Chapter 3: Shoulder Dystocia
The baby’s head was out, a shock of dark, wet hair against pale skin, its face pressed against the cool porcelain of the tub. For a second, there was a terrible stillness. Jihyo’s breath hitched, a prayer lodged in her throat. Then the body didn’t follow.
Nayeon’s exhausted panting turned into a sharp, guttural cry as something inside her resisted. Jihyo’s hands, steady until now, slipped slightly as she tried to guide the tiny shoulder. It wouldn’t budge. It was stuck, a hard, unyielding ridge behind the pubic bone.
“Jihyo?” Nayeon’s voice was a thin thread of panic. “Why isn’t it—”
“Hold on,” Jihyo said, the words automatic and hollow. She applied gentle downward traction.Nothing. She tried to lift Nayeon’s leg higher. The baby’s face, free in the air, began to turn a dusky purple.
A bright, arterial ribbon of blood, shocking and red against the water, swirled from between Nayeon’s legs. It didn’t trickle. It flowed.
“Oh, fuck.”
The word was a cold stone dropped in Jihyo’s stomach. She forgot the sterile gloves, the textbook diagrams. She snatched her phone from the sink, her wet fingers smearing the screen.
“Jeongyeon, hang on!” she yelled into the speaker before fumbling for the other open line—the one to Dr. Lee, kept on hold, a silent guardian. She put it on speaker and her voice cracked like thunder.“Dr. Lee!Shoulder dystocia. And she’s bleeding. A lot.”
Nayeon’s eyes were huge, unfocused. The pain had shifted, becoming a deep, internal tearing. “I’m cold,” she whispered.
Jeongyeon’s voice erupted from the phone, raw with terror. “What’s happening?! Jihyo, talk to me!”
Dr. Lee’s voice cut through, calm but laser-sharp. “Jihyo. Listen.McRoberts maneuver. Now. Get her flat on her back, legs hyperflexed to her chest. I need you to push suprapubically. Firm, steady pressure above the pubic bone. You’re trying to dislodge the anterior shoulder. Go.”
Jihyo moved. She was no longer a friend. She was a machine of muscle and memory. “Nayeon, lie back. I need you to bring your knees to your ears. Right now.” Her tone brooked no argument. She helped Nayeon, now limp with gathering shock, into the awkward, vulnerable position on the floor tiles, legs splayed wide.
“Jeongyeon, keep talking to her,” Jihyo barked, not looking at the phone as she positioned the heels of her hands just above Nayeon’s pubic bone. She leaned all her weight into it, a steady, desperate push.
“Nayeon, baby, look at me,” Jeongyeon’s voice pleaded, the sound of her car horn blaring in the background. “You are the strongest person I know. You hear me? Squeeze my hand. Pretend I’m there. Squeeze.”
Nayeon’s hand scrabbled on the wet floor, finding nothing. A low, animal moan escaped her.
“Anything?” Dr.Lee asked.
“No movement,” Jihyo gasped, the strain showing in her voice.
“Next step. You need to reach in. Find the baby’s posterior arm. Sweep it across its chest and deliver the arm first. It’ll collapse the shoulder girdle. Do it now.”
Reach in. The thought was a cold wave. But the blood was pooling, a dark, spreading stain on the towels beneath Nayeon’s hips. The baby’s color was worsening.
Jihyo took a breath that felt like glass. She guided her hand back inside, past the baby’s head. The world narrowed to touch. The warmth, the terrifying tightness. Her fingers, probing, blind. She found a tiny, bent elbow. Gently, with a precision that felt both brutal and holy, she hooked her fingers and drew the little arm down and across the tiny body.
It was a terrible, intimate pressure. Nayeon screamed, a raw, ragged sound that bounced off the bathroom walls.
Then, a release. A sudden, wet slide.
Jihyo caught the slippery, limp body as it tumbled free into her waiting hands. A girl. Small and alarmingly still, her skin mottled purple and blue.
“Baby’s out,” Jihyo choked out. She laid the infant on a dry towel on the floor. No cry. The tiny chest was still.
“Clearing the airway.Now,” Dr. Lee commanded.
Jihyo used the bulb syringe from her kit with frantic efficiency, suctioning the nose, the mouth. She rubbed the little back with a towel, a brisk, rhythmic friction. “Come on,” she whispered, a mantra. “Come on, little one. Breathe for your moms.”
A choked gasp came from the phone. Jeongyeon was sobbing, listening to the silence.
A gurgle. Then a weak, sputtering cough. A thin, furious wail pierced the steam-filled room.
The sound was a lightning strike of pure, dizzying relief. Jihyo almost crumpled. She bundled the crying newborn, pinkening rapidly now, onto Nayeon’s bare chest, placing a fresh towel over them both. “She’s here. She’s breathing.”
But the relief was gutted a second later. The flow of blood from Nayeon hadn’t slowed. It pulsed, dark and relentless, soaking the towels beneath her. Nayeon’s eyes were fluttering, her skin pale as wax against the baby’s vibrant, crying form.
“Jihyo, the bleeding,” Dr. Lee’s voice was urgent. “You need to massage her fundus. Find the top of her uterus through her abdomen. Firm, circular massage. Get it to contract. Now.”
“Jeongyeon, the bleeding’s bad,” Jihyo said, her voice cracking as she pressed the heel of her hand low on Nayeon’s belly, feeling for the muscular lump. She found it and began to knead, a deep, insistent pressure. Nayeon whimpered, her arms loose around her daughter.
“The ambulance?” Jeongyeon cried, the sound of her car screeching to a halt evident in the background. “I’m at the building, I’m coming up!”
“Sirens stopped,” Jihyo said, realization dawning. The storm must have swallowed the sound. They were close. “They’re here. They have to be.”
She worked Nayeon’s uterus, her own arms screaming in protest, her eyes locked on her friend’s face. “Stay with me, Nay. Look at your girl. Look at her.”
Nayeon’s gaze drifted down to the bundle squirming on her chest. A tear tracked through the sweat on her temple. “Jeong…” she breathed toward the phone.
A thunderous pounding shook the apartment door. “EMT!”
“In here!” Jihyo screamed, her voice ragged. “Bathroom! Now!”
The door crashed open. Booted feet pounded down the hall. The small, steamy world of the bathroom exploded into a chaos of crisp uniforms, barked questions, and the sharp click of equipment cases.
A woman with kind eyes and a no-nonsense voice took over the uterine massage from Jihyo. Another paramedic gently checked the baby, listening to her strong cries with a nod.
As they lifted Nayeon, baby still on her chest, onto the gurney, Jihyo finally staggered back. She slumped against the bathroom wall, her hands and arms stained, her clothes soaked. The tile was a battlefield of red-streaked towels and discarded wrappers.
The lead paramedic glanced at her. “You did good,” she said, simple and direct.
Jihyo just nodded, numb, as they wheeled Nayeon and the baby out into the hall.
She heard Jeongyeon’s footsteps then, frantic on the stairs. A second later, Jeongyeon burst into the apartment, her hair plastered to her face by the rain, her eyes wild. She took in the bloody scene, the empty bathroom, the retreating gurney.
“They’re okay,” Jihyo managed, her voice a scratchy whisper. “They’re both okay. Go with them.”
Jeongyeon’s gaze met Jihyo’s for a fractured second—a look of shared, breathless terror and gratitude—before she turned and ran after the gurney.
Alone in the wreckage, Jihyo slid down the wall to the floor. The steam was beginning to clear. The shower still ran, a quiet hiss against the sudden, ringing silence. She stared at her trembling, stained hands, and for the first time since Nayeon had knocked on her door, she let herself cry.