could only detect a lip and bulging forewaters. She couldn’t feel past the bulge to the presenting part. Damn. A fully dilated cervix ruled out getting back to Hué hospital to have the baby.
Not to worry. Babies basically delivered themselves. Melissa and Mark would have a surprise to take home to the family from their outing to the temple.
Melissa grunted as a strong contraction gripped her. Liquid gushed from her vagina.
Bec immediately removed her hand. A black substance stuck to the end of her gloved fingers. Meconium.
Bec’s heart beat faster. ‘I’m sorry, Melissa, I just have to go back one more time to feel the baby’s position.’ Her brain already knew but she needed to feel the presenting part to kick her disbelief out the door.
As her fingers reached she prayed to feel the hard, bony skull of the baby. Her fingers made contact. Soft.
Bec took in a deep breath and felt again. Soft and yielding.
No. She sent up a prayer of help to whoever was out there and listening. They were facing an obstetric emergency and about to deliver a breech baby with no equipment.
‘What’s happening?’ Tom’s cheerful voice reverberated around the room.
Bec glanced around over her shoulder. ‘We’re about to deliver a breech. Ask the nuns to boil water and bring towels.’
Tom stood perfectly still for a moment, his eyes glued to her face. His expression reflected all her emotions—fear, professionalism and relief they could back each other up.
‘Breech! But isn’t that bottom first?’ Mark’s anxiety morphed into terror.
Tom put his hand on the other man’s shoulders. ‘It is. But in an unlucky situation you have the fortune to have a midwife and a doctor here today. I’m Tom and I’m a doctor. You go and hold your wife’s hand and leave the rest to Bec and me.’
Bec was certain his words indicated more control than either of them felt.
Tom hauled open his medical kit, passed a pair of scissors to one of the nuns and asked for them to be boiled. He asked the other nuns to stay. Then he stepped up to Bec, standing very close, his breath stroking her cheek. He spoke softly so only she could hear. ‘How long since you delivered a breech?’
‘About a year ago. You?’
He shook his head. ‘Not since I was a student. You lead, I’ll follow.’
He squeezed her shoulder, his confidence trailing through her, reducing her misgivings.
‘Melissa.’ She touched the woman’s shoulder and fixed her gaze on the woman’s fear-dilated eyes. ‘I need you to listen really carefully. Your baby is coming and it’s bottom first. Together we can deliver this impatient imp but you must do what I say, when I say. We’re going to need patience and co-operation.’
Melissa nodded, her eyes huge. ‘I can do that.’
‘Great. First we’re going to swing you around so you’re lying across the bed. Mark and Tom will have to hold one of your legs each.’
They helped position Melissa so her bottom was on the edge of the bed. One of the nuns sat behind Melissa, cradling her head and supporting her during contractions.
Mark held Melissa’s hand, his face pale and dripping with sweat.
‘I … want … to … push.’ Melissa grunted.
‘Go for it.’ Bec watched, fingers crossed, hoping the buttocks would deliver with the back uppermost. A swollen scrotum announced the birth of a boy.
It was too early to celebrate.
She gently put her fingers into the vagina. ‘His legs are flexed.’ Bec spoke out loud, keeping Tom in the picture.
‘Pressure behind the knees.’
Tom’s quietly spoken words mirrored her thoughts. She gently applied pressure and splinted a leg with her fingers, to draw it down.
‘Warm cloths, I need warm cloths.’ It seemed outrageous to be demanding warm cloths in the stifling heat but a cold breech could send the cord into spasm and cut off the baby’s oxygen supply.
The baby’s legs and trunk were delivered and Bec gently held the baby at the hips, keeping his spine uppermost at all times to allow the head to enter the pelvis in the correct position. Please, don’t get stuck.
‘You’re doing so well, Melissa.’ Bec tried to infuse her words with a sense of calm that she didn’t feel. She gently looped some cord down to prevent compression.
She rotated the baby’s back from one side to the other to encourage the arms to gather in a flexed position across the chest as she delivered the shoulders.
‘Lovsett manoeuvre—well done.’ Tom left his post for a moment and draped the baby in warm cloths. ‘I’ve checked the foetal heart by counting the cord pulsations. He’s doing OK.’
Melissa swallowed hard and glanced at Mark. ‘It will be OK because we’re here at this place.’
Bec’s heart stalled at the belief in Melissa’s voice. The delivery of the head was the hardest and most dangerous part of the breech. She hooked her gaze with Tom’s, expecting to find trepidation and dread to match her own.
Instead, respect shone back at her from deep within his eyes. He mouthed, ‘You can do this.’
Kneeling on the floor, she straddled the baby’s body across her arm, preparing to deliver the head by flexion. With her right fingers flexing the head and her left fingers on the baby’s face, she waited for another contraction.
Nothing happened.
Seconds merged into one minute and then another.
‘Melissa, your baby needs to be born.’ Quiet urgency infused Tom’s words. He sat her up, feeling her abdomen for a contraction.
He nodded to Bec. ‘Now, Melissa. One big push, now.‘
‘Arrgh!’ Melissa pushed, her face puce with effort.
The baby’s head slipped through the pelvis as Bec directed it downward and then up over Melissa’s abdomen, in a large arc.
Purple and unresponsive, the baby lay completely still on his mother’s stomach. No!
Tom quickly tied off the cord with suture thread and cut it with the boiled scissors. He rubbed the baby firmly with the cloth. ‘Come on, little guy.’ His words sounded loud in the painful silence of the room.
Bec wiped the baby’s nose and mouth and tilted the baby downward. ‘We don’t have anything we can use to aspirate.’ She couldn’t hide the panic in her voice.
Tom rubbed the sternum and blew on the little boy’s face in short, sharp puffs.
The baby’s colour deepened to a dusky blue.
Melissa
