Delivering babies is a magical and at times, terrifying process. More often than not, things are smooth sailing, but the times when they are not are when you have to tell yourself to calm down and not to panic. In school, most students going into a medical profession will learn some "cardinal rules of medicine". These “rules” are there to help you when things get tough and also to make sure you can help patients as best you can. This week, one of these rules, Rule #2, was tested out as I helped deliver a set of twins to a sweet first time mother.
During our typical morning rounds, the midwives presented us a first time mother who had come to the hospital late in the night for labor pains. She was at term (>37 weeks) and ready to meet her new babies; however, ultrasound revealed that both babies were breech (butt first instead of head first like they should be). Due to them being breech and the fact that there were two of them, we decided it was necessary to perform a C-section.
After she was prepped and ready to go, Dr. Enoch started the delivery. Within a few minutes, the first baby came out. It was a big, healthy boy with a strong cry. He was taken over to the newborn table before Michelle started to dry him off and assess him. About a minute later, the next baby, a girl, was delivered. Unlike her twin brother, she was not crying. Concerned, we quickly brought started to warm her up and rub her chest to stimulate her lungs. Normally this works pretty well and the newborn will start taking some breaths. This little girl however could not seem to get her lungs to work. While I continued to stimulate her and suction out her mouth and nose, the midwife got the newborn bag-mask to start giving the baby ventilation. Thankfully we didn't have to give her ventilation long before a small meek cry squeaked out. We continued to support her airway and supplied her with oxygen until she was crying strongly on her own.
In reality, the entire time that the baby was not breathing on her own was probably less then a couple minutes, but when you’re in the moment, it can feel like hours. No one wants a patient to stop breathing or die, especially a newborn. In times like these, it is easy to start to freak out. You start to worry that the baby hasn’t had enough oxygen and that they could have brain damage or organ damage or worse, that they may not survive. In medicine though, you have to set your feelings aside for a moment and do what you have been trained to do because it's times like these that if you panic, you forget what you have been taught, start making mistakes, stop helping the patient and possibly start harming them.