I don’t normally tell many stories about the types of things I have seen while working as a paramedic, but this particular story does have a happy ending, is a little comical (well I think so anyways) and is somewhat relevant to the reproduction part of our current unit. I told part of this story to my tutorial group but decided I would just post the rest on the blog. No names and locations will be used to ensure confidentiality.

As a paramedic, our training was heavily geared towards managing acute, emergency situations. Most of the time it was to deal with chest pain, shortness of breath, and trauma. But, another skill that all paramedics receive training in, is how to deliver a baby. Today, this is not a very common call for a paramedic as most expectant mothers get to the hospital long before they would ever need a paramedic to deliver their baby. In fact, other than their inhospital training, most paramedics will never deliver a baby. Nevertheless, all paramedics are trained to deliver a baby, as well as manage complications such as breech delivery, problems with the umbilical cord, neonatal resuscitation, etc. The thing to remember though, is that although they call it delivering the baby, it is the mother who does all the work. For the most part childbirth is an uncomplicated process, and mothers have been having babies long before any doctors were around. Usually you will just be there to “catch”. Now onto the story…

Around 7 years ago now, it was around 0630 and I had 30 minutes left in my 24 hour shift when the emergency tone went off for a woman in labor. Soon my partner and I were in the ambulance on our way to the scene receiving updates like “Contractions are every few minutes” and “Delivery is imminent”. After around 15 minutes we arrive at the house, we grab our gear, and make our way up the stairs. Unfortunately the stretcher couldn’t make it up the small stairway and into the house so we had to leave it outside. At the door we were met by the husband, who was holding a 2 year old girl, and a 5 year old girl. They were Chinese, not overly important to the story at this point, but more relevant later.

Anyways, we ask the husband where his wife is and he says she is in the very back bedroom, furthest from the door. Of course she is I thought, where else would she be?!! So my partner and I make our way down the very narrow hallway in single file with the husband and kids following us to the last room. I entered the room to find a woman (in her late 30s I think) laying on a mattress on the floor and the first thing I saw was part of the non-ruptured amniotic sac protruding from her vagina. Immediately I knew this delivery was going to be happening here. So I ruptured the membranes and at this point my partner asked me what I wanted to do. I said we should try to get her to the ambulance in case there were any complications and that way we could just leave for the hospital. I also said we needed a second ambulance with 2 more paramedics, standard protocol for an at home delivery as soon we were going to have a second patient. The only problem was there was no second ambulance available. So who did we call for extra help, the fire department. All we needed was some extra people to help lift, etc, but apparently it became the “big story” in this little community that the fire department was called to a woman in labor!

So my partner leaves to take to some gear back to the truck and to try and figure out a way for us to get this pregnant, soon to deliver, woman out to the ambulance. At this point the little 2 year old girl is now clinging around the neck of the mother on the floor, so I tell the father that he needs to take the little girl out of the room to let the mother have her space and not be stressed further. Now it is just me in the room with the mother and 5 year old girl. I then look back to the mother on the floor only to now see the top of the baby’s head! Things had progressed so quick to this point that I didn’t even have a chance to open the obstetrics kit, so with only my 2 gloves on, I started to put gentle counter pressure on the baby’s head to prevent an explosive delivery and supported the perineum so it wouldn’t tear. At this point the “inquisitive” 5 year old asked me “Is my Mom having the baby?” and I said “Yes, your Mom is having the baby! Do you remember the other guy who is wearing the blue coat like me?” She nodded yes. “Go find him, and tell him I need him right now” I said. So the little girl runs off to find my partner and a minute or so later I hear my partner coming down the hallway saying “Yeah the little girl said you needed me to come back right away…” just before he entered the room to see me delivering the head and then he said “Oh my God!”. I then asked him to open the obstetrics kit to get set up for the delivery in progress. Now these obstetric kits are wrapped in plastic, and when my partner ripped open the plastic, in the heat of moment, the plastic bag popped open like a bag of chips and its contents went flying everywhere.

At this point the head was fully delivered so I said just give me the bulb syringe and I suctioned the mouth and then the nose. Next I had to check for the umbilical cord around the baby’s neck. So still supporting the baby’s head, with 2 fingers I pushed back the labia and felt around the neck for the cord. The cord was tightly wrapped multiple times around the neck. There was no time to waste. We told the mother to stop pushing, but she didn’t speak English or at least not very well, and I don’t think she fully understood what we were telling her to do. I first tried to loop the cord over the head but it was wrapped too tight. Next I tried to clamp the cord where it was and cut it before the rest of the baby delivered. But the cord was so tightly wrapped that I was having trouble getting the clamps around the cord. At this point I thought we were going to end up having to try to resuscitate this baby.

Unfortunately despite our pleas, the mother kept pushing and the rest of baby delivered right into my arms. Now, if you recall from earlier I said I had to rupture the membranes. That is true, but as the head had already descended into the birth canal, all the amniotic fluid was still trapped behind the baby. So once the baby came out, so did all the amniotic fluid, and guess who was in the “line of fire” so to speak? I’ll leave it at that. With the baby now free, I quickly unwrapped the cord from around the neck and rapidly dried off the infant with towels. Then I suctioned the mouth and nose again and gave the baby a few slaps on the foot and the baby started to cry. A huge weight was off my shoulders. I then did a quick visual inspection and told the Dad that they now had another baby girl. I then evaluated the infant’s respirations, pulse, and skin color and all were fine. I then asked the Dad if he wanted to cut the umbilical cord but he said no, so I clamped and cut it.

At this the point the fire department had showed up so it was now pretty crowded in the bedroom. There was the mother, the father, the newborn, the 2 sisters, 2 paramedics, and a crew of firefighters. Now that things were under control, we were able to move the mother and newborn to the ambulance and we had a nice, calm drive to the hospital. I monitored the mother and newborn on the way, but the mother never delivered the placenta before we arrived at the hospital. After dropping off the Mom and baby, we said congratulations, packed up our gear and left.

Shortly after the call, my paramedic partner that day and I both received stork pins for our delivery in the field. Months later, the family invited us to attend the baby’s baptism which we did.

This certainly is one of the most unique calls I have ever attended, and I am sure will forever be