“We’re not waiting, Hassan, so calm the fuck down. You brought us this situation, and we’re going to find a way to deal with it.”
“How? How?”
“How do you think?” Crocker retorted, checking his watch again. “Deliver the baby.”
“Here, in this disgusting place? Are you crazy? Jamila will die. The baby will die, too. And both their deaths will be your fault!”
Crocker reached out and grabbed him by the shoulders. “Listen to me,” he said evenly and with authority, even though he wanted to slap him. “You’re going to be a father soon. You need to start acting like one.”
“What does that mean?”
“It means you need to help your girlfriend by calming her down and acting positive, even if you’re scared to death.”
Hassan looked like he was about to cry. “How can I look at her, when she will see the truth in my eyes? The midwife who examined her yesterday said that the baby had not turned. It isn’t in the right position. She said she needs a surgeon or an obstetrician.”
That brought a new wrinkle to the situation.
“Now do you understand? That’s why we have to find one in Turkey.”
“Great idea, but not happening,” Crocker said, trying to remember what he had learned about different birthing methods. “Did the midwife say what position the fetus is in?”
“No, of course not. Why would she tell me that? I’m not a doctor. You’re not, either. That’s why we have to leave now! What’s preventing us? Why are you being so stubborn?”
“Because there’s no time, Hassan. The baby’s in distress, and so is your girlfriend.”
“But the baby’s in the wrong position! Didn’t you just hear me? It won’t come out!”
“It has to,” answered Crocker, “and it will.”
Chapter Twelve
Death, taxes, and childbirth. There’s never any convenient time for any of them.
– Margaret Mitchell
Mortar rounds started to fall in the vicinity as Crocker and his men improvised a clean bed out of sheets and an inflatable mattress on a table in what used to be the dining room. One of the two schoolteachers, the shorter woman with a bowl of straight black hair who hadn’t said a word so far-Natalie-volunteered to act as Crocker’s assistant. She and Suarez boiled water and sterilized the rudimentary tools in the emergency medical kit as Amira held Jamila’s hand and Hassan wrung his hands and paced.
“You think you can handle being in the room?” Crocker asked him as a helicopter passed overhead.
He nodded, then whispered, “I want you to know that Jamila’s a very wonderful person and has suffered so much already. Her mother is dead, her father was arrested, she hasn’t heard from her brothers since they joined the resistance.”
“Duly noted.”
Crocker had delivered babies before-once to a feverish young woman in a barn in Honduras, another time twins to an injured woman in Iraq.
Upon examination, he discovered that this was going to be his first breech birth. What that meant was that instead of the normal head-first presentation, this baby was presenting itself bottom first, with his or her legs extended at the knees.
“You seen anything like this before?” whispered Suarez, who had some corpsman training.
“No, but there’s always a first time.”
A shell exploded outside, shaking the remaining tiles on the roof. One of them crashed two feet away from the table where Jamila sat. Amira held up a towel to shield Jamila’s face.
“We’re fine,” Crocker said. “Suarez, find Davis and ask him to check if there are any more loose tiles over this room.”
“Aye aye.”
If Jamila were in a hospital, chances are the baby would be delivered via cesarean section. But not having a properly equipped operating room with ultrasound and heart monitors, Crocker didn’t want to risk excessive bleeding and infection, so he planned to try to perform a vaginal breech birth, which was problematic but the only real option he had.
The contractions were coming closer together and were more intense-every minute now, and a minute in duration. Jamila was in serious discomfort, with especially strong pains in her back. Crocker was reluctant to administer morphine, because he thought it might numb the fetus and affect its heart.
“Okay,” he said, as he exposed her lower back and prepared to inject the sterile water from his kit just below the skin of her lumbosacral region. “This is going to sting for a minute, but it won’t put you out or damage the baby in any way.” The way it worked was simple. The sudden burst of intense pain from the injection closed off transmission of the sensation produced by the contractions.
Jamila let out a scream and did the paced breathing Amira had been teaching her. The pain in her back abated. So far, so good.
Crocker had been concentrating so hard he hadn’t realized that the artillery and rockets were falling with more frequency.
Suarez, who had noticed, now whispered in his ear, “It could be the lead-up to some kind of ground attack on a nearby target.”
“You mean the artillery?”
“Yeah, boss.”
“We’ve got to finish this first.”
“How about we move the canisters to the Ford and do the delivery in the back of the van?”
Crocker examined Jamila’s cervix again. It was open ten centimeters and the mucus plug had released, which meant that cervical dilation was complete. Aware that it would be hard enough to manage a difficult breech birth in a stationary location and almost impossible in a moving van, he whispered back, “The baby’s coming. No time.”
His first goal was to turn the fetus by manipulating its body through the mother’s abdomen. He had Jamila lie down on her back on the mattress with her feet on the table and her knees apart. Then he and Suarez pressed and applied pressure. They weren’t successful. The baby was so big there was very little room inside the vaginal canal for it to be maneuvered. And Crocker didn’t want to keep trying because of the stress they were putting on the baby’s heart.
“Now what?” Suarez asked.
The baby’s butt was showing through the cervical opening. Crocker said, “I’ll hold on to the butt while you try to twist the fetus to the right.”
“How do I do that?”
“Grab it near the chest. Firmly, and turn gently.”
Slowly they applied pressure and managed to turn the fetus slightly, so that its right side faced Jamila’s back. Then they watched as her pelvic floor muscles helped complete the process.
“Nice.”
“What happened?” Jamila asked through gritted teeth.
“It’s all good. We’ll have the baby out soon.”
Crocker saw that the new position of the fetus would allow the baby to come out one hip at a time. Since its bottom was the same size as its head and the mother’s pelvis was relatively large, labor could begin.
The big danger they faced now was injury to the baby’s brain or skull due to a rapid passage of the head through the birth canal. With the fetus positioned the way it was, it was impossible to determine the angle of its head. All Crocker could do was hope that the head wasn’t in the “star-gazing” position, looking straight up, with the back of the head resting against the back of the neck.
The other serious danger was that the umbilical cord would prolapse, diminishing or cutting off the flow of blood to the baby’s brain.
Amira and Hassan whispered encouragement into Jamila’s ears while Suarez mopped the sweat from Crocker’s brow.
He glanced at his watch: 1855 hours. The sun was starting to set outside as artillery continued to shake the house.
What Crocker hoped to accomplish was a smooth, quick delivery so the baby wasn’t hung up in any way that might put undue pressure on its heart.
He took a deep breath. As he did, an explosion shook the farmhouse, causing Hassan and Natalie to gasp and Jamila to tighten up.