Delivery at 36,000 feet
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It’s a scene straight from Hollywood – a sky-high medical emergency and an urgent question over the aeroplane’s intercom: “Is there a doctor on board”?
That’s what happened last November to Erin Sullivan, a University of Limerick medical school graduate flying home from Amsterdam with KLM airlines to her native Canada. She reached up to the flight attendant call button to let them know she could help – and was called out of her seat immediately for an emergency.
Brought to the airplane’s toilet, she discovered a 19-year-old woman deep in labour – one who didn’t speak English at all, and did not look at all well. Erin had never delivered a baby alone before, though she had done so supervised.
“She was pale and sweaty, and I initially had no idea if she was bleeding or if she had had any issues during her pregnancy,” Erin said. “I put her on oxygen, got her lying down and comfortable.”
Erin cleared one of the business class sections of other passengers to make use of the extra leg room between the seats, and took stock of the on-board medical supplies – two bags of saline, an IV kit, some silk sutures, a pair of scissors and clamp, with instructions in Dutch.
Then, another bombshell – Erin was told the baby was only six months along, so it looked like she’d have to deal with a 24-week premature birth.
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In a hospital scenario with a full neonatal unit, a birth that early would be right at the cut-off for viability, according to Erin. The flight attendants asked if they needed to organise an emergency landing – and with delivery imminent and the plane still in the air, Erin said yes.
“I told the attendants that yes, we were going to have to have an emergency landing, and that they needed to ask (the other passengers) for more medical assistance. At that moment I was envisioning a postpartum haemorrhage,and a flat baby [one that needs resuscitation” ” she explained.
“My only relief was that at least if it was a small baby there was less likelihood that I'd have a dystocia [a difficult childbirth] or other 'passage' complications.”
Most airlines, including KLM, advise against flying after 36 weeks of pregnancy – about eight months in. The supplies for an obstetrical emergency were woefully inadequate on board– the saline supplies weren’t enough to deal with haemorrhaging, and drugs such as oxytocin or misoprostol weren’t on board. The plane was equipped to deal with cardiac emergencies and nausea, but not a birth.
Looking for more medical help, the flight crew gathered other medical professionals on board – three nurses and another doctor.
“The doctor was a bit shaky and looked more afraid than me,” Erin said. “When I asked when his last delivery was he muttered something about a 'long long time ago' and then disappeared to ‘wash his hands’.
“[Later], when I ran into him in the luggage line he gave me his card, which showed that he was a hospital administrator for some time.”
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The plane, however, didn’t reach its airport in time, and Erin delivered the infant at 36,000 feet. To her great relief, it was instantly clear that the newborn was a full-term baby – and not months premature as she’d been told.
“It is sometimes tough to tell by looking,” Sullivan said. “I thought I was delivering a six-month-old … but he was a healthy weight, fully developed, and making a ruckus right away.”
With a lack of supplies and only one clamp for the umbilical cord –there are usually two – one of the nurses provided a clamp of her own from her purse: one used for re-sealing packets of crisps.
“I put the baby on mum's bare chest and got them wrapped in blankets, just kept an eye on the cord … the placenta was better in than out, and I was definitely not pulling on that cord.”
With a seemingly healthy baby and mum, the plane finally touched down in Yellowknife, Canada, and was greeted by firefighter EMTs on the ground.
With no doctor on the tarmac, Erin hopped in the back of an ambulance with her patient.
“When we walked in, all the emergency department nurses and doctors were lined up and cheering. It was quite the reception!
“I have never witnessed emergency staff cheering at the arrival of an ambulance,” she said.
The obstetrician and paediatrician gave mother and baby the all-clear, and their congratulations to Erin on a job well done – despite the crisp bag clamp.
Unfortunately, the detour meant many passengers – including Erin – had missed transfers and connecting flights.
“They announced overhead that the baby was born while we were in the air and the plane applauded,” she said. “But when I got back on I got some evil stares.
“One of the flight attendants said: ‘Oh, it was a full-term baby? So we could have carried on to Calgary then? And not had to land?’”
Having missed her own connecting flight from Calgary, Erin was stranded for a seven-hour layover and had to shell out for a $200 ticket with another airline –though KLM did provide flight vouchers and a thank you.
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Now, Erin’s a first-year family medicine resident – which is similar to being on a GP scheme in Ireland – in Saskatchewan, hoping to specialise as a GP-Anaesthetist in rural areas. But thanks to the sky-high drama which made the news, she’s something of a celebrity rookie (as she was dubbed by Canada’s National Post).
“One lady told me, between pushes while she was delivering ‘hey, I recognize you from TV’, and another obstetrical patient told me they googled me and read the articles.”
Sadly, she's never heard from the mother, but has heard she may have been a new immigrant to Canada, and possibly a Syrian refugee – though she has no way of knowing. All she knows is from the police in Yellowknife: that mother and daughter eventually found their way to their destination.
The media attention has been nice, but surprising – and she’s just hoping it doesn’t repeat.
“[It’s] certainly a once in a lifetime experience – at least I hope so,” she said.
