room! I ran to her room where I watched the obstetricians performing a classic (long, vertical incision) C-section in her bed, doing their best to keep things as sterile as possible under the given conditions, while the anesthesia team continued to bag mask the mother to give her the oxygen she needed.

The feeling in the room was absolutely crazy and intense. I yelled over the noise, “I’m right behind you!” so the obstetricians could locate me in the midst of all the other gowned medical staff crowded into the small room. They pulled the baby out, clamped the umbilical cord, and practically threw her into my arms. I turned around and shouted, “Please move!” as I ran (I usually never run with the babies, but this was a special circumstance) through the crowd of people gathered outside the room, down the hallway to the pediatric resuscitation room next to the operating rooms where the little one should have been delivered.

The rest of the pediatric team was there waiting for us with all the equipment ready to go. The baby was not breathing, had no movement, and had very poor color and tone. At one minute, we gave her an Apgar score of only 1 (out of 10), for a very weak heart rate. We gave her oxygen through a bag mask, suctioned the fluid from her airway, and tried to stimulate her by rubbing her vigorously, but there was no response. At three minutes, we called the neonatologist to tell him he’d better get on his way to the hospital while we grabbed the equipment to intubate her, and then she suddenly started crying. A beautiful sound! She pinked up quickly and continued to scream, so that by five minutes we were able to give her an Apgar score of 8.

With the baby doing so well, we allowed the father to come back and spend some time with her. He had been escorted out of the mother’s room when the code was called and had no doubt been beside himself waiting while his wife’s and child’s lives were on the line. At this point, all we knew was that the obstetricians were still trying to close up the mother’s incision and there was a lot of bleeding. Her heart was beating, but we didn’t know much else. But here we had a beautiful, perfect baby. It was a sweet moment to see a grateful and overwhelmed father hold his healthy newborn baby’s hand.

I guess I take for granted the incredible miracle and risk that childbearing is in this era where we have three-dimension ultrasounds, medications, and the medical technology and skills available to anticipate most problems before they occur. We can induce labor at any time, perform complex gynecologic surgery to protect women at high risk from pregnancy and childbearing, and even keep babies alive as early as 24-weeks gestational age.

In this case, however, it was the medical technology itself that almost cost the lives of a mother and her unborn child. The truth came out shortly after this series of events that a potent narcotic had accidentally been administered to the mother in a quantity that was ten times the normal dose, and this had been the cause of her arrest. Thankfully, after hours of repair and a stay in the intensive care unit, the mother, last I heard, was doing fine. And you can bet that this family will not have any medical bills to worry about in order to prevent any litigation, which they would certainly have every right to pursue!

Anyway, this is my shout out to all those brave moms out there who undergo more physical, emotional, and psychological stress than I can imagine and sacrifice all that they can to bring such beautiful, little spirits into the world! You are all amazing.