Sirens approached. We heard them outside the clinic, and then we heard shouting. I pulled on gloves and ran outside with a birth tray in my hands- ready for anything (I thought) "A midwife" "Help" "Baby at home" "Veloso St" were the broken phrases I heard. The next thing I knew I was ushered into a 911 Police truck by two officers and we were off. My mind quickly pieced together what had happened. I had no clue what adventure lay waiting ahead!
The sirens wailed as we drove along. It was a quick ride, but seemed to take forever. The Philippine sun was hot as it beat down. The wind whipped my hair in my face as we flew down the street. I tucked it back, not wanting it in the way. As we screeched to a halt three gloved midwives jumped from the back of the 911 Police Truck- one carrying a tray with birth supplies, another with prepared injections of an oxytocic drug (for hemorrhage prevention/treatment) and another with other supplies. The midwives hurried to follow the police into the little home.
I entered the dimly lit house and saw a woman laying still on a bamboo bed. Between her legs lay a blue baby boy. His cord wrapped once around his head, once around his arm and a third time around one leg. I avoided a puddle of fluid on the floor, which I presumed to be amniotic fluid, and quickly moved in closer. The first midwife set down the tray, grabbed the baby, unwrapped his cord, and started stimulation. The head midwife assessed blood loss and the third injected the mother with pitocin.
"Baby's first Apgar score is 7" spoke the first midwife as she clamped and cut the cord. "Current estimation of 50cc blood loss" assessed the head midwife. The third helped hand necessary supplies and find a plastic bag for the blood. There was lots of commotion as little children milled about crying and scared. Some had eyes wide open in wonder. The police waited at the door and the father moved back and forth as if unsure what to do.
The first midwife continued to stimulate the baby who had a weak cry while the other midwives tried to talk with the police and father about bringing mom and baby to the clinic. Suddenly the first midwife noted that the mother had started to bleed again! She called out to the head midwife that the mother was bleeding and jumped in to rapidly deliver the placenta. She sat at the end of the bed and used a method called continuous cord traction (CCT) while supporting the uterus. The placenta followed with a gush of blood and the head midwife gave a second injection. "300cc estimated blood loss" said the first midwife to the head midwife who was firmly massaging the mother's soft uterus. It rapidly firmed and the third helped wrap the baby in a clean blanket as the other midwives examined the placenta to ensure it was complete.
No stretcher was available. The mother would need to be carried to the truck. The head midwife covered the mother with a towel as the first midwife grabbed the mother's head and shoulders while a policeman grabbed her legs. Together they hoisted her out and into the truck where she lay across their laps- the floor was much to hot from the sun. The head midwife grabbed the supplies and the third midwife held the baby. Sirens were again on and we sped off.
Once at the clinic, everyone again jumped into action. The guards rushed out with a stretcher, the first midwife followed her in and helped to stabilize her. The head midwife reported to the supervising midwife and the third rushed the baby to get some oxygen as he was still blueish from his shocking birth. He recovered quickly and was returned to be placed in his mother's waiting arms.
The midwife who helped to stabilize the mother continued to care for the mother and her little son. She learned this was the 41 year old woman's 8th baby and her 3rd boy. The mother had no prenatal care anywhere. She knew of the clinic and once she realized a taxi would not arrive in time for her to go to the hospital, she told her bana to call for help. The 60 year old man hurried out the door and yelled to the police who happened to be at a small eatery a few houses down. They rushed in as the baby's head was birthing and the mother told them to get a midwife. The poor policemen rushed to summon us- and the rest has been told.
One never knows what each day will bring! I am thankful that I was able to help welcome this little guy into the world- even if I did only witness the birth of his placenta rather than him as well! Happy birthday Baby Jerome! Born at approximately 12:25pm June 12, 2014 weighing 3600g (7lbs 15oz)!