Air Born

 We were less than halfway into a 10 hour flight when the call was made for medical assistance at the back of the plane. There had already been hints that something was amiss. Chasing around a one year old, I had noticed that they were washing the floor in the back galley and didn’t want children freely coming back for water and snacks. I overheard a flight attendant asking one of the other dads who was also running after his child if he spoke Arabic. So the call for medical personnel did not surprise me. I scooped up my son and walked toward the back. Please, Lord, don’t let this be an old man with a cardiac problem, I thought. Instead, it was a younger-looking woman, sitting in the jump seat that flight attendants use for takeoffs and landings, and though she wore a traditional abaya, I could see on her face that she was in labor. I was so relieved.

Though not our plane, this is identical to the one we flew in. (Photo credit: flyinginireland.com)

You see, an OB/GYN responding to a cardiac emergency could be compared to a Toyota mechanic stopping to fix a VW bug on the side of the road. Sure, we’ve had all the training and theory, but it’s going to take some time for us to remember what the right dose of drug might be needed. In addition, we haven’t likely been keeping up with new recommendations outside of our specialty in an ever-changing field of medicine. So I was relieved. Actually, I was feeling right at home. For those of you who clicked on this blog but don’t know me, I’ve spent the past 3 years overseas, working in limited-resource settings, usually with a translator and definitely without epidurals or many IVs. And for some reason, I’ve had several instances of births in unconventional places. Not one, but two babies were born in my apartment building in France, both requiring my help. At least on the plane, we had plenty of blankets and gloves!!    

Blankets and pillows prepared for delivery. Photo credit: airliners.net

 The flight attendant’s eyes widened as I confirmed that, indeed, her water was broken and her cervix already dilated. After the initial questioning, I thought her baby would be quite premature and I wanted something to help stop her labor. My mind was racing as I scoured the medical kit for their available drugs. However, after further questioning and examination, I felt like she was more likely nearly at term. In that case, I told the flight attendants, we could simply observe her contraction pattern. Her contractions had significantly slowed after her water broke. With nearly 6 hours left, there was a chance she could make it until we landed, especially if her contractions didn’t pick up, but we should be prepared for a delivery in the air.

Our flight path from Lomé to New York (photo credit: cheapoair.com)

Contractions weren’t too frequent, so I suggested we get comfortable. We moved from the back galley makeshift bed of pillows and airline blankets into the back two rows of the airplane. She rested, her dutiful husband recorded contractions, and I spent time with my kids and updated my husband. The flight attendants were able to use that galley for its intended purpose. The only excitement during this time was the frequent trips to the bathroom, which is quite common when a baby’s head in the pelvis is acting like an overweight man next to you in an economy seat. One particular instance, as she was trying to exit the tiny bathroom, her husband and I could not contain our laughter as we watched her snatching the end of her abaya from the clutches of the automatic flushing toilet. Let me tell you: in person it is even funnier than in the movies.. And it sure helps lighten the mood when things are tense and uncertain.

With less than three hours to go, it was becoming painfully obvious, pun intended, that her labor was intensifying. We decided to move back to the galley for more privacy and space to stand and move around. Her husband didn’t leave her side. One or the other of my kids occasionally escaped from my husband to see what I was doing at the back of the plane. My daughter, who has seen a cesarean section from the window of an operating room, gently asked me, “Are you going to break her?” I reassured her that I would not need to, but that the baby would be here soon.

Back labor can be excruciating. From my extensive experience in labors without epidural pain relief, I have found a few tricks to help with pain naturally. Providentially, less than a week prior to our departure from Africa I had learned a new osteopathic technique which can help improve labor specifically when the fetal head is putting pressure on the sacrum. I had been a bit skeptical that I could actually apply this technique with my limited osteopathic experience, but it clearly made her pain more tolerable judging from her body language. And then she turned to me and said, through her husband translating, “Something is coming out.”

Upon examination, indeed, the baby’s head had descended. I turned to the flight attendant and asked how long we had. Thirty minutes was her answer, but then she added that even with an emergency priority landing (meaning we land as soon as we get into the airspace instead of waiting our turn) we would still have a 40 minute taxi before the ambulance could be ready to take her. I looked back at my laboring friend, knowing she would not be able to suppress her urge to push for over an hour. I said, “Well, when you feel like you need to push, go for it.” The flight attendant holding up an extra blanket for increased privacy said in disbelief, “So this is happening. Ok. Well should we ask the pilots to hold the landing?” We had been rapidly descending, and our ears were popping as we laid out extra blankets. I said, “No, we just need to get there as soon as possible. Let’s land!” I said, fearing that any delay could jeopardize a chance at higher level care for her or her baby if it was needed.

She pushed just a few times, holding on to the safety bar used by flight attendants as they work in the galley. I told her husband, “Tell her to trust God that He will help her push this baby out.” And with the next contraction, the head delivered, then the body, and we had a screaming beautiful newborn baby getting wrapped in Ethiopian Airlines blankets. The mama sat down and we quickly put her new baby skin-to-skin to breastfeed, with only a moderate amount of wrangling her battle-scarred abaya to make way for the baby. When the placenta came, we put it in a small trash bag, tied it closed with a string, and wrapped it and the cord up with the baby in fresh airline blankets. It was a lotus birth by default, and it was beautiful.

The flight attendants took everything in stride, but they still had business to do. With just minutes left, they said, “We are assuming she cannot go to her seat for landing. How should we do this?” With her husband on one side and me on the other, we shielded the mama from moving while holding with our free hand onto the same safety bars she had used for delivery. “Ok good.” The flight attendants said as they buckled up in their jump seats. “She can hold the baby. We’ll let you know exactly when we are landing.” With that, this precious new life touched ground for the first time. As we taxied toward a waiting ambulance, the whole crew of flight attendants came back to get pictures with the new family in a joyous celebration. 

My personal photo, edited to protect identity and posted with permission. Notice the food carts behind us.

 Due to the noise generated by the airplane during its descent and the calmness displayed by the mama and the entire Ethiopian Airlines crew, most of the other passengers on the airplane had no idea that a baby had just been born. The paramedics and police and border patrol agents came on and escorted the beautiful family through the plane. The mama went first in a wheelchair, her triumphant abaya looking no worse for the wear. I followed the dad who was carrying the newborn. When he reached the row where my husband and kids sat without me for the last 6 hours, he turned to my daughter and bent down to show her the new baby, just as we had told her a few hours before. Until that moment, there had been little interest in the pile of airline blankets that he was holding, but all eyes turned to the bundle. A flight attendant then pointed to me and said in answer to their questioning eyes, “She just delivered a baby. She’s a hero.” I just pointed to the strong mama who just delivered a baby during crazy changes in pressure and turbulence. For me, it was all in a day’s work. And it certainly was easier than chasing around a one year old for the whole flight.

Photo credit: the proud daddy- taken in the hospital.