President, Senior Scribes
Abruptio Placentae
By Delbert Blickenstaff, M.D. 

Cindy Adams and Craig Nixon finished their Childbirth Education classes with flying colors. Craig was a biology major, heading for the teaching profession, and he enjoyed learning about the anatomy and physiology of pregnancy and labor. He was a reliable coach, and Cindy needed him with her as she neared term in her first pregnancy. 

When they arrived on the OB floor with Cindy in active labor, and two days past her due date, they expected to go directly into the labor room. Instead, Miss Long, R.N., stopped Craig and told him to go to the waiting room. 

Craig objected. “But we’ve taken the classes and we understood that I would be able to be in the labor room with Cindy as her coach.” 

Miss Long shot back, “Are you two married?” 

“Not yet,” Craig answered. 

“Then go to the waiting room like I said,” Miss Long commanded. 

“Is that hospital policy?” Craig questioned. 

“It is my policy. I am the head OB nurse on this shift, and what I say goes.” With that Miss Long marched to her station, indicating that the conversation had ended. 

Craig was disappointed, but he did not want to cause trouble. He was afraid that Cindy would receive the brunt of Miss Long’s negative attitude. He gave Cindy an encouraging kiss and went to the waiting room, reluctantly. 

Dr. Church was just sitting down to dinner with his family when he was paged to call OB. He received the report on Cindy’s progress and made a quick calculation of time. He could eat for five minutes and then leave for the hospital. “I’ll be there in twelve minutes,” he promised. The nurses had learned that they could count on his exact timing. 

When Dr. Church peeked into the delivery room to assure Cindy that he was present, he noticed that Craig was not with her. “Where’s Craig?” he asked. 

Cindy almost cried when she answered that Craig was not allowed in because they were not married. 

 “Who says so?” Dr. Church demanded. 

 “I say so, Dr. Church,” from Miss Long, standing right behind the doctor. 

“Well, Miss Long, I’m the head of the OB department and I think that I outrank you. So I want you to swallow that sanctimonious prejudice and see to it that Craig Nixon gets to perform his coaching duties. Is that clear?” Dr. Church asked in as tone as firm as he could without shouting. 

“Yes sir, Doctor,” Miss Long murmured, as she backed away. 

“I’ll be right in as soon as I change and scrub,” said Dr. Church to the nurse attending Cindy. 

“Thanks a lot, Dr. Church, WOW!” Cincy screamed. “That’s a different kind of pain, and it’s getting worse.” 

Dr. Church looked at the fetal monitor and recognized that the baby was in some kind of distress. Cindy’s pain did not let up. “That looks like there is a partial separation of the placenta. Get her ready for an emergency section, and get Craig in the dressing room so that I can explain what’s going on.” 

The delivery room nurses knew how and when to move fast. Within ten minutes Cindy was scrubbed, draped, and was about under the anesthetic when Dr. Church and the OB resident entered the surgery room. Craig had been informed about the partial separation of the placenta by Dr. Church, and he realized that if the placenta separated completely the baby wouldn’t get any oxygen and would die. Thus the rush to get the baby out before that happened. Craig asked permission to be in the room with Cindy. 

Dr. Church made a transverse incision the abdominal wall and also in the distended uterus. With deft hands he lifted the squawking full term female infant out, and handed her to the nurse. Craig was ecstatic! He was at the head of the table by the anesthetist, and he had seen the whole procedure. 

Dr. Church examined the placenta carefully, and sure enough, there was a large clot indicating that he had made the right diagnosis. He and the resident closed the uterus sand the abdominal wall as they had done hundreds of times. Craig watched in awe as the nurses suctioned amniotic fluid out of the baby’s mouth and nose, clamped and cut the cord, put a cap on her head and wrapped her in a warmed blanked before handing her to him. “I can’t wait to see Cindy’s face when she sees this beautiful creature,” he said. 

After Cindy went to recovery and the baby went to the nursery, Dr. Church asked Craig if he had any questions. 

“Yes,” Craig answered. “What would have happened if you had not been here when Cindy got into trouble?” 

“Well, it’s a race against time when you know that a complete separation of the placenta is possible. No one can predict the exact time. That’s why I believe it is best to move fast and get the baby out before it is too late,” Dr. Church explained. 

“I’m glad that you were in the right place at the right time,” said Craig. “Even though we weren’t happy about our introduction to the OB floor, everything turned out OK.” 

“Oh, you’re referring to Miss Long,” Dr. Church said with a chuckle. “I hope that she decides to retire soon. She just doesn’t fit in here. She reminds me of the attitudes of some of the older docs thirty some years ago when we started natural childbirth here. When we wanted to conduct natural childbirth classes and allow the fathers in the delivery room, they thought we were crazy. They predicted all sorts of terrible things would happen, but none have.” 

“One more thing, Dr. Church,” Craig said. “When we were visiting my parents on the farm last week, my mother told me that I am your blizzard baby. Of course I don’t remember, but mother says that when she went into labor we were in the middle of a terrible blizzard, and no one could get out. So Dad called you and with the help of your instructions over the phone, he delivered me. Mom wanted me to remind you.” 

“Well I’ll be,” said Dr. Church. “I remember the story well, but I had forgotten the names after all these years. Thanks for reminding me, and give my best to your folks.” 

Delbert Blickenstaff, M.D.