Labor and Delivery is a very specialized, unpredictable service line. There is a great deal of misconceptions about the work that goes on in the "Women's World". Many think we feed and cuddle with babies all shift, and that it is beautiful rainbows and butterflies. Labor & Delivery is every service line, wrapped in one, in a blink of an eye, which is part of the reason the teams in L&D are so crucial to our facility. One afternoon in January, all was well in the L&D unit at MCMC. I had Rebecca Torres (Becky), the L&D Scrub Tech, working on special projects with me in my office since the unit was "stable". Being an L&D RN for 10 years, I am fully aware that the words "stable" and "quiet" should never be mentioned out loud. While we were working on the project, we heard an all too familiar sound, ambulance sirens, right outside of the L&D entrance. Becky opens the door and the entire hallway was lit up by the ambulance lights. Becky opened the double doors to notify the staff of the ambulance outside, not knowing the fate we would all meet in the next few minutes. As the L&D team began getting up to meet the Paramedics outside, I went to L&D room 1, the closest room we had available, to prepare it for the arrival of the patient. I heard a loud yell from Becky "the baby is out, grab warm blankets!", as I was now preparing our warmer to receive the infant. When I step out of the room to see where the patient was, the L&D double doors opened and I saw Desiree RN and Michelle RN running inside with a limp baby in their hands, wrapped in the warm baby blankets. The baby was not breathing. Immediately a Baby Code Blue was called. As the L&D team rushed to the baby to begin resuscitation, I opened the double doors again for the Paramedics. That is when I witnessed Nursery RN, Kimberly Head, turning the corner out of the elevators and running full speed towards me. The type of thing you would only see in TV shows and movies. As Kimberly RN ran into the room, the paramedics quickly joined after her, pulling their stretcher with our next patient, Mom. The stretcher leaving a trail of blood, a lot of it; Our mom was having a postpartum hemorrhage. I began getting information from the paramedics as I assisted in rolling the stretcher into the room. One of the paramedics had a horrified look on his face and kept repeating "the baby didn't cry. It just came out and it didn't cry".  As I looked over to the warmer and saw the team performing CPR on the infant, I had a gut-wrenching feeling, but I knew I had to now focus my attention on mom, she also needed our help. We quickly moved mom onto the L&D bed and Dr. Nwankwo began assessing how dire mom's situation was. Her placenta was still inside, but she was bleeding. As he tried to stop the bleeding, I started to try and get an IV on this momma while at the same time, talking her through the current situation and trying to calm her down. Her concern at this moment was not her bleeding, it was her baby. "Why isn't my baby crying?," she asked me, and all I could say was "You have the best team helping your baby right now" knowing that the situation did not look good over in the corner where the baby was. After 2 failed attempts at getting an IV in this momma, I called out to our CRNA Marsha to help me in establishing access. The patient's veins were weak, her blood volume depleted, and we were in big trouble. Jacquelyn was also next to the patient, trying to see if she could be successful in getting an IV. Meanwhile, over at the warmer, the team working tirelessly on baby girl and Dr. Nwankwo working tirelessly on our momma. Becky and Michelle at this time were running in and out of the room, fetching supplies for mom and for baby. After Marsha CRNA had a few attempts- for IV without success, I told Michelle, "Go call everyone. We need someone with the Sonosite here STAT". During this time, Mom kept asking me how her baby was doing. All I could say was "They are still working hard with your baby". At this point, although it felt like an eternity, it might have been maybe 10 minutes into her arrival. All I could do was take a glimpse of the team at the warmer and hear their efforts "Compressions resumed, Epinephrine administered, Heart rate 0, baby intubated, compressions resumed" and feel sick to my stomach. The rest of the staff that was working with Mom and assisting, were all just staring at each other, hopeless. After multiple medications were administered to mom, Jordan CTL from ICU came in with her Sonosite machine and successfully placed an IV line. Jordan quickly acted, asked no questions, and became part of our team. We were able to get the bleeding under control and Mom stable.
       
26 minutes. Our team worked on the baby girl for 26 endless minutes. For most people, it passes in a blink of an eye, but for us on that day, it was an eternity. Dr. Ali called the baby's time of death after 26 minutes. Our patient's beautiful baby girl was gone. He came and told the patient the worst news any parent would ever want to hear, "We couldn't save her". The shrieking cry from that mother still haunts me, and I am sure it will for years to come. The patient asked for us to let her die, she wanted to be with her baby. As a mother myself, I felt her pain. We as a team, grieved with her. Her loss, was our loss. We initiated RTS care which is specialized care for patients who have experienced a pregnancy loss and included pastoral services in her care. She lost her perfect baby girl, at 36 weeks gestation.
       
Our mom had a medical condition in pregnancy known as Severe Pre-Eclampsia, with her blood pressure out of control. It caused her to have a placental abruption which in turn caused her to lose her beautiful baby. Our mom did not receive prenatal care, as she had no way to get to doctor's appointments. Our patients are the reason why we are here every day. They are the drive that push us for improvements. That day really made me realize, that our team is the glue and foundation to provide the care our community needs. Every single person involved that day provided compassionate, empathetic, and phenomenal care. I am proud every day to be an MCMC employee. That day my team showed up for the patient, my team showed up for each other, and my team showed up for me.