Often in the “practice” of medicine, we have help…
I was at home assisting the kids with chores on a 1983 Spring Saturday afternoon when the phone rang—since it was my weekend on call, I’d already fielded about two dozen calls from our Family Practice clinic. Hoping it was for her, one of my teenage daughters answered it but frowned and immediately handed off to me. Dr. Rogers, the ER doctor on the other end of the line got right to the point, “Hey Doc, I’ve got a pregnant 16-year-old here that is absolutely insistent that she couldn’t be pregnant—says she has never been with a guy—so, no prenatal care, obviously. Belly looks like she’s about 20 weeks or so—can’t tell for sure, because the on-call ultrasound tech is not answering his phone. She’s having a lot of pain—appears to be in labor. I sent her over to OB.”
“And,” he paused and sounded relieved to dump the responsibility, “You’re on call for drop-in OB.”
I hung up the phone and while trying to assimilate the information I had just been handed, sheepishly mumbled an apology to my angel wife and busy children for leaving them—yet again—to do the work around the house without me.
We lived out in the country near an Arizona town of about 50-60,000, and at the very best of times (the middle of the night) our house was exactly 12 minutes from the hospital delivery room, but on Saturday afternoon it might be more like 20. I hopped in my small truck and took off down our lane, still attempting to formulate complete ideas from the cursory details Rogers had given me: very high-risk pregnant girl in denial with no prenatal care; probably in labor; markedly premature baby possibly too small to salvage; no neonatologist; no neo-ICU; 3-hr by ground ambulance from us to the nearest neonatologist/neonatology unit; most of the OB specialists in town would not be readily available for consultation in case this young mother had serious maternal complications—I did not want to do this.
Of three Family Practice docs in town who delivered babies, I was obstetrically the busiest (averaging about 30 deliveries a month)—there were 7 or 8 Board Certified Obstetricians. All of us who did obstetrics took an equal number of OB calls for drop-in deliveries (no prenatal care, or from out of town—we averaged about one-a-day). For us Family docs, in case we had an emergency C-Section or severe maternal complications, we had to try to track down one of the specialists. But I was on my way to the hospital and I had no way of contacting anyone else until I arrived there and I first had to assess the situation.
I slammed to a stop at the hospital back door and still in my street clothes sprinted down the hall to the OB Dept and entered. I had hoped we could give some IV terbutaline to slow her labor for long enough to get her transferred by ambulance to Phoenix, but by the time I arrived, the pregnant “child”, Sylvia, had already been moved into the Delivery Room and been put her up in stirrups—the experienced, astute OB nurses had assessed her and found that delivery was imminent.
I rushed into the Doctors Lounge and—as I had done before hundreds of times—yanked off my shirt and pants and jumped into green scrubs, stretching disposable shoe covers over my penny-loafers. In the delivery room I grabbed and jammed my hands into a pair of sterile latex gloves so I could check her.
“Oh crap!” I thought as I inserted my right middle finger and forefinger into the birth canal and immediately encountered the baby’s head—completely dilated—NO cervix remaining—head engaged! No time to stop labor! No time to call the backup OB! Nothing to do but stand there and deliver her!
Sylvia was writhing all over the place and screaming with each contraction—there was little time between them. Mrs. T, my stalwart delivery RN, was desperately trying to use the doppler to hear the baby’s heart—initially, it had been good at about 160/minute, but with everything else going on, including Sylvia’s mother standing by the bedside, crying with anxiety and fear, while her daughter was squeezing Mom’s knuckles white with each contraction—the fetal heart was now not heard .
Mrs. W, my other nurse called the newborn nursery to find out where the on-call Pediatrician was—he happened to be right there examining babies—”Great! Send him in!” Dr. Cranston rushed through the door that connected the Delivery Room to the Nursery and between Sylvia’s screams I filled him in. I watched his countenance drop—he was only out of training for a couple of months—“Carlin, you KNOW we don’t have a neonatologist!”
“Cran, she’s going to deliver any second! We are just going to have to do our best! I didn’t choose this!” He just stood beside the stirrup shaking his head.
Then, with an ear-piercing, mighty, long, loud yell, Sylvia began pushing the baby’s head out as I grabbed some sterile towels and did my best to not drop the slippery newborn. Because the baby was so small, Sylvia only had to push once, and I was suddenly gripping the smallest baby I had ever delivered! She couldn’t have been more than about 3 pounds! My heart sunk and the Pediatrician just stood there. They usually weren’t yet saving babies this small even under the best circumstances with Neonatologists in Neonatal ICUs in the big cities! And this tiny peanut of a baby here in rural Arizona was not breathing, was not moving—she just lay limp and purple on the green surgical towels I held in front of me—apparently dead. Sylvia and her mother looked at us in fearful anticipation. Cranston silently shook his head back and forth in a sign that this was beyond anything we could handle—this baby was NOT resuscitatable—she was too small, too dead! My experienced nurses standing by knew it, too.
We stood helplessly looking, hoping for breathing, for movement—nothing—it had been two or three minutes since she had popped out of the birth canal—I clamped and cut the cord and carried the limp, lifeless, purplish baby girl to the bare stainless-steel surgical table beside us and gently laid her there, still partly-wrapped in the towels.
As I placed her there, I said a silent prayer, “Heavenly Father, if you want this baby to live, you’re going to have to please do something, because we are in WAY over our heads here.” Then, leaving her alone on the cold table, I started to rotate back to deliver the placenta. But, just as I finished my silent entreaty to Heaven and began to turn around, abruptly the baby spontaneously took a big deep gasp of air and let out a cry that, moments before, would’ve rivaled her young mother’s yells. Cranston’s eyes got huge and immediately he lunged for her, folding the slimy green towels over her now animated body—he bolted for the nursery with her in his arms, placed her in an infant warmer and gave her generous amounts of oxygen.
With deep, sincere “Thank-You, Father” prayer in my heart, I again turned back to Sylvia and uneventfully delivered the placenta. The new grandma was still crying—only for a different reason.
The baby girl, who they named Emily, was 3 ½ pounds. Once she instantly began spontaneously breathing and got into an isolette on oxygen, she never turned back. She went home at 3 weeks of age and was healthy and happy. 
I saw again her with her mother when Emily was 3 years old, and I couldn’t tell she’d had such a rocky start. Sylvia was gushing gratitude for what she thought I had done 3 years earlier. I reminded her that Emily was there only through divine intervention—certainly NOTHING that I could take credit for.
PS—A couple of days after her delivery, I interviewed Sylvia when she was alone. She had known that not having periods was not a good thing but, in her immaturity, had been in denial that she could be PG, even when she began to show and was successful in covering it up.
There wasn’t much Grandma could do about any of this under the circumstances, so she just enjoyed being the Grandma.