Some girlfriends and I were discussing maternity leave in other countries.  Some countries have none, some have six months paid leave, some have 12 months paid leave, and Americans have 12 weeks guaranteed unpaid leave.  When I went back to work with my first child after her C-Section delivery, I remember my Austrian neighbor being appalled that I was going back to work so soon after having a baby, and major abdominal surgery.  I just felt lucky to have enough vacation time to have 12 weeks paid leave.  Honestly, I was ready to go back to work after having both of my kids.  I was really nervous and tearful with baby #1, but not so much with Baby #2.  With both kids, I had thoughts in the back of my head of, “I’m I ready?  Have a lost my mojo after having all this time off?  Would I remember how to be a nurse?”  It can be tough going back to the trenches after so much time off.

First day of work after 12 weeks off, Baby #2:

It’s 9am and I’m thinking, maybe I should go pump now.  One of my favorite midwives, the one who delivered Baby #2 via VBAC, asks if I will catch one of her babies.  Her patient is a primip, but the baby seems a little big so she would like NICU backup.  No problem

We chit chat with the patient and between ourselves during pushing.  Small talk.  “How’s your babies?  Your doing a great job pushing!  No epidural?  You rock!”

The patient is crowning.  I stand at the foot of the bed, warm blanket in hand to catch the baby and place on mom’s chest.  Baby’s head comes out…..and nothing else.  Looks like a turtle.  Big head, no neck.  No neck?  Sh-T!  SHOULDER DYSTOCIA!!!!!

“What do I do?  What do I do?  Oh, crap!  Deer caught in the headlights!  I should run away, yes that’s what I’ll do,   I’ll run away!“

Baby’s head is coming out but the rest of his body is stuck.  His head is turning a deep, dark, purple.  I stand and stare.  The midwife snaps me back to reality.  Yells at me to grab the mom’s leg and bend it back towards her head.  God I feel like I’m splitting her in half. The room is suddenly filled with people.  A large episiotomy is cut into the woman’s unanesthetized perineum.  A nurse is standing on a stool, pushing down hard on the mom’s suprapubic bone.  The patient is screaming.

We are screaming.  PUSH!  The baby’s  head is such a dark shade of purple, it looks black.  There is murmurings of pushing the head back inside the uterus and taking the mom back for a C-Section.  Please God, no. PUSH!  The OB reaches in and releases one of the baby’s shoulders.  The rest of the body slides out.  The limp, blue baby is handed to me.  The delivery room looks like a war zone.

I place the rag doll of a baby on the radiant warmer.  We wipe the baby off vigorously with warm towels.  The baby refuses to breathe. Should we call a Code Blue? I breathe for the baby with the anesthesia bag and oxygen.  Breathe baby, breathe.  How long has it been. Seconds later the baby let’s out a weak cry.  He is still limp, but has a good heart rate and is turning pink.  His right clavicle is broken.  He weighs 10 pounds.

We bring the baby to the nursery, place him on monitors and IV fluids.  He slowly comes around and cries in protest that this is how he had to enter the world.  He gives the NICU nurses major attitude but quiets for his mother.

The staff all relax and breathe a sigh of relief that this baby is OK.  We congratulate each other on the great save.  I still had my mojo after 12 weeks off, even if I needed a little jump start.  My mind did not let me forget how to be a nurse.  My body was not letting me forget that I was a new mom.  It was now 12 noon, and the front of my scrubs were dripping with breast milk.

Should we call a Code Lactate?

RR