The call was for a “woman in labor.” The Mat-Su Valley has the highest number of out-of-hospital deliveries in Alaska, and allegedly per capita in the United States.
The night was sharp and cold, with dawn still double digits away. Called to a back room, we wove through the living room and glanced down the hallway. The woman in the plain housedress with hair plastered to her head knelt next to her bed, hands clasped in front of her. Except she wasn’t praying, she was delivering—her thighs shaking with an unmistakable bulge between them.
Without preamble or exaggeration my partner and I slid into the room on our knees, covering home plate just in time to catch the pitch. Eight-plus pounds of full-term baby boy landed in our hands. Extricating the baby, I told Joe to inform dispatch of an “outside delivery” so we could get an official time.
Sprawled on the bed just in front of mom, a 3-year-old slept peacefully, undisturbed by the miracle of life happening on the edge of the floral blanket. We pushed his limp, snoring body over to the side and got mom up on the bed, delivering the placenta and allowing her some time off her feet before we made our next move. Securing the placenta in a bag, I set it down on the bed.
The husband, vibrating with excitement and joy, stared at the bag for a moment. Tucking it under his arm like a football, he raced out of the room. We heard furniture falling as he headed for the kitchen. He threw open the door of the fridge and set the bag on a shelf, sighing with relief as he closed the door.
We caught up with him, shock still registering on our faces. Placing his hands on his hips, he nodded with satisfaction for a job well done. “We’re saving that,” he said to me with confidence. “It has cells.”
“Sir, step away from the placenta!” is now officially off the list of things I never thought I’d say.
The baby was perfect, mom was doing well, dad gave up the hostage placenta, and the 3-year-old slept through all of it. The sense of relief and happiness was palpable. She graciously allowed us to take some pictures of both her and the baby.
As we wheeled her out to the waiting ambulance, I glanced up. The stars are not shy in Alaska. Brilliant points of light stood out through a faint green swirling haze from the aurora. Mom, son, and placenta were safely loaded and transported to the hospital. It was a good night.
Dispatch contacted me some time later. It’s easy to forget they routinely only get one side to any story—and not always the best parts. I updated them on a healthy delivery and good outcome.
“Was it steamy?”
“Well, you guys said it was an outside delivery, so we were trying to figure out just how she’d gotten outside, where you would put her, and what the heck she was wearing. It must’ve been so pretty under the northern lights. But my God, it’s so cold tonight. We figured it must be steamy.”
There are times when Alaska still doesn’t understand me. Translation failures between New Jersey and Alaska have caused incidental confusion.
This is a common, though not average, EMS call. It combines challenges to all levels, some not immediately seen on the surface. It’s late at night, there are no resources, no immediate help available. The temperature is subzero, road conditions ice-packed and treacherous, and the closest hospital is 30-plus minutes away. The house is an unknown of occupants and hazards.
The delivery is imminent and full of unknown risk factors to both mother and baby, representing a call that carries enormous risk, stress, and provider discomfort.
As you read this true story, I hope you smiled and nodded knowingly. If I’m lucky, you laughed, because frankly it was surreal and awkward and funny for a long time afterward.
A year earlier Joe and I were on another call for a different child. Slightly older, but still a baby. She struggled to breathe, her chest moving at an impossible rate. Her small heart beat frantically, trying to keep up, until it couldn’t. Just as we turned over care, it failed.
As hospital resources poured over her thin frame, her mother keened over and over again, “Come back to me.”
In the end the little girl did not return—but the voice never left. It has quieted, until something like typing these keystrokes is enough to bring it back to me, along with the indelible sense of loss.
A career in EMS gives you a bunch of mental files. Sights, sounds, smells. It’s a language as common as the acronyms we use. I can say “burned flesh” or “lower GI bleed,” and if your nose wrinkles, you know it.
Under sounds there is an interesting dichotomy. The guttural cry of true active labor is directly balanced by the pure tone of unbridled grief. Voices of pain and joy. Mothers’ voices.
If it left a mark on me, what would it do to someone who did not have a career of experience to fall back on? It hurts. It causes struggle and self-doubt, it haunts and accuses, it becomes an inherent failure even if there’s no blame. It can take a career as easily as it took that young life.
Later Joe would tell me just how much delivering the boy meant to him. The little girl haunted him, and he’d been struggling for a long time. He second-guessed himself constantly, replaying the call over and over. Participating in this delivery and being able to laugh afterward helped bring balance. We both have pictures of baby Charles on our phones.
Help control the narrative that defines your practice. Use positive feedback, practice your craft, share the wins, and remember the losses. Both will come, and you will get through them.
Tracey Loscar, BA, NRP, FP-C, is chief of operations for Matanuska-Susitna (Mat-Su) Borough EMS in Wasilla, Alaska. She is a member of the EMS World editorial advisory board.