A frightening start to a precious new life

Having her first baby was nothing like Miranda Silveira imagined. Her pregnancy was picture-perfect – no morning sickness, no complications, and just the right amount of weight gain.

But toward the end of her pregnancy with no signs of labor, Miranda had to be induced at 40 weeks. “The baby was measuring very large and I was more than ready to deliver,” said the petite 5’2” woman.

Everything was progressing normally throughout the big day and, after 13 hours of labor, it was finally time to start pushing. And pushing. And pushing. The baby was “sunny side up,” in the posterior fetal position, where the back of the baby’s head is against the mother’s back, making birth difficult.

And then things literally took a turn. Once the baby’s head was delivered, another obstacle was evident – the baby’s shoulder was stuck under Silveira’s pubic bone. Called shoulder dystocia, this can be extremely dangerous for baby and Mom.

“This is an emergency situation, making delivery much more complicated,” said Nikita Wilkes, MD, Silveira’s obstetrician who delivers at Baptist Medical Center South. Typically, there’s only about a six-minute window to prevent brain damage. Other injuries could include a fractured collarbone or arm, and some babies develop a brachial plexus injury, where the nerves tear away from the spinal cord.

Silveira’s nurse, Katie Coleman, BSN, RN, who has training in emergency births, knew exactly what to do. Without hesitation, she performed the McRoberts Maneuver, in which the mom’s legs are hyperflexed back toward the abdomen. At the same time, Coleman applied tremendous pelvic pressure to dislodge the shoulder.

“Katie literally got on top of me and pushed down on me with all her strength,” Silveira said. The maneuver worked and a few minutes later, baby Lukah, weighing a whopping 10 lbs., 10 oz., was born.

All new Baptist South Labor & Delivery nurses go through 16-week boot camp so they are fully prepared to handle emergency births. “We all have a role and we all know what to do,” said Coleman.

To make sure baby Lukah was fine, he spent one night at Baptist South’s Level II Neonatal Intensive Care Unit (NICU), which is conveniently located on the same floor as the Labor & Delivery unit. As a Level II NICU, Baptist South is able to provide advanced medical treatment for moderately ill newborns. Babies who have more critical needs are transferred to Wolfson Children’s Hospital’s Level III NICU.

Fortunately, Lukah was able to return to his mom the next morning. X-rays showed no damage to his bones and that he was deemed completely healthy and ready to go home.

“If it wasn’t for Katie, Dr. Wilkes and the other nurses I had – Christine Cobb and Cami Sykes – I would not be cuddling my son today,” said Silveira. “I will always remember their love and care.”

If you are planning to get pregnant and need an obstetrician near you, visit Baptist Health's maternity services. If you are currently pregnant, you can register for a free maternity tour at any of our Baptist Health hospitals.