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| 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!!
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| 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.
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| 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.
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| My personal photo, edited to protect identity and posted with permission. Notice the food carts behind us. |
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| Photo credit: the proud daddy- taken in the hospital. |
