The Resuscitator

I am standing at the mother’s head in the theatre. I have given the spinal anaesthetic and the surgeon is cracking on with the Caesarian. My mind is wandering a little – it is late in the evening and I have yet eaten. The mother needed the Caesarian after it became clear the baby was becoming distressed with a high heart rate and meconium appearing in the mother’s liquor.

I am broken out of my reverie by the midwife. Like me she is dressed in surgical scrubs with a blue theatre cap and mask.

“Dr, will you help me with the baby?” She is clutching a sterile sheet, ready to take the baby from the surgeon when the time comes. I throw off my daze and nip over to the Infant “Resuscitator”, a small mattress with a heater, oxygen, suction and set of airway tubes. I have never seen one this close before. I nervously open drawers, pretending to check for things which I think should be there. I have, of course, no idea what. I spot a laminated A4 sheet stuck to the wall, obviously placed there in the distant past by some predecessor – it is a step by step account of how to resuscitate a new born baby. I start reading feverishly – my increasing nervousness significantly impairing my ability to retain the facts.

I turn back to the operating table. The baby’s head is out of the uterus and the surgeon is just releasing the shoulder. The body is delivered. The midwife takes the baby and wraps it in the sheets. There is no cry, no noise. She rushes over to the resuscitator and places the baby on it. It, a he, is blue and unmoving. The midwife sucks out the secretions from the nose and mouth and checks the pulse. He stirs a little but there is no breathing and no cry. I grab the bag and mask, turn the oxygen to full and place the mask over the baby’s mouth and nose. I gently squeeze the bag looking for movements. Nothing. I squeeze a few more times. The knot in my gut gets tighter – I don’t think I am getting any oxygen into the baby’s lungs.

I take a deep breath – I’ve never done this before: “Sister, can you pass me the laryngoscope?” She passes me the silver device used to find the vocal chords so the airway tube can be inserted correctly. I gently pass the blade to the side of the baby’s tongue, pushing it to one side. “Suction please.” The midwife passes me the slim suction tube and I suck away the meconium and secretions that obscure my view. I catch a glimpse of the chords and, acutely aware of the seconds passing during which the baby is getting no oxygen, pass the slim airway tube down between them.

I pull out the scope. It feels like ages but has probably only taken 10 seconds. I rip the mask off the bag and push the bag onto the tube. The midwife fits the stethoscope to my ears and I gently squeeze the bag whilst listening to the baby’s lungs. The relief is a physical wave down my body – I can hear the air in each lung. “Is there a pulse?” The midwife checks and yes, there us. I continue working on the bag and watch as the lips turn pink. A hand twitches. The midwife rubs the baby. He moves a leg. A hand. Both hands. His face contorts and I realise that if my tube were not stuck between his chords he would be using them to make a hefty cry.

I pull out the tube and the theatre is filled with sound, a sound I have heard many times before but this is surely the first time I have classed it as beautiful – the wail of a newborn baby.