Doctor-in-training talks dad through delivery during Irma

Posted at 4:02 PM, Sep 18, 2017

A young doctor just three years out of medical school talked a frantic father in Miami through delivering his baby’s placenta as Hurricane Irma’s winds whipped outside his door.

The placenta was stuck inside the uterus — a potentially deadly situation for the mother.

At 3:30 Sunday morning, the baby’s father, David Knight, called 911. His girlfriend, Tatyanna Watkins, was having contractions one to two minutes apart.

Maria Perez, an emergency dispatcher at the City of Miami Department of Fire-Rescue, took the call, according to Desiree Farrell, a midnight shift supervisor.

It was too windy for an ambulance to reach the family, so she advised Knight to gather a paper clip, string or shoelace, and clean towels. The paper clip was in case the baby was born inside the amniotic sac and he needed to pop the sac. The string or shoelace was to tie off the cord, and the towels to wrap the baby.

She asked him to check and see if the top of the baby’s head was showing. He answered no.

“That’s as far as she went. She disconnected the call,” Farrell said. “If there’s no head presenting, labor can take 24 to 48 hours sometimes.”

But the baby, Watkins’s third, apparently was in a rush. Two hours later, Knight called to say the baby was born. He’d done it on his own without guidance from emergency services, Farrell said.

“I just can’t believe it. I delivered my own baby,” Knight said at a press conference arranged by Jackson Health System and the University of Miami Health System a few days later.

“This guy deserves a medal,” Farrell said.

She advised Knight to have the baby breastfeed, which helps stop the mother’s bleeding. Then she instructed him to use the shoelace to tie the cord about 6 inches from the baby, and asked him to gently pull on the cord to encourage the placenta to come out.

“He kept groaning. I thought he was going to pass out. I could hear the mother saying, ‘Just do it, honey, just do it,’ ” she said.

When the placenta wouldn’t come out, Farrell asked a colleague to call Jackson Memorial Hospital and patch a doctor there into the call.

At Jackson, Dr. Kendra Anderson was finishing up an emergency cesarean section. A staffer ran up to her with a telephone.

Anderson, an obstetrical resident, instructed Knight how to cut the cord.

“I had to make sure he cut in the right place, because dads often want to cut it in the wrong place, and the baby can bleed out,” Anderson said.

Anderson asked how long had it been since the baby was born

Thirty-six minutes, Knight answered.

Anderson knew that could mean trouble.

It’s standard practice that the placenta should be delivered within thirty minutes of childbirth, said Dr. Alyse Kelly-Jones, an obstetrician-gynecologist in private practice in North Carolina. If it’s not, it could be attached to the uterus, and the mother could hemorrhage.

“It’s called placenta accreta, and it’s very, very dangerous,” Kelly-Jones said.

Anderson instructed Watkins, 23, to massage her uterus to encourage the placenta to come out.

“When that didn’t work, I had to talk Dad into being a little more aggressive,” she said.

First, she instructed Knight to pull at the cord but not too hard, or else he could invert his girlfriend’s uterus, which could kill her.

That didn’t work either.

So Anderson instructed Knight to put pressure on Watkins’ pubic bone with one hand while pulling gently on the cord with the other.

“I kept asking him if there was a gush of blood, or if the cord was getting longer, both signs that the placenta was on its way,” she said.

But he said no.

“I started to freak out a little bit,” Anderson said.

Then she heard the father scream uncontrollably.

“That’s when I knew it was out,” Anderson said.

While relieved for the mother, the young doctor became nervous for the father, who wouldn’t stop screaming.

“I was worried I might have two patients on the phone,” she said.

Then the phone line fell silent, which made her even more nervous.

“I kept on saying, ‘Dad, are you okay? Are you okay?'” Anderson said.

Then she heard Watkins laughing.

“He’s fine,” Anderson said Watkins told her. “He’s just a little traumatized.”

Anderson, relieved, told Watkins to breastfeed her new daughter, Destiny Janine Knight, to help control bleeding.

“Then I congratulated them on their new baby,” she said.

When the winds died down and emergency services could bring the family to the hospital, Anderson congratulated them in person.

“It was so gratifying,” Anderson said. “I’m still kind of in awe.”

Kelly-Jones said she’s in awe of Anderson’s skills, especially so early in her career.

“It sounds like she was calm, cool, and collected, and that’s what you need to be when you’re helping a dad who’s never done this,” she said. “I’m rather impressed.”