14 year-old mom survives a delivery room emergency- An Amazing Childbirth Story

The young mother was not at all prepared for what was about to happen to her. Unfortunately, neither were her doctors.

It was my first time in the delivery room at the University Hospital. The doctor “training” me was an intern with 3 weeks experience. Our combined knowledge and experience would have filled a page and a half in a medical textbook. But there we were, attending the delivery of a 14 year old girl. That is not a typo. The mom had gotten pregnant as an 8th grader. She was from Mexico and spoke no English at all.

The birth of the baby was routine, and the intern performed the delivery of the baby without any difficulty. The umbilical cord was quickly cut and clamped and the baby handed off to the nurse.

The intern then turned to me, “Want to deliver the placenta?” It wasn't a hugely difficult medical procedure, but third year medical students take what they can get.

“Sure!”

I switched positions with the intern and grabbed hold of the clamped umbilical cord. I gently pulled downward. Nothing happened. I continued to pull for a few minutes. Seeing no progress, the intern instructed, “Pull harder.” So I did. Still no progress. The intern repeated the instruction. A few minutes more, still no progress. I thought I as pulling pretty hard, but according to the intern I wasn't as she instructed me to increase the downward traction even more.

Finally the amount of visible cord began to lengthen, indicating the placenta was on its way out. But what appeared between the mother's legs did not look to me like a placenta at all. It was big and round and purple, with lots of veins. It looked like a martian head. (If martian heads actually existed and came out in delivery rooms!)

“Oh my God! What is that?” exclaimed the intern who was watching me. As she verbalized the question the answer came to me, the words came out of my mouth simultaneously with the realization of what it was-

“It's the whole d--- uterus!”, I said as quietly as I could.

I had pulled the cord so hard that the girl's uterus had turned inside out and come out with the placenta still attached. The uterus was now located outside of her body. I lacked experience, but I was pretty sure that this was NOT a good thing. (I later learned how bad it actually was. If the placenta detached while the uterus was out, the uterus could not contract down to stop the bleeding and the mother could bleed to death. If the uterus contracted with the placenta still attached, it would take a lot of medication and skill to safely put it back. It was a race against time.)

“What do we do now?” I whispered.

“I don't know!” was the intern's non- reassuring reply.

The nurse, who actually had experience, reacted quickly and called for the senior doctor on the OB unit. The doctor arrived quickly, and surprised me by rapidly pushing the intern aside. She then used her balled fist to forcefully shove the uterus back inside. I vividly remember repeatedly seeing the outline of the doctor's fist through the mother's abdomen as the doctor worked to make certain that the entire uterus had completely returned to its correct position, and would stay there.

I also remember wondering- what is this young mother thinking? She was alone. There were no family members with her in the room. She was in a foreign place surrounded by doctors and students she did not know, speaking a language she did not understand. She had to have felt significant pain given the pounding pressure of the doctor's hand inside her body, and she did not even know why. Things happened so quickly no one had taken the time to explain. And- she was only 14 years old.

14 years old... about the same age that Mary was when she gave birth to Jesus. We have sanitized the Christmas story and ignored the pain of childbirth, the bleeding after the placenta released, the cramping that came as she nursed her baby, and the vulnerability of that young family. Mary was in an unfamiliar city, alone except for Joseph, her young husband. Shortly after the birth shepherds arrived, strangers intruding on her first moments with her son, relating an incredible story of an angelic announcement. What was Mary thinking?

The story of the young girl in the delivery room reminds me that Mary's experience was not all halos and choirs. Childbirth, especially to a young woman in a strange place, can be a frightening experience!

- Bart

This is the 4th of Six Amazing childbirth stories. you can read the previous ones in our archives, and subscribe to the blog to have coming posts delivered straight to your inbox. 

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The Baby is Healthy, but the Doctor Needs Surgery- An Amazing Childbirth Story

Moments before delivery, the concerned mom paused to ask the doctor, "Are you okay?"

Very few woman choose natural childbirth, mostly because it hurts really bad and epidural pain relief is safe and effective. This patient was the exception. She was determined to deliver her baby naturally, no medications at all. As a result during labor she could move and position herself as she pleased.

When it came time to begin pushing, she asked the nurse if she could squat at the end of the bed so she could push more effectively. The nurse and I found a "squat bar," attached it to the bed and helped her position herself for the final stages of labor.

Between contractions she rested, and then with each labor pain she lowered herself into a deep squat, hung on to the bar and pushed, her lower half a few feet off of the floor. While this was an effective pushing position it made it difficult for me to monitor her progress! I needed to kneel to perform an exam. When I thought the moment of birth was near, I again squatted down to check the baby's head position as she pushed.

As I settled into the squat, I suddenly felt searing pain as the reconstructed anterior cruciate ligament in my left knee exploded, my leg buckled and gave way beneath me. I felt myself falling and, almost in slow motion, I stumbled forward. In a panic I reached out my hand and grabbed the delivery table to catch myself, stopping my face mere inches from experiencing an embarrassing head on collision with the baby. (Not sure how I would have explained that to the dad!). The baby's head was "crowning" meaning the top the head was just emerging and delivery was moments away!

I gathered myself, balancing on my good leg. Pain had drained color from my face and I felt droplets of cold sweat appear on my forehead. The contraction ended and the mother looked at me with a concerned look on her face and asked, "Doctor, are you okay?" I wasn't, but it didn't matter. It was time.

I turned to the nurse, "Can you check and see if there are any other doctors on the floor?" I was not sure I could complete the delivery. The nurse picked up the phone and called the nurse's station. She turned back to me, shaking her head, "No one is here but you."

I took a deep breath and replied, "I think I am going to need a stool!"

The nurse wheeled a stool over and lowered the bed so I could be seated while the baby was born. Within a few minutes the baby arrived, fortunately without any difficulty or complications. Once I was sure mom and baby were fine, I hobbled out of the room. Leaving behind a happy family and a memorable story!

I was not at my best, but I was the only doctor available. There were no other options. It was an “Apollo 13” moment, failure was not an option!

I wonder if maybe Mary's husband Joseph didn't feel similarly incapable the night Jesus was born. Young, inexperienced and alone, there were no other options available. A teen-aged mother and a young man had no choice but to trust God and do their best.

Isn't that life in a nutshell? So many times we find ourselves in challenging circumstances, overwhelmed and seemingly alone. In those moments trusting God is so crucial. We must do the best we can, knowing that the God who "delivers" will "deliver" us again.

- Bart

This post was originally published 2 years ago, I share it again this Christmas in the hope that it will give perspective as we approach again the season of the year in which the Savior was born. Feel free to share it with others, or offer comments below.

When People Don't Matter, Opinions are Worthless

People are more important than their opinions and their value is independent of what they think.

This is a basic truth founded in the teachings of many of the world’s religions. It is foundational for Jewish and Christian faith, both of which have the command to “love your neighbor as yourself” as one of their essential tenets. It was once commonly taught to American children, accepted as true even by those who denied the existence of the supernatural. Those days are gone. It seems a large portion of the population believes it is perfectly acceptable, even desirable, to berate and demean those with whom they disagree.

Consider actor Seth Rogen’s recent assessment of neurosurgeon turned Presidential candidate Ben Carson. Dr. Carson, while making the reasonable assertion that an armed citizenry is better able to resist tyranny, made a questionable assertion that Hitler may have not been able to murder so many innocents if the population had been disarmed. Instead of challenging the doctor’s historical perspective by pointing out the widespread popularity of Hitler in 1930-40’s Germany, Mr. Rogen simply tweeted “F--- You @realbencarson.”

I observed a similarly demeaning tweet in response to those who oppose new gun control legislation. John Marshall of the website TalkingPointsMemo, commenting on those who favor gun rights wrote, “Amazing that w/2 new school shootings today, Obama greeted in Oregon by pro-Massacre activists.” To Mr. Marshall, the opinions espoused by those with whom he disagreed did not just make them confused or wrong or misinformed, it made them in favor of mass murder.

The dehumanizing insults are everywhere, a common feature of modern political discourse. Few attempt to engage or be engaged as it is easier to call someone an idiot, a misogynist, a bigot, a thief, or a racist than it is to dialogue and understand.

This modern tendency is not just worrisome, it is dangerous. When we dehumanize people, we make their lives mean less. The journey from devaluing a person to harming a person is not a long one. It is time for all of us to take a step back and ask ourselves what our true values are. When our opinions and political views are more important than people we have lost sight of that which matters most in life. When this is lost, our opinions don’t matter anymore.

- Bart

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A lot of Blood, a little needle, and a life saved-An Amazing Childbirth Story

In a near death story of a mom and a baby we find a reminder that little things can make a big difference-

She had been hospitalized for a month, placed on bed rest for complete placenta previa. Instead of implanting higher up in the uterus, the placenta was low, completely covering the opening of the cervix. This was a potentially deadly situation for both mom and baby. Once labor started and the cervix began to open massive bleeding would occur.

Once the condition was diagnosed at 24 weeks of pregnancy the waiting began. She was placed on bed rest to stave off any contractions and cervical dilation and was to remain in the hospital until she either reached 36 weeks of pregnancy or the bleeding started. Either way the baby would be delivered by c-section, as a vaginal delivery was impossible.

I was the intern on the OB floor, responsible for rounding on each patient every day, performing deliveries and assisting on c-sections when needed. I came to know her well, as would be expected when a doctor sees a patient every day for a month. The first month had been uneventful, with no bleeding at all. We we all optimistic that things would go well. She had made it to 28 weeks, and each day that passed brought another day of maturity for the baby and an increased chance at survival.

Everything change in a moment. It was just after lunch. I had just changed from surgical scrubs into shirt and tie for my outpatient clinic that afternoon when I heard a nurse call out from the patient's room, "Dr. Barrett, she's bleeding!"

I hurried into the room. The patient lay on her back, a bedpan filled with blood between her legs. Unsure of how much blood there was, I grabbed the water pitcher from the bedside, dumped it out in the sink and poured in the contents of the bed pan. 500 cc of blood, a half of a liter. In less than 2 minutes she had lost over a unit of blood. I turned back to the patient, and watched as blood began spurting out between her legs. It was even worse than I feared. She was going to bleed to death in a matter of minutes.

I had one nurse place an urgent call for the obstetrician and another nurse call for the anesthesiologist. What else could I do? I surveyed the room and saw her single IV line. I remembered from somewhere in my training that when treating a patient in shock it was important to have at least two IV lines inserted so fluids could be rapidly administered. I turned back to the nurse, "I need a second IV, large needle, NOW!" The nurse got to work and a second line was quickly in place and fluid poured in. Moments later the anesthesiologist arrived and took over the case. I watched helplessly as they wheeled her away, the combination of my inexperience and clinic responsibilities excluding me from the operating room. I paused to whisper a prayer and went to the clinic, fearful for mom and baby. Things did not look good.

As soon as my clinic shift was over I hurried back to the hospital to check on her status. The anesthesiologist was at the nurse's station completing paperwork when I arrived. "Hey, Bart! She made it! 16 units of blood, 10 packs of platelets, but she made it, and so did the baby." I let out a sigh of relief.

She went on, "Oh, and great job getting that second IV started. She went downhill so fast that without it we would have lost her. It made all the difference."

Her words caught me off guard. I had a hard time believing that something so simple could be so important. Yet, according to her, a single needle was instrumental in saving her life.

A little thing made a big difference. I didn't think I had done much but when the time came to save her life, and the life of her child, everyone, including me, had played a part. Nurses, surgeons, anesthesiologists, lab technicians, blood bank employees, and me, a green intern, all had contributed.

It is easy to overlook bit players, but they can be important, including the bit players in the Greatest Childbirth Story ever. This Christmas, as you read the Christmas story, take some time to consider all of those who had a part in the story. Shepherds, angels, Mary, Joseph and the wise men, all had a role in the story of the amazing birth of the Savior.

A final note- Nine years ago I received an email from name I did not recognize. It read, "you do not know me, but 15 years ago, you saved the life of my sister and my mother. I just wanted to say thank you and let you know that we have not forgotten what you did for our family."

All because of a needle.

- Bart

This is part 2 of 6 of the Christmas series "Amazing Childbirth Stories". It was first posted to years ago. I am sharing it again this Christmas season. Subscribe to the blog to have the future posts delivered to your inbox! Enjoy the stories? Please share with your friends on Facebook or other social media by clicking one of the share buttons. Comments and questions are always welcome.

7 Lessons From San Bernardino

Families have been shattered by the loss of fathers, mothers, sons and daughters. Survivors will carry forever the scars of the attack. The community is united in its desire to find out why and how the attack occurred and to prevent it from happening again. With this in mind I share some of the lessons we need to learn from this tragedy. While they may seem obvious the comments of our leaders suggest they may be ignored.

 1-      There are evil people in this world, and they are here. We have long lived our lives comfortable in the illusion that terror attacks and mindless killings were for places like Israel and Iran. Those illusions have been shattered by the Islamist’s brutal attack.

2-      Our government is incapable of rooting out potential attackers. The female attacker gave false information on her visa and was a known member of one of the most radical Mosques in the world. She was “screened” when she was allowed into the country and passed through easily. She was not on any watch list. Something to remember the next time we are told not to worry because the government conducts a “rigorous” screening process for all who wish to come here.

3-      Political correctness has no place in a battle against terror. A neighbor who saw suspicious behavior did not report it for fear of being considered racist. Continuing the absurd policies that make a 90 year old grandmother as likely to be stopped at an airport as a 30 year old single man of Arab descent makes no sense. Not all Muslims are radical, but the overwhelming majority of terrorists are today. We need to live in this reality.

4-      Gun laws don’t work to prevent mass killings. California has the toughest gun laws in the country. The gun laws being put forth by the president already exist in California and they did nothing. We all want to make the nation safer and it does us no good to be focusing on regulations that have already been proven useless.

5-      Law enforcement was unable to stop these attacks. Police were at the scene within four minutes. In those four minutes there were over 30 casualties. The sad saying that “When seconds matter, the police are minutes away,” was proven true. As much as we hate to admit it, in circumstances such as this only an armed citizen, already present, is in a place to make a difference. 

6-      Police officers displayed sacrificial bravery. The officer who told the evacuating citizens that he would “take a bullet” for them has been deservedly praised.

7-      This will happen again. Our world has changed forever.

- Bart

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