A doctor's life: Breech

Kids born in MVC have a unique experience in life. It's a cradle-to-the-grave thing for some with both facilities - delivery room and cemetery, present in the area. I was privileged to bring many kids into this world at Strahle hospital. I have watched these kids grow, circumcised the boys, treated them when they got sick and watched them succeed in school. The 17 years that we were there gave me this opportunity. One kid's second name was after my nickname and another baby was named by her mother after "measles" when it was noted upon delivery that she was physically normal even when her mom contacted German Measles (Rubella) during the first trimester and I was afraid that the baby would be affected. 

One particular lady who lived 3 towns away had her first son delivered by me, because she happened to be in the campus for a convention with her husband who was a pastor. Since she lived in a faraway town this was the only time that I saw her, which shows that there were no previous visits for prenatal checkup. The delivery was successful and after the convention she and her husband went home with an added family member. I never imagined that about 2 years later with another convention in the campus, that I would have the same woman with another pregnancy, and in active labor.

We laughed and joked about the timing of her delivery when she came in. She was placed on the examining table for the internal vaginal examination and I proceeded with determining how soon she may be ready to delivery, when I discovered that the head of the baby cannot be found. External examination confounded my fears that this baby was in the breech presentation. We were taught in medical school that babies who are not in the normal cephalic presentation should be delivered by caesarian section (CS). By this time she was having strong and regular uterine contractions that sending her through a bumpy road to the hospital with CS facilities was unthinkable. I warned her about the possible problems with delivering her baby and that she should cooperate as much as she could. I also rehearsed the nurse on how to hold the feet of the baby as soon as I have managed to bring both feet up, and to keep a positive traction while I felt for the baby's chin and mouth and delivered the head.

This would be my second vaginal delivery by breech presentation and the memory of the first one was still fresh in my mind. With the team and the patient now ready we got down to deliver the baby as careful and as fast as we could. A delay in bringing out the head after the body is out would mean a smaller birth canal and the exit of the larger head might be too difficult or too late for survival. I managed to deliver both feet and from this time onwards was crucial. The body came next and it was good that the chin and mouth were easy to secure and in one moment the head was out and the baby let out a big healthy yell. Like the previous delivery this woman was discharged and went home with her husband, son and a newborn girl after the convention. 

Three years later she was at the entrance of the clinic again, during yet another convention, but this time without a baby bump on her tummy. The two active and healthy kids that were with her came forward and hugged me and that was undoubtedly one of the many happy moments of my life.