Babies, and their entrance into the world, are always unpredictable. At this point in my short residency career, I have delivered about 12. By the middle of my weekend on call, I felt pretty darn comfortable with the process. The head is delivered with a little downward pressure, followed by one shoulder, then the next. The rest of the body is delivered quickly after. Then, with a swift move of the hands, you flip the squirrely little neonate into a secure football hold while you suction out his nose and mouth and clamp the umbilical cord. Seems pretty straightforward right?
Ha. Today’s call day reminded me that I am a mere intern with a lot to learn.
Working in triage today, I hear the team call out, “She’s complete (read: fully dilated)! We’re taking her straight to L&D!” Being the team member assigned to vaginal deliveries, I hop out of my seat and follow the patient up to the labor floor. We rush into the room and everyone takes their places. Patient is moved to the bed, nurses pace around frantically setting up for the delivery, and my attending physician, Dr. T, and I gown up in what one patient called our “storm trooper outfits”. It’s true. Baby deliveries are messy! You have virtually every body fluid being thrown your way at any given time. You’ve got to protect yourself! So, we don our face shields, surgical boots, surgical gowns, and sterile gloves. Now the process of pushing to delivery can vary anywhere from a couple of minutes to a couple of hours. As the baby catcher, you generally have a bit of time to get mentally prepared for the upcoming events. Alas, that was not the case today.
One push and the baby’s head slides out easily. Too easily. My hands on either side of the head alternate between applying upward and downward pressure to ease out the baby’s shoulders. All of a sudden, the rest of the baby catapults out. I try clumsily to secure the baby in my football hold but can’t get a grip on her legs – she just comes out way too fast. Before I know it, in painful slow motion, I am fumbling to keep this baby in my grasp. And everyone is watching. After a split second in real time (but eons in my brain) I regain my grip. Like a magician pulling a rabbit out of a hat, a jump up with the baby in my arms. Ta da!!! “Here is your beautiful baby girl!” I quickly clamp and cut the umbilical cord and place the baby in her mother’s waiting arms. A decent recovery but my face still burns with embarrassment. Shaken and struggling to remember what to do next, I undo the clamp on the placental sided umbilical cord to collect a routine cord blood sample. I replace the clamp and hand the specimen off to the nurse. When I look back there is umbilical cord blood spraying all over the place. It’s hosed the floor, the nurses, my boots. Apparently, in my self-conscious stupor, I replaced the clamp but did not secure it shut. Don’t worry, everything that came out was from the placenta, not the patient, so no one was hurt by my debacle. Just my increasingly fragile intern ego. And my happy place with those labor floor nurses.