Leaving Enchantment

“Your baby is fine, Mary.” She smiled across the room at Steve, who was leaning against a wall. “And you’re doing great, too, Dad.” Steve mustered a small smile in reply.

“Here comes another…” Mary pushed as best she could through the force of the contraction. With legs open and feet resting on the birthing bars, she sat at a fifty-five degree angle, grabbing her thighs.

“Oh-oh-oh…”

“Good work, sweetheart.” Steve spoke in an attempt to be reassuring. He couldn’t watch anymore, poor man. Lydia was about to suggest he take a breather, when suddenly the baby was crowning.

“The baby’s coming, Mary!” the doctor said.

The next contraction came only seconds after the previous. “Keep pushing, Mary,” Lydia urged.

Valiantly Mary bore down and the baby’s head delivered—large, pink and topped with matted black hair. Oh, he’s beautiful, but Lydia no sooner had that thought than the head receded partway into the birth canal.

She glanced sharply at the doctor, who frowned in return.

“One more time, Mary,” he instructed.

The next contraction should have done it. Mary’s face contorted with the effort of pushing. But nothing happened.

Fear, sharp and cold, froze Lydia. Something was terribly wrong here. The baby’s shoulders were trapped within the pelvis.

“Heart rate is one hundred,” the nurse reported. She put in a call for more help and a second nurse arrived a moment later.

Come on! Come on! Lydia chanted silently as another contraction proved as ineffective as the one before. Lydia slid in next to the doctor.

“Shoulder dystocia?”

Dr. Ochoa nodded.

Lydia had dealt with this complication before and delivered healthy babies every time. Still, she was very relieved that she’d made the decision to transfer the birth to the hospital.

“Why isn’t the baby coming?” Steve asked. “Is this normal?”

Far from it. In this position, the baby’s supply of oxygen was compromised. Every second counted. But Lydia was trained to project calm, even in moments of crisis. “We’re trying, Steve.”

“Let’s reposition the mother.” Dr. Ochoa’s tone was becoming more curt by the moment. Lydia did her best to reassure Mary as the bed was lowered to a flat position. Each of the nurses took one of Mary’s legs and lifted it up and back toward Mary’s ears. The doctor swept his fingers inside the stretched tissue of the perineum.

Seconds ticked by. A minute.

Lydia empathized with Dr. Ochoa as he tried desperately to angle the baby’s head down to the floor. But this baby simply would not move. Ochoa was sweating now, trying various maneuvers in increasingly desperate attempts to release one of the baby’s shoulders. If he had to, Lydia knew he would break the clavicle. They were running out of time.

“What are you doing?” Mary could barely utter the words through her exhaustion.

“Trying to get the baby out.” Lydia glanced at her watch, calculating the time that had already passed.

Come on! Come on!

“But we didn’t—” Another contraction knocked the words out of Mary’s mouth. She bore down and Lydia prayed.

“Come on, baby!” His face was turning blue. They had to get him out, his heart rate was continuing to drop. Eighty. Now sixty. Blue skin deepened to purple, and Lydia fought to keep calm.

“What’s happening?” Steve searched faces anxiously. He and Gina were standing too far back for him to actually see the action.

More personnel flooded into the room. Among them, Lydia recognized Dr. Joanna Weston, an excellent local pediatrician. No one bothered with the pleasantries of a greeting. All eyes focused on Dr. Ochoa and the baby he was trying desperately to bring into the world.

“Try a lateral push.” The doctor continued to work at delivering the shoulder, while one of the new nurses applied pressure across Mary’s abdomen hoping to dislodge that stubborn shoulder.

“Come on, honey,” Lydia urged. “This will be the one that does it.”

And it happened. With a grunt of effort, the doctor managed to pull out the anterior shoulder, then the posterior one. The baby was finally out.

Normally Lydia felt relief at this point. But not today. The baby’s face was bluish-purple, his body flaccid and blanched.

His. The baby was a boy. And big. Lydia’s estimate had been correct. He had at least a pound on his sister.

But he wasn’t breathing. Lydia watched the doctor check for a pulse. She could tell by Ochoa’s furrowed brow that he didn’t find one. He clamped and cut the cord, then passed the baby to Dr. Weston. She was the only one who could save this baby now.

Dr. Weston moved quickly and efficiently. She suctioned the baby before beginning to bag him with oxygen.

“Oh, my God. Is my baby okay?” Mary started to weep.

Turning from the resuscitation efforts, Lydia focused on Mary. She smoothed Mary’s damp hair and murmured softly. Gina, she noticed, was patting Steve’s shoulder.

As she repeated meaningless, comforting phrases, an internal dialogue ran through Lydia’s mind, a prayer for the baby lying lifeless under Dr. Weston’s care. Oh, Lord, please let this baby be all right. Please let him be strong and healthy like his sister. Mary and Steve are such good people, excellent parents. Please…

As Lydia prayed, Mary began to bleed. The flow was too heavy. The doctor inserted his hand into the vagina to see if the placenta was separating.

The next second Mary’s eyes rolled back and her body fell limp. She immediately turned blue.

God, no!

“We need oxygen! Fluids!” Dr. Ochoa ordered tersely. “And let’s get a second IV going.”

Lydia stepped back to give the nurses and doctor better access to Mary. The primary nurse began to bag her with one hundred percent oxygen.

“Code blue to room three-twelve stat.”

As the nurse summoned yet more help, Lydia guessed what had happened. Amniotic fluid embolism. She’d seen a few in her career. When the amniotic fluid was sucked into the mother’s circulation, the results were instantaneous and often dire.

This whole delivery was turning into the worst obstetrical nightmare anyone could imagine.

Lydia thought of little Sammy, probably sleeping at just this moment. That little girl needed her mother. They couldn’t lose Mary tonight. They just couldn’t.

While the nurses concentrated on their jobs, Dr. Ochoa delivered a complete placenta. Blood from Mary’s uterus flowed freely onto the doctor’s shoes, splattering onto the tile floor. The second nurse massaged the uterus frantically, but the bleeding continued.

“Pitocin!” the doctor ordered.

Another nurse, having anticipated this need, got the drug flowing through the second IV. At that moment the crash cart and team arrived and Mary was intubated. The team frantically tried other drugs to try to stop the bleeding.