It didn’t take me long to fall in love with labor and delivery. As a new graduate nurse, I was enamored with my co-workers, who seemed to know exactly what was going to happen and how every provider was going to act. Most deliveries go exactly as expected, surprisingly producing a pink and screaming baby, regardless of any circumstance that may have complicated their labor or delivery. Usually, we are presented with a perfect baby who everyone can ohhh and awww over. It’s the deliveries that don’t go expected that surge the adrenaline through our veins, stealing every ounce of our energy in its wake.
In OB, there are few emergencies that unquestionably warrant a cesarean delivery. A prolapsed cord is one of these emergencies. Compression of the umbilical cord causes the baby’s heart rate to decelerate quickly. Fresh off of orientation, I experienced my first prolapsed cord. I was standing next to the bedside when the patient said she thought her water had broken. The words were barely out of her mouth when I heard her baby’s heart rate suddenly drop. I pulled back her blanket, relieved not to see her baby’s umbilical cord hanging out of her vagina. But her water was definitely broken and her baby’s heartrate was definitely down. I quickly put on a glove and carefully checked her. And then—there it was. I could feel her baby’s umbilical cord inside, pulsating against the back of my hand. Even in nursing school we were taught what to do if our patient ever had a prolapsed cord. But no one ever told us how frightening it would be, feeling a baby’s sluggish heartbeat through its umbilical cord. I knew at that moment that I wouldn’t be able to take my hand out of the patient until she was taken to the OR and her baby was delivered. I put a little pressure against the baby’s head, trying to relieve some of the cord compression. I looked at the patient, certain she could see how alarmed I was. I tried to sound calm and told her that a bunch of nurses were about to come into the room and rush her to the OR. She looked like I felt, scared and uncertain. And as she titled her head up to the ceiling to put on a brave face, nurses rushed through the door, simultaneously yanking on cords and pulling IV fluids. I hopped on the patient’s bed, my hand still in her vagina, and looked up at the patient to see tears falling silently down her cheeks. I could feel all the force of her body as it tried to push out her baby, and all the time feeling her baby’s heartbeat steadily decline against the back of my hand.
Before I knew it, we were in the OR and the patient was asleep. I was covered with a drape, my body literally on the OR table with the patient. My hand trembled inside of my patient, trying to relieve pressure off the cord. I never prayed so hard in my entire life. Under the drape, I could feel how hurried everyone’s actions were. Under the drape, blood and amniotic fluid soaked through my scrubs. Under the drape, I soundlessly started crying…I knew there would be no cry when the doctor pulled the baby out of that woman’s abdomen, because there was no more heartbeat against the back of my hand.
When the baby was born, I scooted out from underneath the OR drape. I stoop up, dizzy from every emotion running through my body. I didn’t know what to do. I was still new, fresh off of orientation, constantly looking to my coworkers for guidance. I looked at the doctor, suturing the mother back up, and saw her crying behind her mask. She didn’t make a sound, but the tears welled in her eyes, forcing decent down her face. Her eyes steadily focused on the work in front of her. I looked at the nursery nurses, coding a baby who had never made a sound. They worked determined, their hands steady and their actions focused. I looked at the anesthesiologist, her hand on the patient’s shoulder, comforting her even as she lay sleeping. And I looked at my patient, sedated and so peaceful, completely unaware of what was happening.
I remember standing in the middle of that room, the sterile glove still on my hand, my scrubs wet from blood and clinging to my body. Everyone worked in a whirlwind around me. And it was that moment that I pledged myself to nursing. Images of every single thing everyone was doing flashed through my mind, the beauty and sadness of it all made my heart hurt and my whole body weak. Tears, and a comforting hand, and nurses and a neonatologist all performing a perfectly executed code, and the patient sleeping and serene, and her family outside the OR door, and everyone hurting for this family, and no one to witness it all except me…new, and fresh off of orientation. I didn’t know what to do then. I didn’t know what I was supposed to do and I didn’t want to leave and have to tell the family waiting outside the room that their baby had been born without breath.
That day, I went to the bathroom with the extra scrubs I kept in my locker and washed the patient’s blood off my body. And I cried and I cried and I relived every second from the moment the patient told me her water broke. And to this day, I still remember the force of her body trying to deliver that baby and I think of all my failed attempts to give that family a different outcome.
Nursing isn’t just about nurses. It isn’t just about patients or their families or their babies we witness being brought into this world. Nursing is about teamwork and comfort and care and knowing what to do when things don’t go as planned and being surrounded by people who know more than you do when you need it. It’s about crying when things don’t go as expected, no matter how hard you want something, no matter how hard you tried. It’s about comforting someone, even when they aren’t aware they need it. It’s about all of us, every single person who works on a hospital unit, wishing and wanting the very best outcome for every woman and baby.
I love being part of the nursing profession. I love knowing that no matter how many times we are blindsided by something unexpected, we still hurt for the family. If you’ve ever been the patient who experienced something that didn’t go as planned, know that every single person on that unit wished and wanted and prayed for you to get the very best outcome. It’s never just another cesarean delivery for us. It’s never just another birth. When we think about any unexpected outcome, our hearts still hurt and our bodies feel weak and we remember you.
Until my next delivery ❤