Earthquake Reflections 2-Last week OB night call.

Well I never 'officially' took first call but many nights when I woke to a Haitian women 'singing' through labor I'd wander up and use my Creole and years of coaching labor patients to advise the lady and her family how to improve the situation.

This night differed from the other nights in that when I arrived the pharmacy and OB area I found no lights on and all the doors locked. Not finding any of the Haitian nurses to inform me about the two singing ladies I took my own histories. One informed me that this would be her 5th child and she had been checked 'earlier'. The younger lady labored for the first time.

Now from past experiences I've learned never to trust a lady in labor-not even for the first baby but my trust level drops as the number of children goes up. Also one could assume that as the ladies had been checked and then left on their own that they had been in the early stages of labor but how long ago?

Nervously I hunted for the person with the key to the pharmacy/OB room. My pace quickened as one of the singers shrieking set off excited yells that the baby was coming. In the dark I fumbled my way through the pharmacy, grabbed some gloves, turned on the light of the OB and opened up the door.

Checking the first time mom where she stood by the bench the emergency became clear. When her waters broke the cord prolapsed out ahead of the baby's head. Now if mom pushed at all the baby's oxygen supply could be cut off causing brain damage or death. Please Lord let us help and have a good baby.

Rapidly her family and I moved her into the OB room while yelling for help. Getting her on her knees in a head down position took some doing as she didn't understand the urgency. Now with my hand pushing the little one's head back from the cervix and with gravity helping we needed to plan.

• Check for baby's heart rate. Normal.
• See if any medication to slow and weaken the contractions could be found. Yes! She received the shot which should make my job easier-keeping that head from pushing on the cord.
• Call the local hospital to see about an Emergency C-section. They said they would be waiting.
• Get another doctor along to catch the baby as I could not leave my job until after the baby's birth.
• Get yet another doctor for the delivery of the second lady -now singing with greater intensity.
• Then while still holding the baby's head back the mother and I needed to move together-her getting on a stretcher-out the door, across the dark rock filled yard, up onto the back of a pickup truck, back off the truck, into the hospital, onto the OR table.
• We then rotated the mom into position for her spinal anesthesia, Foley catheter and preparation for surgery. I lowered my body as low as I could-hand now painfully cramping with the effort to protect the cord-as the surgical drapes descended around my head and body. Even in this strange position I enjoyed the air conditioning.

Soon I felt the lifting of the head as the pressure on my fingers released. I followed the baby out of the OR into a near by room. After incubation and suction he received a few minutes of oxygen with the help of an ambu-bag. He received glucose and volume though an umbilical line. A dose of antibiotics and a lovely blue outfit with matching hat and blanket.

He and mom did fine according to the report from the hospital later in the day. The second mother delivered her baby and left for home before we returned to the campus. Thank you Lord.