Paramedics explain what it’s like to deliver a baby in an ambulance
Racing down Route 422 in the back of an unsteady, cramped ambulance is one of the last places most paramedics would want to deliver a baby.
But sometimes, it’s the only choice.
“We knew she was in labor, but didn’t think she was going to deliver that quickly,” said Aaron Natali, a paramedic supervisor for Butler Ambulance Service, said of a patient.
The mother wanted to be taken to AHN West Penn Hospital in Pittsburgh where her obstetrician was, but in the ambulance on the far side of Meridian, the crew questioned if they would even make it to Butler Memorial Hospital.
They didn’t.
Natali said the woman felt she had to push and it only took two pushes for the baby to come out.
“It’s a really neat thing being the first human being that another human being ever lays eyes on,” Natali said.
He’s delivered five babies in his more than 30-year career.
They don’t all come out so quickly.
Natali said he recently had a call where the crew was at a home for 45 minutes with no baby delivered. Forty-five minutes with no delivery is technically a complication since it can put stress on the baby, Natali said, so the crew took the mother to a hospital before the birth.
“It pretty much does itself,” Natali said about delivery. “If the baby’s going to come, the baby’s going to come.”
People calling 911 for labor can be all over the place, Natali said. Most haven’t tried to get to a hospital yet. Some work themselves up thinking they’re in labor when they’re not and others are in labor when they call, but put off going to the hospital.
He said most labor and delivery calls are for women experiencing contractions but not in labor yet, so most times, crews check on them and take them to a hospital.
“It seems to be one extreme or the other,” Natali said.
It can be the same for the paramedics.
“Everybody’s frankly scared to death of it because, it’s exciting, but it’s also scary because there’s a whole lot that can go wrong,” Natali said.
He added a former Butler Ambulance Service paramedic used to say “that’s your one call” that cheers you up when others can be draining.
Natali said the mother does all the hard work during these calls. He’s there to offer support and his signature “gallows humor” during tense situations.
Another former paramedic would sing “Happy Birthday” every time she delivered a baby, he said.
Paramedics only deliver the baby in the home if the mother is in active labor. Natali said crews bring an OB kit with them that includes supplies such as a bulb syringe to clear the baby’s airway, foil bunting to wrap the baby and a scalpel for the umbilical cord. Then, he may ask the homeowner for extra towels and pillows to keep the mother comfortable.
Of Natali’s five deliveries, four have been in the home and none have had major complications.
He added he has seen an umbilical cord wrapped around the baby’s neck once, but this is a very common complication. The cord had enough room to pull it out more and unwrap the baby’s head, he said.
Where extra hands may be needed, is after the birth.
“Once she delivers, we go from one patient to two,” Natali said.
Ashley Mitchell, a paramedic who’s been with Butler Ambulance Service for about a year, said she’s delivered three babies in the field.
Only one of hers turned out to be difficult due to heavy bleeding from the mother. Both the baby and mother recovered. However, she’s heard stories of paramedics having to make decisions on who has the highest chance of survival.
“That sucks, making that decision,” Mitchell said.
Otherwise, the baby receiving plenty of prenatal care always helps the paramedic know what they’re getting into and ensure a smooth delivery.
Mitchell added once babies are delivered, the baby and mother are always taken to an obstetrics hospital. Any emergency room can deliver a baby, but complications require specialists.
Natali recalled one instance several years ago when Butler Memorial Hospital had a patient with a high-risk pregnancy during a winter storm. Hospital staff wanted the patient to be taken to UPMC Magee-Womens Hospital in Pittsburgh, but the roads were closed.
“We basically told them we couldn’t take that risk because they’re in a hospital with doctors, and that’s much better than upside down in a ditch along the roadway trying to deliver this high-risk baby,” Natali said.
