This is from the twenty-ninth chapter from my best-selling book, Bryson City Tales. I hope that you’ll enjoy going back to Bryson City with me each week, and that if you do, you’ll be sure to invite your friends and family to join us.
THE HOME BIRTH (PART 2)
We stopped by the hospital to pick up an emergency delivery kit and then headed out of town.
The mountains were covered with ice. Old-timers called it “rhine ice.” It completely covered each trunk, branch, and twig. The trees looked like ice sculptures. It was hauntingly beautiful. But I was nervous about the branches overhanging the road. I knew that the heavy branches—now weighed down with ice—could break off and fall. Being struck by one can result in some pretty horrific injuries.
Fortunately the ride out wasn’t as bad as I had imagined. Don explained how the older docs, especially Dr. Bacon, had done home deliveries for years. “Once Sylva brought in an obstetrician, the guys here just quit delivering the babies. So, folks wantin’ a hospital delivery go over there. Those wantin’ to stay home just call the granny midwives. There’s only a few of ’em left, and their practices are very secretive. Tell you the truth, Doc, I think the old midwives do a better job. We almost never get called to a problem.”
Billy, usually the quiet one, couldn’t resist sharing some local lore. “Some folks say that if the granny midwife loses a baby, the family just buries the baby and never calls the coroner. It’s never reported to the officials. The local clergy know, and they’ll help with the burial and a small family service. But otherwise it’s hush-hush.”
“Yep,” chimed in Don, “you’ll see a lady, pregnant as can be, then next thing you know she’s skinny as a rail and has no baby. Just says she ‘took off some weight.’ But everyone knows what really happened.”
“Don’t you guys have to report those sorts of things?” I asked.
Don and Billy looked incredulously at each other, then at me. In unison they chimed, “You stupid?” I laughed. Obviously they’d been around Dr. Mitchell way too long!
Don went on, “That’d be one sure way to get kilt. There’s some things a fella’s not to mess with—and this is one of them.” The ambulance became very quiet. I sensed I was treading into some fairly deep weeds.
Billy was the next to speak. “Doc, speaking of the old docs.”
He paused for what seemed like several minutes.
“Yes?” I prodded.
Billy looked at Don, who nodded. “Go ahead, Billy. It’s OK.” Billy sighed. “Well, Doc, the way we hear things, some of the
older guys really have it out for you and Dr. Pyeritz. They don’t particularly like Dr. Cunningham either, but since he’s hooked up with Mitch, they have to tolerate him. You and Dr. Pyeritz being in their building has bought you some time for now. But . . .” He paused again. “Doc, be careful. Watch your step. They’ve got the nurses reporting to them everything you all do. I’ve heard they’re as mad as hornets about Dr. Pyeritz treating your son at home.”
Now it was my time to sigh. “Anything we should do?” I inquired.
Don spoke next. “Well, you’ve got a lot of the town behind you. The athletic department and the rescue squad are in your camp. You know the park rangers like workin’ with the younger doctors. But the old guys are powerful politically. I’d say you just keep practicin’ good medicine and good citizenship, and you’ll be all right.”
“I appreciate you boys sharing this with me. I know you didn’t have to.”
They both nodded.
As it began to get dark we turned off the main road, up a narrow, twisting snow-covered lane. In the headlights we could still see a single set of tracks in the snow and ice from what I presumed was the midwife’s car. The cabin looked decrepit from the outside, where a single car was parked near the door. There were two rusting cars on concrete blocks nearby. And there were piles of items gathered from dumpsters and other trash scattered around the front and the sides of the cabin. A small barn was off to one side.
“Doc, it’s probably pretty cold and crowded in there. How ’bout we keep the unit runnin’ and stay put, less’n you need us. OK?”
I nodded and grabbed my equipment bag and went to meet Elizabeth and the family. Before I could lift my hand to knock, a fifty- or sixty-year-old woman opened the door and let me in. She closed it quickly behind me.
“Glad you’re here, Doc. Let me take your coat. I’m Sally Scroggins, a friend of the family. Elizabeth’s in with Isabella.”
The cabin was small and not well insulated. But it was clean and well kept. The common room had a small kitchen on one side with a potbelly stove that had a crackling fire going. On top of it a large pot of water was steaming but not boiling.
On the other side of the room several people were sitting around a small lantern. Sally quickly introduced me to the pastor and several family members—children and adults. They seemed to glare at me, and not one of them spoke a word or moved from their chairs. Clearly I wasn’t very welcome here.
“Excuse us, folks,” Sally declared as she took me by the arm and escorted me to a door on the back wall. “We’ve got some work to do.” As we approached the bedroom door, the midwife stepped out and introduced herself. Elizabeth looked to be in her eighties, small, lanky, and leathery—a true granny midwife. She whispered, “Thanks for coming. You’re not a minute too soon! The baby’s heartbeat is starting to get slow and irregular. We don’t have much time.”
“Mrs. Stillwell, wouldn’t it be a good idea if the paramedics came inside?”
She looked apoplectic. She still whispered, but now in a more agitated tone of voice. “No way! Absolutely not!” was her emphatic response. “It was hard enough to convince the family to let me call you.”
“The Shoaps have a phone?” I asked, surprised.
“No, of course not. I have a radiophone that the sheriff dispatcher can patch into the phone system. Now we’d better hurry!” We entered a small bedroom. There was barely enough room for a small bed and a chest of drawers. The woman was lying on her side, moaning. She didn’t acknowledge my arrival. A man, sitting alongside and stroking her hair, stood up and faced me.
“Let me be real honest,” he stated bluntly. “You’re not wanted here. Not real sure we trust your type. Elizabeth here says you can save my baby’s life. I’d be obliged if you did. This here is Isabella and I’m Donnie.” He turned back to his wife and sat down on a small wooden chair by the bed.
“Isabella,” I said, “I’m Dr. Larimore. Would it be OK if I checked your baby?” She nodded, then began to grimace as another contraction began. I reached over to palpate her abdomen. During the quick exam I had time to offer a quick prayer. Lord, guide my hands. Give me wisdom. Protect this small baby. I know children are special to you. Great Physician, be with us.
The baby felt headfirst and was big—my guess, somewhere in the vicinity of nine pounds, maybe more! As the contraction intensified I could see the sweat glistening on Isabella’s brow, reflecting the lantern light coming from atop the chest of drawers. Her husband looked genuinely worried.
As the contraction waned I warmed the head of my stethoscope in my hands. Then I placed it on Isabella’s abdomen. What I heard caused a knot in my stomach. The baby’s heart rate was about one beat every one to two seconds—I guessed about forty beats per minute, the normal was more than 120 beats per minute—but was beginning to speed up.
“Mrs. Stillwell, heart rate’s about forty. We’ve got to move fast. Let’s get some oxygen started. I’m calling the paramedics to come in.”
Elizabeth gave me a concerned look, but without comment she quickly set up the oxygen and placed the mask on Isabella’s face.
As she was doing this I opened the door. “Pastor!” He leaped from his seat and ran over to me.
“I need you to do two things and do them now.” He glared at me.
“Get out there and get my paramedics. Tell them I want them ready to receive this baby. Let them know the baby is in trouble.”
He nodded and started to turn. “One more thing!”
He turned back to me.
“When you get back, I need you and everyone here to pray for this baby and for Isabella.”
He smiled, ever so slightly. “Be obliged.”
“Pastor, one more thing.”
I paused. He furrowed his brows, listening intently.
My voice softened, almost quivering, “Pastor, will you all pray for me, too?”
He reached out to place his hand on my forearm and gave it a squeeze. “Yep.”
I quickly returned to the bedroom. We moved Isabella to the end of the bed and positioned her on her back. I had Mrs. Stillwell hold one leg and Sally held the other. Now sweat was beading on my forehead. I heard Don and Billy entering the cabin.
“Doc, you OK?” Don called from behind the closed door. “Don, just set up for a resuscitation.”
“You need us in there?”
“No room now. Just set up, OK?”
I put on sterile gloves and began to examine Isabella again. The birth canal was filled with an enormous head. Fortunately the cervix was completely dilated. Then I checked for the position of the baby’s head.
“Drat,” I muttered. “Elizabeth, she’s OP!” This was not good news. The baby was in the same nose-down position my son had been in before he was born.
Elizabeth was listening to the baby’s heart rate. “Doc, heart rate’s in the thirties.”
I felt panic starting to build. The child was in immediate danger.
“Elizabeth, can you open the forceps for me?”
“Isabella and Donnie,” I continued, “I’m going to gently place some forceps around the baby’s head. They will protect the head in the birth canal and will help me deliver the baby.”
I was well trained in forceps deliveries, and I quickly applied the instrument. After double-checking the position of the forceps to be sure the application was correct, I waited. In just a few seconds the next contraction began. With it I began to pull and pull. The baby didn’t budge. It felt stuck.
I tried gently pushing the baby back up the birth canal. Doing so would sometimes allow the head to flex and present a smaller diameter to the birth outlet or perhaps allow me to rotate the head to the normal OA position, which would then make birth easier and faster. In this case, once again the head didn’t budge.
Then I quickly tried to rotate the head. I knew the odds of this being successful were nearly zero, but it was worth a try. But to no avail.
“Doctor, the heart rate’s in the twenties!” exclaimed Elizabeth.
I suddenly felt nauseated. “Let’s roll her back on her side.”
Within seconds of getting Isabella off her back, the baby’s heart rate soared into the fifties and then to one hundred beats per minute. “Much better!” I said, almost to myself. Still, the normal baby’s heart rate at this stage of labor should be 120 to 160 beats per minute. We were in big, big trouble. I was thinking as fast as I could—and praying even faster.
- The Murder (Part 1); (Part 2); (Part 3)
- The Arrival (Part 1); (Part 2)
- The Hemlock Inn (Part 1); (Part 2)
- The Grand Tour (Part 1); (Part 2)
- The Interview (Part 1); (Part 2); (Part 3)
- Settling In (Part 1); (Part 2)
- First-Day Jitters (Part 1); (Part 2)
- Emergency (Part 1); (Part 2)
- The Delivery (Part 1); (Part 2)
- The “Expert” (Part 1); (Part 2)
- The Trial (Part 1); (Part 2)
- Shiitake Sam (Part 1); (Part 2)
- Wet Behind the Ears (Part 1); (Part 2); (Part 3)
- Lessons in Daily Practice (Part 1) — Anal Angina; (Part 2); (Part 3); (Part 4)
- White Lies
- The Epiphany (Part 1); (Part 2)
- Becoming Part of the Team (Part 1); (Part 2)
- Monuments (Part 1); (Part 2)
- My First Home Victory (Part 1); (Part 2)
- Fisher of Men (Part 1); (Part 2)
- Fly-Fishing (Part 1); (Part 2)
- Something Fishy (Part 1); (Part 2)
- A Good Day at the Office
- An Evening to Remember
- Another New Doc Comes to Town
- ‘Twas the Night Before Christmas (Part 1); (Part 2)
- A Surprising Gift
- The New Year (Part 1); (Part 2)
- The Home Birth (Part1); (Part 2);
© Copyright WLL, INC. 2017. This blog provides a wide variety of general health information only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment from your regular physician. If you are concerned about your health, take what you learn from this blog and meet with your personal doctor to discuss your concerns.