Going that Extra Distance: Nurses Deliver a Backseat Birth at Tisch Hospital

The nurses in NYU Langone Health’s Labor & Delivery unit at Tisch Hospital are the best at what they do. They help each mother and new baby safely through birth with medical know-how and experience. Check out how two outstanding nurses teamed up to go the extra mile—or, in this case, fifty feet—to make one harrowing delivery a success.

Kathleen Pirozzi, RN, had finished a busy shift on Labor & Delivery (L&D) and was heading through Tisch Hospital’s main lobby exit on First Avenue a little after 8:30 pm. She heard shouting outside and saw security running toward a car in the hospital driveway.

Kathleen Pirozzi: I saw a large pregnant belly kind of sticking out of a car. A medical student and the father were trying to pull the mom out of the car by her shoulders. She was holding onto the inside of the car, screaming, “No!” Her baby was coming. She was really panicking.

It was the mother’s second baby. Apparently she was contracting, and they were on the way to the hospital, and I guess her water broke in the car. Things escalated extremely quickly, as they can with a second baby. And they just couldn’t make it upstairs in time. The mom just couldn’t get out of the car.

I called to a security guard who was there and asked him to call the labor response team (LRT), then I hopped into the car. I told her I was a labor nurse and pulled her pants down. The baby was crowning.

Thankfully, someone had medical gloves, so I put some gloves on. Mom gave us a couple of pushes, and the baby started coming right out.

Brenda Jantsch, RN, had finished the same shift as Kathleen and was only a few minutes behind on her way out of the hospital.

Brenda Jantsch: I usually go out the 34th Street exit to get the M34 crosstown bus, but decided to go through the main lobby that night. And I saw a lot of security starting to gather. People were running through the lobby. On my way out, I saw Kathleen in the backseat of a car. And I looked in. A woman was having a baby.

I know Kathleen and I know that if there was a moment to help or to transport the mom, it would have happened by now. Knowing her and knowing birth, I just knew it was imminent. So I turned right around and asked the security officers to call LRT. Then I returned to the car and saw the baby was delivering.

KP: Oddly enough, I wasn’t scared in that moment. I think it was because there was a lot of adrenaline and I also knew that the team was on their way. I was almost nervous for a second until I saw Brenda. Once I knew there was another labor nurse with me, I knew we could do what was necessary to take care of the situation.

BJ: I looked closer, and there was pretty thick meconium in the fluid, which has a lot of risk for a baby at birth. A baby could inhale it or choke on it. Even in a normal circumstance, we would have a pediatrician at the delivery of a baby with meconium, if we know ahead of time. So I threw my purse to the side and just crawled to the backseat of the car.

There were security officers around, and there was already a stretcher outside, so I asked them to hand me a sheet off the stretcher.

It was a girl! She was a little limp at the first moment of birth—she hadn’t breathed yet—so I started drying the baby, which is the first thing we do, to stimulate her to cry.

KP: She needed a little bit of dry stimulation for a few moments and then gave us a nice cry. So we put the baby skin-to-skin with mom to keep her warm.

BJ: Once the baby is breathing, you know the airway is clear. But the meconium is still a risk factor. The baby could still have some breathing difficulties, and, without having any equipment, I was still concerned. We stayed with the mom and baby. The father was standing behind the mom, physically supporting her head and shoulders through the door. He was a good coach.

KP: The labor response team arrived. It had only been four minutes, total. We transferred mom to a stretcher and took her upstairs.

BJ: It was kind of a hobbling experience to get the mom out of the backseat of the car, onto a stretcher. She’s holding the baby in her arms because the baby was still connected on the umbilical cord to the placenta that hadn’t been delivered yet.

At that point the whole team was there: the night charge nurse, the assistant nurse manager, the doctor—I think someone from the NICU was still there—so we accompanied everybody to the inside service elevators. They seemed to have enough people and help around them.

It was great collaboration, and I’m just glad that the family had a good outcome. It wasn’t the first baby that I’ve personally caught as an RN. Deliveries outside the unit do happen sometimes.

I called Kathleen a little while later, after I got home, and we were both saying, “That was so incredible. So glad you were there.”

The most important thing, as we always say: “We had a healthy mommy and a healthy baby.” And it’s OK that I got home twenty minutes later! I was just really pleased that we had such a great outcome for this family.

Kathleen Pirozzi, BSN, RN, C-EFM, has been working in labor and delivery at NYU Langone’s Tisch Hospital since 2017. Brenda Jantsch, BSN, RNC-OB, C-EFM, worked in critical care for three years and has been a labor and delivery nurse for five. She joined NYU Langone in 2018.

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