Birth on Korean Airlines on way to Philippines
Korean Airlines Flight #12 on November 15, 2010 took off from LAX on time with Scott and I on-board, en route to Manila to start a new charity maternity clinic for the poor. We scored the exit row seats in economy, so had plenty of leg room and slept for a few hours.
When I woke up about 6 hours into the flight, I noticed a flight attendant was bringing a woman to the jump seat in front of us, and she was sitting like she was in pain. My subconscious brain immediately recognized the unique type of squirming and sideways twisting that I had seen thousands of times...but my conscious brain said "no, people don't go into labor on airplanes except in the movies!" and anyway, in the dark I could not even tell if she was pregnant. But being medically trained in emergency and primary care as well as being a midwife, and being a generally helpful person, I got up and approached the scene to see if I could lend assistance.
A short history revealed that the woman (a Korean citizen named Jannie, who lived in Los Angles) had boarded the plane feeling fine but had been having stomach pains the past 4 hours, and had just gone to the bathroom and discovered she was bleeding. This was her third baby, due Jan 1. Her squirming had now turned into low moaning as well, and the steward looked terribly uncomfortable, unsure of what to do. He helpfully approached her with an oxygen mask, which is what you do for heart attacks, but was not much help for this situation. I told the steward we needed to get her to a private place, that she was going to deliver. He looked shocked and in denial and so did the woman. I insisted he think of a plan for a private place...perhaps clear out the back row of seats?
Finally making up his mind, the steward turned and led the way, so we walked forward, me supporting the laboring woman, all the way through the plane to the very front (the part I had never seen) where the first class passengers live in a world apart. It was like a small apartment, with wide seats that made into fully reclining beds, and very wide isles. We got the woman situated on a makeshift bed. By now she was really in hard labor. The steward in charge came up and demanded some medical ID from me, which Scott produced out of my handbag. It was pretty obvious the word "midwife" did not register with them. They were scared, understandably; they called on the intercom for any other medical assistance, and a Korean cardiologist came forward. However, since delivering babies was not in his scope of practice, he deferred to me and seemed very relieved at my answers to all his questions; "had I done this before, because he had not"..."yes" I said, "over 2,500 deliveries"..."did I know how to resuscitate a baby?"..."yes, I am trained in Neonatal Resuscitation"..."did I know how to stop bleeding if she hemorrhaged?"..."yes", ...and on and on.
The woman's water broke with a splash at this point, and discussion ceased. They all agreed I was in charge and they seemed very happy for it. The stewardesses tripped over each other each time I would ask for something, and rounded up every bit of medical supplies they had on the plane, though most were for heart attack emergencies. Since by dates the baby would be 6 weeks premature, I asked for lots of blankets, and told everyone we would be doing kangaroo care, with the baby skin to skin on the mother covered by blankets after birth. Since the doctor was worried that we had no anti-hemorrhage drugs, I told them all we would use breastfeeding and massage to contract the uterus. Since we had no resuscitation equipment or suction, I figured out a plan how to that if necessary with what we had on hand.
At the time of the birth, there were about 6 stewardesses up there helping, holding the woman's hands, wiping her brow, giving her sips of water through a straw. it was like a homebirth and they were all her sisters! Scott was standing at my shoulder to hand me the improvised items I had found to use for emergencies should I need it. Fortunately I did not.
Ten hours after take-off, and with 4 hours left to go before landing, a nice baby boy was born, and with a little stimulation he cried and pinked right up. The stewardesses clapped and laughed and cried. The Apgar score was 9/9, meaning he transitioned well to extra-uterine life at 37,000 feet! By exam the baby was 38 weeks, meaning her dates had been a month off and he was really full-term. The placenta came after about 45 minutes, and the baby began to nurse like a champ. Airline policy actually forbids cutting the cord after an in-flight birth, so that was great; I just wrapped it up in a first class linen napkin, and tucked it in the blankets, preventing any chance of infection.
For the rest of the plane ride into Seoul, Scott and I sat up in first class and I monitored the mother and baby. It was a very joyful atmosphere. The mother was so thankful and happy, and appreciative, and so were all the airline personnel. Scott took a short video using his laptop computer after everything was cleaned up and the mom and baby were relaxing. (Watch a few seconds of post-birth video below.)