The Dash Between Life and Death

By Jill Roper

Ever wonder if your calling as a midwife makes a difference? That question comes up a lot when you come to a place like Haiti. The other day we were up to our ears in patients. Clinic had ended and we had three Mama's in labor at the same time. In walks patient number four, fully dilated ready to push out her baby. At her last appointment the midwife was unsure if the baby was breech so asked the Mama to get an ultrasound. Before she could, her labor began. I had taken several day classes on breeches and had done only one surprise footling breech so I was quite anxious to help. I swapped with another midwife so I could help. 

It didn't take long for the butt to appear. The body rose higher and higher until it hit the umbilicus. Out comes the cord. I start the clock. One minute goes by, then two, then three tense minutes. The baby stops moving. The lead midwife starts trying to get the shoulders out and we hit the five minute mark. The room is tense. Another midwife is trying to explain to the Mamahow important it is for her to remain calm. At this point I suggest Mama flips over on hands and knees. As soon as she does the midwife has a much easier time helping the baby out. At around the seven minute mark the head is finally freed. I take a breath and get busy on the baby. On Mama's belly is this little lifeless body. No respirations and zero heartbeat. I call out to the other midwife that there is no heartbeat. She grabs a board for resuscitation. I start chest compressions and start breathing for the baby. At the three minute mark I have a heartbeat but still no breaths. It took around 20 minutes to finally get the baby to take a breath. By this point the baby is very cold so I quickly strip off my shirt and put the baby skin to skin with me. Even though my heart is pumping adrenaline at a rapid pace, I'm calm. I keep talking to the baby. "Come on baby, it's not your time to go, stay with me, breathe little one". Finally the baby is stable and breathing on her own. I wrap baby and put her back on Mama's belly. I stay with Mama and baby checking vital signs. By this point that little one is fully aware of what just happened and starts screaming, trying to get her story out. The baby is inconsolable. Reluctantly I finally pick up the baby and snuggle her close. I talk words of comfort to her telling her yes that was scary but she's safe now. She calms pretty quickly and finally looks at me. Yes little one you are safe. That peak into the other world is gone, you are here safe ready to grow and laugh and run. 

The next morning Mama shared with me that even though she didn't say a word while I was working on her baby her heart was in her throat. The smiles and happy thank you's filled that little room. She was so thankful that her baby lived. Watching that precious little baby nurse at her Mama's breast made me thankful to be here at this time and this place. That space between life and death can be so short, but this time the battle was won. For that I'm eternally grateful.