A Sacred Moment

Kristen here…

 I was standing over the table in the OR about to start a c-section when the call came that there was an emergency coming to the operating theater.  I wasn’t sure what the commotion was about, but I didn’t ask question as we quickly ushered out the current patient and made way for the emergency.  I poked my head outside the building to see a team of maternity nurses rushing a patient up to the OR on a gurney.  The patient was covered by a blanket and on her hands and knees trying not to fall off the bed that has no railings as the nursing team turned the corner.  The other patients turned their heads with curiosity from the surrounding wards to see what all of the commotion was about.

As they reached the OR doors one of the nurses seemingly attached to the patient looked at me and said, “cord prolapse.”  Her arm was inside the patient trying to hold the fetal head up above the umbilical cord.  This is the maneuver that would save this baby’s life.  Cord prolapse is a true emergency.  The umbilical cord tries to deliver first which is a life threatening problem when the after-coming head of the baby slams down on top of it cutting off the blood and oxygen supply with every contraction.  It is exceedingly difficult to fight against the strength of every contraction and keep the head from pinching off the cord.  Time is of the essence.  “She was transferred here from another clinic for cord prolapse.  When I checked her I could feel the cord pulsating,” the nurse said as we ushered the patient into the operating room.  Pulsating tissue in the birth canal is pathognomonic of a cord prolapse.  “Is it still pulsating?” I asked, hoping that the answer would be yes, hoping that there was still a chance that this baby was alive.  “Yes, I can feel it pulsing,” she replied.  Relief washed over me as we moved the patient to the operating bed.  I left to go scrub as the OR exploded with activity preparing the patient.

 I stood across the table from one of my colleagues and flew through the maneuvers to do this c-section and deliver the baby as quickly as possible.  I had no idea how long the prolapse had been going on for or how much reserve this baby still had left.  I opened the uterus and reached my hand inside to deliver the head.  My fingers touched the fingers of the nurse still desperately trying to hold the baby up from the other side.  For a split second my mind paused, I couldn’t feel the cord. Something wasn’t right. 

I looked down as I pulled the baby up through the abdomen.  I couldn’t help the groan that came from deep within.  Anencephalic.   This is a rare condition where the brain does not develop properly in utero and much of it is missing.  The whole back of the head was sunken in where normal brain tissue should have been.  I looked down at the soft spot between my fingers and could see brain tissue protruding through the forehead.  This is what the nurse felt pulsating.  There wasn’t a cord. It was much, much worse. 

The baby gave a guttural cry as we cut the cord and handed him over to the waiting nurse.  My heart sank.  Though there is some very rudimentary brain function that allows for reflexes such as breathing and some gross movements, anencephaly is not a condition that is compatible with life.  The hours for this baby are very, very numbered. 

We finished up the c-section with heavy hearts.  How was I ever going to explain this to the patient and her family? I asked one of the nurses what the people in the patient’s village would say or what her family would think and she responded, “they will say that there was a curse put on the patient or her baby, or maybe they will say that there is a deep family conflict and god is punishing her.”  All of it is so far from the truth, but so much a part of the reality here. 

I went to check on the baby after we had finished in the OR.  Still alive.  Still breathing, moving, crying.  I wanted desperately for this mom to see her baby while he still had life.  I didn’t know how long that would be. 

After she got settled in her bed in maternity, I walked quietly over to her side and pulled the curtain – the only form of privacy on the ward.  Kneeling down beside her I began the heart wrenching conversation.  As I told her about the baby and the anencephaly tears rolled down the side of her face as she stared at the ceiling.  Still numb from the anesthesia she lay flat on her back, unable to move.  I described the baby’s appearance, reiterating that this was not a curse, that she didn’t do anything wrong, but unsure that she was hearing anything that I was saying.  After discussing that this baby may only have a few hours left I asked if she would like to see him.  She agreed with some hesitation.  Scared by what she might see and haunted by the thought that he might die before she had ever met him.

I could hear his cry as the nurse brought him down the hallway and set him on the bed beside her.  I stepped back as she took it all in.  The mixed emotions raging within this 19 year old mother came in waves across her face as she looked at him.  Slowly, she reached her hand out to touch him with hesitation.  He grabbed hold of her finger and held tight.

I knew in that instant that I was standing in the presence of a sacred moment.  Witnessing the bond between mother and child that God forms so strongly before they have ever even laid eyes on each other.  Something holy, something beautiful was happening in those few, precious moments.   It was a moment that I didn’t deserve to be a part of; it was a moment I will never forget.