The first time I saw her I felt like it was a miracle from God. The first day I hugged her, I felt a lot of love and happiness because she was alive … because she was there.
On Feb. 6, Belky Aguilar received good news — her gynecologist scheduled the cesarean delivery of her third child for Valentine’s Day. Tired from the day’s excitement, Belky quickly showered and went to bed when she got home.
“Around 3:45 AM, the baby kicked three times, and I felt a lot of hot water. I told my husband, ‘my water broke, we have to go,” she says. The couple got in their car and started to make their way to the hospital. “The pain was very strong. I went to the car and got in the car. I started screaming because the pain was not normal,” she says.
As the couple drove, the baby’s foot emerged. Belky remembers thinking she might have to deliver her baby in the busy roadway as other drivers looked on. Desperate to ensure his wife and child were safe, Belky's husband Francisco López searched for the closest hospital. He found NewYork-Presbyterian Lower Manhattan Hospital.
Francisco ran into the entrance of the hospital and explained to the staff his wife was in labor in his car. As the staff rushed to find a wheelchair, he warned them that Belky needed a gurney because the baby’s foot had emerged (a footling breech). A breech birth is when a baby is born bottom first instead of head first. In the footling breech position, one or both of the baby’s feet point downward, delivering before the rest of the body. Even though most breech babies are born healthy, there is a slightly higher risk of complications.
The emergency room staff called in the obstetrics team, who examed Belky. They found the baby’s foot was causing umbilical cord prolapse, where the umbilical cord drops down below the presenting part of the baby and becomes compressed. Cord prolapse, which can cause the baby’s heart rate to drop, is a major complication of breech birth. An obstetrics physicians’ assistant lifted the cord off of the baby’s leg and then had Belky rushed to an operating room for an emergency delivery. An electronic fetal monitor was placed on Belky’s stomach, but the doctors were unable to detect a fetal heart tone.
“When I was in the gurney, and they were taking care of me, I thought they were going to save our lives. But at the same time I was thinking, ‘will she be breathing well? Will the baby be fine? Will she survive?’” Belky remembers.
Dr. Raymond Wong, an obstetrician-gynecologist at NewYork-Presbyterian Lower Manhattan Hospital, was called in to deliver the baby. Because the baby was already in the birth canal, Belky could not have a cesarean delivery as planned. Instead Dr. Wong and the medical team, which included an anesthesiologist, neonatologist, pediatrician, and a clinical nurse manager, prepared to help Belky deliver the baby vaginally. But a vaginal delivery posed a potential problem. Although Belky had delivered her first child vaginally, her second child was delivered by cesarean section. While vaginal birth after cesarean (commonly called VBAC) is considered a safe option, there is a risk of infection, blood loss, and in rare cases, uterine rupture.
Despite the risk, the team proceeded. After seven minutes baby Tirza Sharon López was born. But her body was limp, and her breathing was shallow.
“I asked, ‘why isn’t my daughter crying? She has to cry.’ They told me they were going to take her away because they had to give her a tube so she could breathe,” Belky remembers. An intubation tube was inserted in Tirza’s throat to help her breath. Soon her breathing normalized and her color improved. She was taken to the neonatal intensive care unit to recover.
After a few hours, Francisco saw his daughter for the first time; Belky met Tirza the next day. “The first time I saw her I felt like it was a miracle from God. The first day I hugged her, I felt a lot of love and happiness because she was alive … because she was there,” she says.