It’s 2am on Saturday. I’m halfway through an obstetrics and gynaecology shift that began at 8am on Thursday and was due to end Monday at 5pm. Exhausted, I collapse onto the narrow bed in the cramped windowless room reserved for the junior doctor on call for the labour ward. After what seems like just minutes later I am roused from a deep sleep by the shrill call of the bleep. It’s 4am. The midwife is requesting that I attend a routine birth – “no rush”, she says. But some inner sense impels me to get up quickly. I feel alert and ready for action.
When I get to the labour room the woman is in the second stage of labour with two midwives supporting her. “A couple of pushes and we’re there,” one of the midwives says cheerfully. The atmosphere is jovial, expectant. The midwives and even the mother (between contractions) are smiling. But then the baby emerges – grey and floppy, like a rag doll. There is no cry, no sign of life. Just a stunned, frozen silence. Time stands still.
I have not been taught how to resuscitate a baby – only adults. I know that every minute (second!) counts. The midwife places the baby on the resuscitator and hands me the laryngoscope. She has been my companion at several difficult moments. Stocky, broad faced, with greying corkscrew hair, her calm, wise presence is always reassuring.
The baby’s heartbeat via the monitor is barely audible – a faint lub dub, ominously slowing down. My own heartbeat, in contrast, is thudding, fast and insistent. In the background, the mother asks anxiously: “Is my baby all right?” I mutter something, gently tilt back the baby’s head and open his mouth.
I take a deep breath. I feel the responsibility as a physical weight on my shoulders. I have to get him back – horrible visions swarm in my mind. Gingerly, but resolutely, I slide in the laryngoscope, pushing down the tongue far enough so I can see the tiny vocal cords. The midwife hands me the breathing tube. It slides in easily. We connect it to oxygen and she begins to squeeze the bag. Within seconds the baby is pink, protesting – his little arms and legs thrashing, his cough expelling the tube from his throat. Quickly and deftly we remove the tube and wrap him in a cotton blanket. He is now warm and vibrant – a life renewed.
We restore him to where he belongs – in the loving arms of his anxious mother. I hug the midwife. At that moment, the paediatrician (who had been called after the birth) crashes through the swing doors. Her eyes swivel from mother and baby to us – laughing, dancing, nearly crying with relief and jubilation.
That week, at the mortality and morbidity meeting, my seniors commended my intervention and cool-headedness. My relationship with the midwives, already surprisingly good despite tribal rivalries, was further enhanced after that event.
Since then, as a GP, I have always supported women who wish to have home births. In fact, the evidence supports many women to do so. But when it came to me, I chickened out and chose the hospital for the birth of my four children. I am aware it is that memory in particular that influenced my decision.
The midwife had found a “true knot” in the umbilical cord – a rare finding. Presumably it had tightened as the mother pushed the baby out. Prior to that there had been no sign of anything being wrong. It needed three of us – one to assist the mother and two of us to save the baby. But in today’s overstretched maternity wards there is no guarantee of having a three-person team there at the ready.
I sometimes wonder what happened to the baby – he would be grown up now, probably with children of his own. Maybe his mother told him the story of his birth, maybe not. But for me it endures as a moment of fear, triumph and wonder.
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