Birth

Delivery between hospitals

 

Birth

 

 

 

 

The siren had become irritating as they made their way to the indigent care facility. Kevin hadn't wanted to run this call emergency traffic, but the transferring hospital did not have their paperwork ready upon their arrival and the receiving hospital wanted another pelvic exam before they would accept the patient. The lost time had made it necessary to use the lights and siren. The last thing he wanted to do was to deliver this baby in the back of his ambulance. The transferring hospital had the mother classified as a high-risk pregnancy and high-risk delivery that called for services that they could not provide. 

            “Ni os?” Kevin asked in Spanish. He hoped he had gotten it correct. The number of previous children was written in the patient’s records, but Kevin always carried on conversations with his patients.

            “Tres chica” she said. The labor pains hit her again and Kevin helped her through the wave of contractions as her body prepared for birth.

            “Yo haber dos chica”

            “!Bueno” she smiled through her labor pains.

            “Como viejo tu chica?”

            “Nueve, Tres y seis. Nosotros quere en chico. !Marca Pablo altanero.”

            “Bueno.”

            The labor pains were coming closer and closer together, lasting longer each time and also getting much more intense. As the ambulance and its crew neared the next small town, it was becoming obvious that this baby would not be born in the hospital, but indeed, in the back of the ambulance. High risk or not, the delivery was now in the hands of not a fully staffed delivery room, but a very experienced Paramedic. Most parents would want better than this for their child’s start in the world, but the poor often do not have that choice. Fortunately, this was something that most medics really love to. As much death as they have to face, childbirth is indeed a very rewarding change of pace. Kevin had over 20 out of hospital deliveries under his belt and had not lost a mother, child or father in his 18 years of medical service. As Kevin put a gown over his uniform, he yelled for his EMT partner to pull the ambulance over at the next wide spot on the highway and stop. The young Hispanic woman was really into the labor, but her contractions were not quite strong enough to push the baby out.

            Gabriel was calling for a back up ambulance just in case the delivery turned into a complicated ordeal, but as luck would have it, a train at a railway crossing delayed the back up unit. Never mind that they were at the same crossing, and could be seen through the slowly moving cars. They were still on their own with the delivery.

            "You have to push with the next contraction", he told her. He was surprised at how calm his voice sounded, but it was the years of experience which gave it that calm solid confidence.  As the next contraction came, his patient began to yell in Spanish for her husband. His partner was still not in the back to assist him as Kevin saw the baby's head emerge from the birth canal.

            "Another push and we're home", Kevin encouraged, this time in the little Spanish he knew. The baby was already trying to breathe and cry on its own even though it was not yet fully delivered.

             “Dificil” she cried. “!Dolor, mucho dolor.”

 "!Apresurar, apresurar ahora", he ordered, again in Spanish. She listened and the baby escaped its former home and entered his new world kicking and crying.

            By now, Kevin’s partner had calmed the father and was able to assist him. Kevin had turned his attention to cleaning the baby and cutting the baby’s umbilical cord. His partner and the young couple were conversing in Spanish and Kevin could only hope they were going to keep things calm and sane as he cut through the tough covering of the umbilical cord. Chico or Chica? The father asked over and over.

            “Parvulo bebe chico.” He was really glad he had taken some Spanish in school and paid attention. It really helped in this area.

            “!Muy bueno”, the father exclaimed and ran to a pay phone just across the tracks. He was so excited about his firstborn son he had to inform his family.    

 A local police officer had heard them request a back-up ambulance and had responded to lend assistance to the crew since a train was blocking the path of the back up ambulance and had delayed their response.

"Need any help?” The officer opened the door and Kevin responded, "Just in time. I’ve just cut the cord."

One look inside the back of the ambulance with blood dripping from the white sheets and blood leaking from the young woman’s birth canal and the young officer had seen more than he had bargained for. The back door of the ambulance closed soundly as the officer slammed it and leaned against the outside of the parked ambulance. Childbirth in the field is not an event for the weak of stomach and they had not really prepared them for this event very well in the police academy.

The train cleared the crossing and the second ambulance finally arrived as Kevin finished with the umbilical cord. He had tied it a bit longer than recommended, but doing so saved cord blood in the event the baby needed more blood tests or the family wanted to save the cord blood. Kevin’s partner was tending to the baby and its small cry was music to their ears. A female attendant came over to offer assistance and found Kevin massaging the woman's lower abdomen in order to aid delivery of the placenta. She helped with the massage and encouraged the woman to help by pushing a little more. The woman's weak contractions were a hindrance in this procedure as they had been during the delivery of the baby boy. Finally, after what seemed to be an eternity, the placenta delivered and was placed in a plastic bag to for transport to the hospital. 

Another medic was tending to the officer, who now had a little more color in his face, but was still a bit shaken by the aftermath of the childbirth. They don’t prepare you for that kind of surprise at the police academy. He had apologized profusely for not being of any assistance. They all laughed it off and the officer gladly accepted the bottle of water Gabriel offered him.  

 With mother and baby now squared away and stable, they could transport the two to the hospital. Kevin recorded the live birth and the baby's APGAR score on the run ticket. He laughed to himself as he recorded a 9.5 for the APGAR. He knew that they would not accept the score at the hospital, but he had to record what he saw.

In all of Kevin’s years of training and practice, this had been one of the smoothest field deliveries he had ever experienced. Not even when the mothers had made it into the labor and delivery rooms had things gone as smoothly as they had today. The father told Kevin that they had lost a baby in Mexico because the doctor had used too much pressure on the forceps and had crushed the baby's skull. It was then that Kevin realized that was the hospital's justification for classifying the mother as a high risk.

The labor and delivery nurses were waiting for him as soon as they arrived. Even though they gave Kevin and his partner the usual lines about bouncing the baby out with wild driving and no shocks on the ambulance, they were very professional in their care of the mother and child. All the joking aside, their number one concern was the welfare of mother and child. They accepted his report and his APGAR score and took the patients off their hands. Kevin was surprised, but tried not to show it.

            As they were cleaning their unit and getting everything ready to go back to their base, the father came out to speak with them once again. He and his wife had decided to name the child Kevin Gabriel, after the medics. Gabriel was surprised, but Kevin explained to him that there were at least 9 other Kevins around the area because he had delivered them. His other 11 deliveries were girls, and Kevin was not a proper name for a girl. 

Kevin drove the unit as they returned to base. Driving was Kevin's way of relaxing and critiquing himself after a run. His partner was complaining of being too hungry to wait until they were back in their zone and wanted to stop and eat somewhere close by.

"I know a place", Kevin said, thinking of another hospital’s cafeteria located just up the road. "It's not in our zone, but I can call home from there and it's not long distance. Besides, food is decent and they give us half price."    

             “As long as they have fried chicken.” His heavy Spanish accent gave the "ch" a "sh" sound. "We Brazilians always eat fried chicken after a baby boy is born."

Kevin wasn't sure whether Gabriel was joking with him or not and Kevin knew that fried chicken was indeed Gabriel’s favorite food, but he assured him that the cafeteria did have some good fried chicken and that seemed to satisfy him for now. The first person Kevin saw at Mainland General was his former partner from Galveston Mainland EMS. Randall was busy under the hood of his rig when they pulled up.

            “Look what the cat drug in” he said as he greeted Kevin.

             “Randall, que pasa?” Kevin replied. “What’s up with that rig now?”

            “Adding some extra HP. We tweaked the computer.”

            “Cool! Still trying to break my record to the Island.”

            “Hell no”, Randall said. “That was insane! Say, what are you guys doing over here. You slumming again?”

 “Just stopped in for some food if the cafeteria is still serving. Gabe over here is all about fried chicken right now.”

            “I could use some grub myself. Save me a seat! I’ll be with you guys in a minute.”

             They had an uneventful lunch, spent mostly exchanging some old war stories from Kevin’s time with GMEMS. Kevin was grateful today was a slow day for everyone. When you work in EMS, you live for days when you can get the good calls and still eat a meal without interruptions. 

            Gabriel was pretty quiet on the way back to the station. Kevin knew he had gone for two days with little rest. The basics worked 48 hours and then took 72 hours off. With the staffing problems, some of the basics were pulling 72 and 96 hour shifts before getting any time off. Kevin was grateful for his set 24 on 48 off schedule. Management had its perks. 

            The rest of the shift was pretty quiet. Gabriel and Marcus took a couple of easy nursing home calls while Kevin completed the inventory of the station for state inspection. Marion, the company owner brought Gabriel and Kevin a set of blue stork pins for their field delivery. Kevin placed his pin next to the other 19 he had on his office wall.

Reviews

[DarkAngelWriter]

Maybe I just missed it, but I didn't know the father was in the ambulance. Dang.

I like it. There's some Spanish up there I couldn't quite translate on my own and some acronyms that I don't know, but other than that, I like it. :)