Future unclear for breech baby born with help from dispatcher
A husband called 911 when his wife went into labor early and he saw a foot; the dispatcher walked him through the delivery moments before medics arrived and used CPR to revive the newborn
By Zaz Hollander
Anchorage Daily News
WASILLA, Alaska — By the time Antares Viens called 911 from a friend's house on Wasilla-Fishhook Road, his baby daughter was already being born.
The birth at the end of January marked the third in less than three months where the Palmer Emergency Dispatch Center helped deliver a baby by phone, the kind of event that usually prompts high-fives and headlines.
But the story of this baby -- her parents have named her Pearl -- was different.
This baby wasn't breathing when she emerged, bruised and still, in "footling breech" position, a much riskier birth than if the baby comes out head first.
Medics performed CPR for more than 10 minutes before they picked up signs of pulse and respiration.
"One of my sisters is a nun in Italy," Viens said last week. "We've had people all around the world praying."
Breech deliveries at home are rare. Most providers schedule cesarean sections rather than deliver breech babies, even in a hospital setting. Complications can include oxygen deprivation if the baby's head gets stuck or the umbilical cord is pinned.
The clock is ticking once birth begins.
Baby Pearl Viens was still recovering from her difficult birth two weeks later. Her parents remain upbeat but they don't know what her future holds.
As of Tuesday, Viens said, his daughter remained at the neonatal intensive care unit at Providence Alaska Medical Center. She was getting better every day but not moving as well as she should, a sign of potential developmental problems. Doctors have put casts on to try to straighten her feet.
Medical staff initially didn't think Pearl would survive for very long, Viens said.
"There's nothing more heartbreaking than seeing your wife hold your baby up to the EMT saying, 'Please sir, my baby's not breathing,'" he said.
'WE'RE IN LABOR'
A U.S. Army veteran, Viens joined the 87th Infantry Battalion of the 10th Mountain Division in November 2001 after the 9/11 attacks. He served a tour in Afghanistan and later Iraq. He met Clarissa. They married before he left for another tour in Iraq after getting recalled to active duty.
Viens started the trip home New Year's Day in 2010 and the couple started their family at a Wasilla four-plex they bought.
Victor, their 2-year-old son, was born at home after 38 hours of labor, and this baby was supposed to be born at home too.
But that wasn't to be.
Everything happened too fast on Jan. 29, the day the baby came, according to Viens and the emergency dispatchers involved.
His 28-year-old wife, Clarissa Viens, was still about 20 days from her due date. The couple was at someone else's house because they had agreed to watch a friend's five children and their dogs.
Everything seemed normal with the pregnancy. An ultrasound at 18 weeks showed a healthy baby. Clarissa's midwife told her the baby was in a head-down position 13 days earlier.
The night before, Clarissa felt some contractions but they subsided and she got to sleep. The next morning she came into the master bathroom.
Antares Viens was showering before getting ready for small-business administration classes at Mat-Su College.
"She says, 'Boy, I'm really getting some contractions," Viens recalled this week. "I said, 'OK, so are we in labor? And she has a really good contraction while I'm watching. Yeah, we're in labor."
He pulled out his phone to time her contractions and realized two things. His phone battery was nearly dead. And the contractions were coming fast, at three minutes apart.
Nothing was ready. They weren't at home. There were six children, ages 2 to 14, downstairs. Their midwife wasn't in the loop.
"My main thought at that point was we are so far behind in this ballgame," Viens said.
Then Clarissa's water broke.
A DIFFICULT DELIVERY
Viens needed to call the midwife. He grabbed for his phone charger, plugged it in and heard his wife yell, "Something just fell out and it's not the head!"
It was the baby's foot. He called the midwife. She told him to call 911 while she hurried over -- to the Viens' home in Wasilla. Viens realized his "unfortunate" mistake later: the midwife was close by and had oxygen with her.
He dialed 911 at 9:39 a.m.
Palmer-based emergency dispatcher Sarah Beranek, a 31-year-old with two years on the job, took the call.
"I had him confirm his phone number and address," Beranek remembered Thursday. "Then he said, 'My wife's in labor and I see a foot,'"
She read off special instructions about breech deliveries that came up on her computer: "This could be a difficult delivery. Listen carefully. I'll tell you exactly what to do next."
Then she told Viens to tell Clarissa to stand and get into a squatting position and push as hard as she could every time a contraction came. Breech births can squeeze the baby's umbilical cord, cutting off oxygen and blood.
"We try to get the baby delivered as quickly as possible," Beranek said.
BABY IN TROUBLE
Viens said once the baby's bottom came out, he was able to reach up and pull her other leg down. Within nine minutes, the baby was out up to her armpits. Three minutes later, contractions continued but the baby's arms and shoulders remained inside her mother.
At 9:54 a.m., the baby was out - 15 minutes after the call started.
"I asked dad if she was breathing and he set the phone down. I couldn't hear a baby crying," Beranek said. "I stayed on the line for 20 minutes. He never actually picked up the phone again."
Viens said he remembered yelping "NO!" at the phone before letting it fall. He knew there was a problem. Even as her little body descended, the baby wasn't moving.
"I had already noticed she was pretty pale," he said. "I was ready for her not to be breathing and she wasn't."
He started doing rescue breathing. His wife began to pray. One of the older children downstairs hollered that the ambulance was there.
Medics ran upstairs to the bathroom, about 60 seconds after the baby was born.
The medics put the limp newborn on a blanket and started giving her oxygen and CPR. They rushed to Mat-Su Regional Medical Center. Antares and Clarissa and their son followed and they met their midwife there.
They got a call about 10 minutes later. Their daughter was breathing and she had a pulse. She was transported to the special newborn ICU at Providence where there's special equipment to treat babies born prematurely as well as other medically compromised newborns.
"I figured that was all we needed was for her to start breathing," Antares Viens said. "I went in to see Pearl and that's when I realized that something was definitely wrong. She just wasn't moving."
Since then, he said, his daughter is moving more, though medical providers and the family are still hoping for additional improvement. She's breathing on her own and getting her mother's milk through a feeding tube. Now the family is waiting to get results back from a genome-mapping test.
A friend said she's set up a fund for donations to help defray medical costs for the Viens, who don't have health insurance.
The family is taking things day by day and praying for the best, Viens said.
|McClatchy-Tribune News Service|