The young mother was not at all prepared for what was about to happen to her. Unfortunately, neither were her doctors.
It was my first time in the delivery room at the University Hospital. The doctor “training” me was an intern with 3 weeks experience. Our combined knowledge and experience would have filled a page and a half in a medical textbook. But there we were, attending the delivery of a 14 year old girl. That is not a typo. The mom had gotten pregnant as an 8th grader. She was from Mexico and spoke no English at all.
The birth of the baby was routine, and the intern performed the delivery of the baby without any difficulty. The umbilical cord was quickly cut and clamped and the baby handed off to the nurse.
The intern then turned to me, “Want to deliver the placenta?” It wasn't a hugely difficult medical procedure, but third year medical students take what they can get.
I switched positions with the intern and grabbed hold of the clamped umbilical cord. I gently pulled downward. Nothing happened. I continued to pull for a few minutes. Seeing no progress, the intern instructed, “Pull harder.” So I did. Still no progress. The intern repeated the instruction. A few minutes more, still no progress. I thought I as pulling pretty hard, but according to the intern I wasn't as she instructed me to increase the downward traction even more.
Finally the amount of visible cord began to lengthen, indicating the placenta was on its way out. But what appeared between the mother's legs did not look to me like a placenta at all. It was big and round and purple, with lots of veins. It looked like a martian head. (If martian heads actually existed and came out in delivery rooms!)
“Oh my God! What is that?” exclaimed the intern who was watching me. As she verbalized the question the answer came to me, the words came out of my mouth simultaneously with the realization of what it was-
“It's the whole d--- uterus!”, I said as quietly as I could.
I had pulled the cord so hard that the girl's uterus had turned inside out and come out with the placenta still attached. The uterus was now located outside of her body. I lacked experience, but I was pretty sure that this was NOT a good thing. (I later learned how bad it actually was. If the placenta detached while the uterus was out, the uterus could not contract down to stop the bleeding and the mother could bleed to death. If the uterus contracted with the placenta still attached, it would take a lot of medication and skill to safely put it back. It was a race against time.)
“What do we do now?” I whispered.
“I don't know!” was the intern's non- reassuring reply.
The nurse, who actually had experience, reacted quickly and called for the senior doctor on the OB unit. The doctor arrived quickly, and surprised me by rapidly pushing the intern aside. She then used her balled fist to forcefully shove the uterus back inside. I vividly remember repeatedly seeing the outline of the doctor's fist through the mother's abdomen as the doctor worked to make certain that the entire uterus had completely returned to its correct position, and would stay there.
I also remember wondering- what is this young mother thinking? She was alone. There were no family members with her in the room. She was in a foreign place surrounded by doctors and students she did not know, speaking a language she did not understand. She had to have felt significant pain given the pounding pressure of the doctor's hand inside her body, and she did not even know why. Things happened so quickly no one had taken the time to explain. And- she was only 14 years old.
14 years old... about the same age that Mary was when she gave birth to Jesus. We have sanitized the Christmas story and ignored the pain of childbirth, the bleeding after the placenta released, the cramping that came as she nursed her baby, and the vulnerability of that young family. Mary was in an unfamiliar city, alone except for Joseph, her young husband. Shortly after the birth shepherds arrived, strangers intruding on her first moments with her son, relating an incredible story of an angelic announcement. What was Mary thinking?
The story of the young girl in the delivery room reminds me that Mary's experience was not all halos and choirs. Childbirth, especially to a young woman in a strange place, can be a frightening experience!
This is the 4th of Six Amazing childbirth stories. you can read the previous ones in our archives, and subscribe to the blog to have coming posts delivered straight to your inbox.
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