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Doctor-in-training talks dad through delivery during Irma

Posted September 13

A young doctor just three years out of medical school talked a frantic father in Miami through delivering his baby's placenta as Hurricane Irma's winds whipped outside his door.

The placenta was stuck inside the uterus -- a potentially deadly situation for the mother.

When the mother, Tatyanna Watkins, went into labor, ambulances couldn't reach her because the winds were too high. The baby, Watkins' third child, was born at home and doing well.

The father, David Knight, needed to know how to cut the umbilical cord. He called the City of Miami Department of Fire-Rescue, which patched his call through to Jackson Memorial Hospital. A staffer there ran up to Dr. Kendra Anderson with a telephone just as she was finishing an emergency cesarean section on another woman.

Anderson, an obstetrical resident, instructed Knight to tie a shoelace around the cord in one spot, grip it with his hand in another spot, and use his other hand to cut in between the two spots.

"I had to make sure he cut in the right place, because dads often want to cut it in the wrong place, and the baby can bleed out," Anderson said.

Then she asked whether the placenta had come out.

It hadn't, Knight told her.

How long had it been since the baby was born, Anderson asked.

Thirty-six minutes, Knight answered.

Anderson knew that could mean trouble.

It's standard practice that the placenta should be delivered within thirty minutes of childbirth, said Dr. Alyse Kelly-Jones, an obstetrician-gynecologist in private practice in North Carolina. If it's not, it could be attached to the uterus, and the mother could hemorrhage.

"It's called placenta accreta, and it's very, very dangerous," Kelly-Jones said.

Anderson instructed Watkins, 23, to massage her uterus to encourage the placenta to come out.

"When that didn't work, I had to talk Dad into being a little more aggressive," she said.

First, she instructed Knight to pull at the cord but not too hard, or else he could invert his girlfriend's uterus, which could kill her.

That didn't work either.

So Anderson instructed Knight to put pressure on Watkins' pubic bone with one hand while pulling gently on the cord with the other.

"I kept asking him if there was a gush of blood, or if the cord was getting longer, both signs that the placenta was on its way," she said.

But he said no.

"I started to freak out a little bit," Anderson said.

Then she heard the father scream uncontrollably.

"That's when I knew it was out," Anderson said.

While relieved for the mother, the young doctor became nervous for the father, who wouldn't stop screaming.

"I was worried I might have two patients on the phone," she said.

Then the phone line fell silent, which made her even more nervous.

"I kept on saying, 'Dad, are you okay? Are you okay?'" Anderson said.

Then she heard Watkins laughing.

"He's fine," Anderson said Watkins told her. "He's just a little traumatized."

Anderson, relieved, told Watkins to breastfeed her new daughter, Destiny Janine Knight, to help control bleeding.

"Then I congratulated them on their new baby," she said.

When the winds died down and emergency services could bring the family to the hospital, Anderson congratulated them in person.

"It was so gratifying," Anderson said. "I'm still kind of in awe."

Kelly-Jones said she's in awe of Anderson's skills, especially so early in her career.

"It sounds like she was calm, cool, and collected, and that's what you need to be when you're helping a dad who's never done this," she said. "I'm rather impressed."

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