“Okay,” she said, fear working its way into the creases at the corners of her eyes.
As I continued to search for heart tones and came up empty, I reached toward the wall and clicked the button that let the staff know I needed immediate assistance.
Bum-Bum. The first sounds of the baby’s heart rhythm finally reached my ears, but it wasn’t the normal, gallop-like noises that reassured. It was slow, much, much slower than it should be.
I gently pressed my fingers to Carmen’s wrist to make sure I wasn’t detecting her heartbeat on the monitor and immediately came to the ominous realization that I did, in fact, have baby’s heart rate.
“Carmen, have you been having any pressure in your vaginal area? Do you feel the urge to push?”
She nodded frantically. “I feel like I need to go to the bathroom right now,” she moaned, and then her eyes went wide. “Oh, no. I feel like I’m peeing.”
“It’s okay,” I said soothingly. “I think your water just broke.” I switched out my gloves—removing the blue ones for a pair of sterile ones off the exam table. I moved toward the middle of the bed and sat on the edge. “Carmen, I need you to relax your legs a bit. I’m going to check to see how far dilated you are, okay?”
“Okay,” she whispered.
“You’re going to feel some pressure,” I instructed. “I just need you to stay as relaxed as possible and breathe through it, okay?”
“Okay.”
The instant my fingers reached her cervix, I knew what the issue was. Not only was Carmen six centimeters dilated with ruptured membranes, but she also had a prolapsed cord. Which was the exact opposite of a good situation. A very, very bad situation, actually. Prolapsed cords were fairly rare, but when they occurred, delivery had to be straightaway. And in Carmen’s case, since she wasn’t fully dilated, it most likely meant an emergency C-section.
It was at that moment that Dr. Cummings stepped inside the room. “Everything okay?”
“She’s six centimeters. Gestation is unknown, but patient believes she’s around eight months. Her water broke about forty-five seconds ago. And now, we have a prolapsed cord. I’m holding the baby’s head above it. Fetal heart tones were fifty but have stabilized a little at 110 with the baby’s head off the cord.”
Will immediately peeked his head back out of the room and instructed the triage receptionist to notify the OR and neonatal team. “You know it’s for sure the baby’s head and not breech?” he asked and immediately shrugged out of his white exam coat and started donning OR gear.
“Yeah, I can feel fontanels.”
“Is everything okay? Is my baby okay?” Carmen asked, her accent thicker with distress, and my eyes glanced toward the continuous fetal heart monitor noting that even with baby’s head off the cord, the heart rate was continuing to dip below one hundred at times.
“Carmen, I’m Dr. Cummings,” he introduced. “We have a bit of an emergency right now. The baby’s head is on the umbilical cord, and we need to get the baby out as soon as possible. We’re going to take you back to do an emergency C-section.”
Her eyes went wide. “Pero…Right now?”
“Yes,” he responded. “But I promise you I’m going to take very good care of your baby.” His eyes met mine, and he nodded for me to get comfortable on the bed. “Ready to ride, Mel?”
“Let’s do it,” I said and pulled my legs onto the bed—with my hand still securely keeping Carmen’s baby’s head off its umbilical card—as Will pushed us out.
“Think your hand can hold up until we’re scrubbed in and I can get the baby out?” he questioned as he pushed the bed down the hall and toward the obstetric ORs.
“Yep. I’ll be fine.” Luckily, it wasn’t my first prolapsed cord experience.
Carmen’s eyes met mine, and I could see the sheer terror of being a powerless mother in her gaze.
“Carmen, you’re in good hands, okay? All you need to do is stay calm and keep taking those deep breaths like you have been. You’re doing great.”
“Okay,” she whispered, and one lone tear started to drip from the corner of her eye.
“Did you come to the hospital by yourself?” I asked as the bed made its way to the OR doors and OR staff members started to help us suit up before heading in. A mask was placed across my face and a scrub cap over my hair.
She nodded as an OR nurse placed a surgical cap over her hair.
“Is there anyone we can call to come to the hospital?”
She shook her head, and a few more tears dripped down her cheeks. “My husband is at work and doesn’t have a cell phone.”
“It’s okay, Carmen,” I reassured again as OR staff helped moved both Carmen and me onto the sterile and draped surgical table. “What’s your husband’s name?”
“Miguel.”
“And where does he work?”
“A construcción company.”
“Do you know which one?”
“Phillips and Neiman.”
I glanced over my shoulder and met the gaze of who I thought was the circulating nurse. “Can you do me a favor and call out to triage? Ask them to find the number to Phillips and Neiman construction company and see if they can get in touch with her husband.”
“Sure thing,” she responded. “What’s her husband’s name?”
“Miguel Dominguez.”
“Did we get fetal heart tones?” Will asked as he moved toward the OR table.
“Yes,” one nurse responded. “Tones were one hundred.”
“Let’s get moving, then,” he announced and stood beside the patient. “Okay, Carmen,” Will said behind his surgical mask as he gripped her hand tightly. “We’re going to have you breathe in some medicine that will put you to sleep so we can perform the surgery quickly,” he instructed while the anesthesiologist placed the mask over her face. “Just take deep breaths. I promise everything is going to be okay.”
As Carmen started to fade to sleep, Will prepared for surgery. His eyes met mine, and he nodded toward my hand that was still striving to keep the baby’s head off of the umbilical cord. “Can you hang in there for about thirty more seconds?”
“Yep.” Honestly, looking into his confident, proud eyes, I felt like I could do anything.
Once the patient was under anesthesia, Dr. Cummings got to work. He didn’t waste any time, making a clean cut and working at a quick yet smooth pace. I’d seen a lot of physicians perform C-sections, and I’d seen a lot of physicians perform C-sections under stressful situations, and it was apparent that Will was the Chief of Obstetrics for a reason.
When it came to emergent situations, he stayed cool, calm, and collected. He never raised his voice at the staff, and that alone made a world of difference, keeping everyone else relaxed and focused as well.
It took a lot to impress me when it came to the medical field, especially obstetrics.