No Guarantee

Note: This story was based on a true story I experienced when I worked in Obstetrics.

 

I felt my body sway slightly. Tears stung in my eyes. A chill tore through my body as I stood in the hallway, isolating myself from the reality beyond the double doors. I had an ominous feeling that I would never become a nurse.

The OB department had always been such a happy place to work. Expecting parents would come to us harboring smiles, jelly beans, cameras, pillows, recorders, instruction books and baby clothes. After a few moans, a baby cried. Everyone was excited. It was a happy place to work.

I looked down at the doctor’s gown I was wearing. It had been sprayed with blood. My shoulders and arms ached miserably from wanting so badly to pull the trapped baby from the mother’s pelvis, but could do nothing but watch the doctor in his struggle. He was on his knees in sticky blood that oozed from the mother’s huge episiotomy, while he twisted and turned the baby’s head, trying to dislodge its shoulder. My stomach cramped from wanting to help the mother push, but I could only stand there — wanting to grab this baby that should have been delivered minutes earlier.

 

babyThe delivery began no differently than any of the hundreds I’d seen before, with the expectant mother puffing and pushing, while her husband sat at her head and coached her the way he had been taught in Lamaze classes. We were all in good spirits, laughing and trying to guess the baby’s sex by the wrinkles on its head. The mother took a deep breath and pushed hard. The baby’s head popped out.

“Suction,” the doctor said. I handed him an ear bulb syringe. He forced the baby’s mouth open and suctioned the watery mucus from deep within its throat. This caused the baby to cough up even more. The cord from the placenta was short and became lodged between the baby’s neck and the vaginal wall of its mother. This meant the oxygen could be cut off if the baby was not delivered soon. The doctor squeezed his hand inside the mother’s pelvis to find the baby’s shoulder. Something was wrong. The doctor’s breathing pattern changed. He looked at me with widened eyes that revealed an anxiety I had never seen in him before.

“It’s a shoulder dystocia,” he whispered.

My heart began to race. I knew what he was talking about. I had read about it in obstetrical textbooks, but had never actually seen one. It was something that happened rarely, after the birth of the baby’s head; its shoulder then becomes trapped in the pelvis because of a short umbilical cord. With each contraction from the mother after this occurs, large amounts of blood are transferred from the baby’s trunk to its head. If the infant is trapped in this position for long, brain hemorrhage or neurological damage may occur.

There was no time to explain all this to the father, who by now knew something was terribly wrong. He began to sweat profusely and became very pale. He was escorted quite willingly to a nearby lounge. The doctor pointed to the circulating nurse to get her attention, then pointed his thumb down. She knew what that meant. Anesthesia was called immediately.

My face became hot from the spotlights, and I began to sweat. The doctor told the mother to push harder, but the baby wouldn’t budge. He tried to slide his hand behind the baby’s head to grab an arm.
The baby’s face by now was deep pink. I felt my insides trembling. I tried to remember what I was taught in class about emergencies: “Detach yourself from the patient to assure a clear mind. Emotions cloud technical skills.” Demanding myself to remain calm, I looked down at the baby’s head. It had turned from deep pink to deep purple. By now Anesthesia had the mother intubated and asleep.

The doctor had a choice to make — either a cesarean section that may be risky because the baby’s head was so tightly wedged between the cervix, or to try a delivery. He squatted down for better leverage, all the while trying to free the baby’s arm from its locked position. I picked up two clamps and a pair of scissors to cut the cord, but the cord was too short to cut. The baby’s eyelids were getting puffy. My stomach began to feel queasy. The doctor, on knee by now, was showing some panic.

“It has to come out! It has to come out!” His voice sounded like an explosive hiss. Then he took a deep breath, composed himself, and mumbled something about a clavicle. Then I heard a crack. By breaking the clavicle of the baby’s shoulder, he was able to gain more space to pull down the right arm, then the left arm and finally deliver then entire infant.

A second anesthesiologist was ready with oxygen at the warming bed. The mother, now awake, pleaded for someone to tell her about the baby. All eyes, except mine, were on the baby. She looked at me in a painful, pleading way and begged for me to tell her that the baby was okay. It was then that I could take no more. I asked the nurse for relief for some reason I can no longer remember. When another tech appeared I quietly slid out of the room. The truth was that I couldn’t bear to watch both the birth and death of this infant who had not yet even felt its mother’s embrace.

At the scrub sink I tore off my gown and mask and threw it in the bin. I couldn’t breathe and needed air. I tried to detach myself, but just couldn’t. That baby was being strangled right in front of me! I wanted to leave the hospital and never return — to forget nursing completely. I blinked the tears away as I left the birthing room area, heading to the rest room. But someone stopped me.

“Is she…the baby… are they okay?” The shaky, anxious father was standing in front of me, with sweating hands still clenching the unused camera. What could I say to him? I was unsure of the consequences myself.

“The doctor is doing the best he can. I don’t know anything else. I’m only an O.B. technician, not a nurse. I’m sorry I can’t tell you more.”

It was a “cop out” line. I knew it and he probably did too. If things were fine I would be more than qualified to tell him. “Technician!” The word stuck in my throat. If I were a good technician I would be in the birthing room right now, opening up sutures, setting up needle holders, sponging and snipping catgut while the doctor repaired the mother’s episiotomy.

In the rest room I pressed a cold washcloth to my face and neck. It brought some life back to me. After some time I realized that there was no “happy place” in the hospital, and that the medical profession was not always fulfilling. It was sometimes frustrating and painful to experience the helplessness that occurs when everything possible is tried to help an individual, and sometimes even that is not enough.

 

Copyright 1988
Spirits Magazine 1990
Hoosier Horizon magazine 1995
**The above printed material is copyrighted, is registered with the Library of Congress and is the property of Sharon Palmeri. Permission is needed before use. Thank you! *S* **

 

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About Sharon

Sharon Palmeri received her BS degree in English and journalism from Indiana University Northwest and IU Bloomington. As a published author she has taught in all areas of writing for 20+ years, and has had over two hundred articles and stories published in magazines and newspapers. She freelances as a ghost writer, editor, book doctor, publicist, and publication consultant. She also has worked as content editor, adviser and book layout designer.
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