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Unexpected Delivery

Children’s Emergency Department Delivers Emergency Birth


When Samantha Clement received an echocardiogram for her baby at 22 weeks gestation at Children’s Hospital Central California, she asked if the Hospital ever delivered babies even though it’s not a birthing center. Little did the first-time mom from Madera know that the sonographer’s reply “only in an emergency” would foreshadow the future.

Baby with giraffe“We didn’t plan to have our baby in the Emergency Department (ED) at Children’s but that’s what happened,” said Samantha. “And our baby couldn’t have been in better hands.”

The fortuitous chain of events began when following several days of contractions Samantha’s water finally broke at 37 weeks gestation. Samantha’s father-in-law sped south down Highway 41 as he drove his son, Steven, and daughter-in-law, Samantha, to a local hospital to deliver the baby.

But as Samantha’s contractions intensified enroute, it didn’t take long for the couple to realize they probably wouldn’t make it to that hospital in time. Only a couple miles north of Children’s, Steven dialed 911 on his cell phone and requested that the operator direct them to Children’s instead.

When they arrived, Rougeh Awad, the ED charge nurse on duty, greeted them in the nearby parking lot. Samantha couldn’t sit in a wheelchair so Awad helped walk her into the Hospital. “He was cool, calm and collected – very compassionate,” recalled Steven. “We knew right away we were in the right place.”

From that moment on, Awad along with the rest of the medical crew who awaited, kicked into high gear. Placed in an obstetrician’s bed in an ED room, Samantha was soon surrounded by an orchestrated team of specialists, including emergency physician, Dr. Kelly Kriwanek, several ED and neonatal intensive care unit nurses, a respiratory therapist and a technician. “With everyone in scrubs, we just saw this sea of blue, like some ER TV show,” said Steven. “They dealt with the situation as if they did this every day. They had everything under control. I was frantic – they were not!”

A quick and smooth delivery

When Dr. Kriwanek heard a pregnant woman was coming to the ED, she wasn’t totally surprised. Sometimes pregnant women stop by with an unexpected concern while onsite for an appointment at Children’s Maternal Fetal Center, a partnership between Children’s and Saint Agnes Medical Center in Fresno, or while visiting their child at the Hospital.

Baby smiling“Typically we check the pregnant woman and then transfer her to another hospital,” she said.

Not this time.

“Usually the ones we see aren’t just about to deliver,” continued Dr. Kriwanek. “In my six years here, I’ve never delivered a baby in the ED.”

In fact, the only baby delivered at Children’s ED in recent memory was several years ago by emergency physician, Dr. Gregory Watts. The first birth recorded at Children’s was on Jan. 21, 1964, when the Hospital was located in Fresno. Cynthia Reyes was born 6 pounds 7 ounces shortly after her parents, “Mr. and Mrs. Pete Reyes, Jr.,” of Fresno realized they weren’t going to reach Saint Agnes Medical Center in time.

And although Dr. Kriwanek received OB training during medical school and her pediatric emergency medicine fellowship, the last baby she delivered was during her fellowship in 2005. “You wouldn’t know it, though,” said Samantha. “She handled everything like a pro. I felt confident she knew what she was doing.”

From the moment the couple arrived at the ED, to the time their little boy, Alexander Mason Clement, was born at 10:53 a.m. on May 1, only 23 minutes had passed. Weighing a healthy 6 pounds, 10 ounces, he measured 19 inches long.

“It was absolutely amazing,” said Samantha. “Everything went so smoothly.”

“Everyone had a job to do and did it well,” added Steven. “After Alexander’s first cry, they handed him to the NICU nurses and I thought, ‘There’s no one better in the US to have this baby right now.’”

Awad explained that when an emergency is in progress, “Adrenalin just takes over. The primary focus became the baby’s safety and the mother’s well-being.”

The couple’s birth plan was also honored. Dr. Kriwanek and the NICU nurses fulfilled the new parents’ wishes for skin-to-skin contact by placing the newborn on Samantha’s stomach, and performing a delayed clamping of the umbilical cord.

“We got everything we wanted,” said Steven. “We couldn’t have asked for better care.”

Parents express thanks to Children’s staff

The couple described Alexander’s trouble-free birth as a “second miracle.” The first, they said, was finally conceiving after two and a half years of trying various methods and procedures to become pregnant. “We are so happy and blessed with him,” said Samantha.

Baby in crib with giraffeTo show their appreciation, Samantha and Steven dropped by Children’s ED a few days after Alexander’s birth and brought a colorful bouquet of flowers for the staff.

“Is this the baby?” Awad said with a broad smile as he reached out to touch Alexander’s hand while glancing at mom and dad. “You were awesome, Samantha,” he said. “You did great, and with no pain medication. I still have marks on my arm from where you squeezed so hard.”

“No words can explain how grateful we are,” said Steven. “It’s good to know there are people in the world dedicated to this level of care, who can take something so chaotic and make it easy.”

While the birth of Alexander was momentous for Samantha and Steven, it was also rewarding for the medical caregivers who helped bring him into the world. “It made our day,” said Carol Pearce, a registered nurse in Children’s ED. “Everything went so perfectly.”

The exciting incident, said Dr. Kriwanek, merely confirms, “We never know what’s going to walk through the ED door.”

And that much can be predicted.



Photos courtesy: Heidi Jones Photography