By Molly Priddy, 9-15-12
||Caption: Days-old baby Mackensie Smith yawns while in the arms of her mother, Bresie Smith, at Kalispell Regional Medical Center's Neonatal Intensive Care Unit. - Lido Vizzutti | Flathead Beacon
When Mackensie Smith is old enough to hear the story about how she entered the world, she may just think it is a fairytale. And rightly so, as her birth has the hallmarks of a myth: a trapped heroine, heroes fighting for her, and her parents’ love conquering intense fear and pain.
Luckily for Mackensie, each aspect of her story is true, and serves as a reminder of the dedication and humanity of the Flathead Valley’s emergency and medical personnel.
Mackensie’s arrival began once upon at time: at about 3 a.m. on Sept. 4 in Kalispell, to be exact. Her mother, Bresie Smith, 25, fresh off a Labor Day weekend camping trip at Lake Koocanusa, got out of bed to go to the bathroom. Bresie was about 34 weeks pregnant, and as she stood up her water broke. She woke her husband, Ryan, to tell him the news, and called her doctor’s office. The doctor told her to come to Whitefish, but then the situation took a new, serious turn.
The fluid that released when her water broke was still flowing, and with it came the baby’s umbilical cord. The umbilical cord is attached to the placenta, which is attached to the uterine wall. Typically, when a woman’s water breaks, the baby’s head or bottom blocks the opening and stops the rest of the fluid from releasing.
Rochelle Mertz, the neonatal intensive care unit (NICU) manager at Kalispell Regional Medical Center and a registered nurse, said that if the baby doesn’t stop the flow, the umbilical cord, the untethered length of which floats around in the fluid, can come out with it. It is called a prolapsed cord, and Mertz has only seen two such cases in her 20 years as a nurse.
Kneeling in her kitchen, Bresie knew her baby was likely in a breech position, and in trouble. The couple called 911, and Bresie and Ryan, who are Jehovah’s Witnesses, prayed to Jehovah to save their baby. Then they heard the sirens. Flathead County Sheriff’s Dep. Brandy Arnoux was the first on scene, followed quickly by paramedics and emergency medical technicians (EMTs) from Evergreen Fire and Rescue.
Once she was loaded into the ambulance, Ryan Pitts, a paramedic, apologized for the all-male crew, Bresie said. But Pitts quickly realized the severity of the situation: If there is too much pressure on the vulnerable cord, the baby is cut off from its oxygen source.
He pinched the cord to determine a pulse, finding an encouraging thump-thump from the infant. That rhythm was growing fainter as the ambulance was moving, though, and Pitts knew he had to keep the baby off the cord.
So the experienced paramedic reached in Bresie to hold the baby off the exposed umbilical cord. They traveled that way until she arrived in the operating room for an emergency cesarean section.
Everything was happening very quickly at this point, but Bresie was still able to find it odd that her obstetrician, Dr. Debra Klein, was suddenly in the operating room at KRMC. Dr. Klein was not supposed to be at the hospital early on a Tuesday morning, Bresie said, but had been called in earlier for an unrelated reason.
Now, in a moment of serendipity, here she was, about to deliver Bresie’s tiny, premature baby. A quick ultrasound determined that there was no heartbeat in utero, and Dr. Klein told Bresie there wasn’t enough time for pain medication before the procedure.
Sitting in her hospital bet ad Kalispell Regional Medical Center's Neonatal Intensive Care Unit, Bresie Smith praises local emergency responders for their calm and swift action.
Pitts, the paramedic, was still in the operating room along with fellow paramedic David Boyce when the procedure began. Since Bresie’s husband was not allowed in, she asked Pitts to hold her hand as the medical team began cutting into her with only a local anesthetic to help with the pain.
“He was holding my hand and I screamed my way through it,” Bresie said.
She watched the doctor pull her baby from her belly, and put the infant on an oxygen bag for five minutes. Then, they knocked Bresie out.
The entire series of events, from the 911 call to the birth, took 13 minutes.
Mackensie was born five weeks premature, and was placed on a ventilator at 12 hours old. She was on that for only 24 hours, Mertz said, and has improved markedly since. She is now being treated as the NICU would treat any other prematurely born infant, Mertz said.
Had the paramedics not recognized the prolapsed cord, and had Bresie gotten in her car and driven to Whitefish – all the while sitting on that cord – Mackensie might not have made it.
“We will never know why the water broke, why the cord fell down,” Mertz said, sitting with Bresie last week at KRMC. “We are not privy to that information from the universe. We’re just here to take care of the babies.”
On Sept. 12, Mackensie weighed in at 4 pounds, 13 ounces, and was taking well to breastfeeding. As the heroine of her own story, she has become a feisty fighter, gaining three ounces last week and nearly earning her way out of the NICU.
“The nurses here say, ‘Babies don’t know how to give up,’” Bresie said.
The Smiths credit the emergency personnel and the hospital for making them feel like family while in their care. They thanked the 911 dispatch; the sheriff’s office; the ambulance crew, consisting of Pitts, Boyce, and EMTs David Christensen and Glen Hartman; Dr. Klein; Dr. Lynn Dykstra; Dr. Judy Rigby; and the NICU nursing staff.
“The world needs more people like these,” Bresie said. “With more gratitude than words and oftentimes wordless tears could ever express, thank you, so, so much.”
And that is the story of Mackensie Smith’s birth. Luckily, due to the happy nature of how it turned out, there are surely plenty of exciting stories waiting to be written in her future.
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