Miracle of Birth

It's 22 and a half hours into a midsummer Thursday, and the pace has suddenly quickened at Parkland Memorial Hospital in Dallas, the busiest maternity hospital in America. A woman named Sanchez has been in labor for 21 of those hours, and she thinks that the baby might finally be coming. With the passionate coaching in Spanish of nurse-midwife Marta Correa, Sanchez pushes mightily, in absolute silence, for an hour.

The baby's heart rate looks healthy, and he tolerates the pushing and attention well. He just doesn't agree that it's time to be born. "He seems really content where he is," says Dr. Pauline Petrovski. "Up in Canada."

If Baby Sanchez is holding out too long, a couple of corridors away, another Baby Sanchez is determined to arrive all too soon. Baby Sanchez number two -- only 27 weeks along -- is being born just moments after his mother was brought down from a hospital room where doctors hoped that bed rest would allow the pregnancy to continue. But Baby Sanchez number two is insistent. He tumbles into a brightly lit delivery room at 10:39 PM, a room crowded with 13 people other than his mother, including three pediatric staff members from a resuscitation team. At a pound and a half, he's small, but he squalls reassuringly. A portable incubator -- the blankets alone seem to weigh more than the little boy -- stands by.

Just as the premature baby is being born, the intercoms throughout Parkland's labor and delivery (L&D) rooms squawk, "Stat C-section in OR 2! Stat C-section in OR 2!" -- and controlled pandemonium ensues. Outside the delivery room of Baby Sanchez number two, a woman on a bed speeds past, surrounded by doctors, nurses, and technicians, all running nearly full-out.

A "stat" C-section means that something has gone wrong or might be going wrong, and doctors want to get the baby born as quickly as possible. The stat is called at 10:41 PM. Within two minutes, the mom is in OR 2, along with 14 medical personnel in blue scrubs, all of whom know exactly what to do. Two young surgeons -- Ike Rahn and DeDee Bingham -- are scrubbing their hands and arms furiously. "Have you ever done a stat before?" Bingham asks. "No," says Rahn. "Well, this is kind of a pseudo-stat," Bingham says, almost reassuringly. "The baby's heartbeat dropped into the fifties and has stayed down, so we're gonna get that baby out."

Rahn and Bingham -- he's at the end of the first year of his residency; she's at the end of her third year -- shrug into sterile gowns and take up positions on either side of the mother's belly. Among the 16 people now gathered in the room are three more-senior doctors. With the anesthesiologist, that makes six doctors in all. Bingham looks across her mask at Rahn and takes 15 seconds to plot out what they're going to do. Standing at Rahn's elbow is Dr. Michelle Holt, the senior resident on duty, and she's impatient.

"Go!" she hisses at Rahn. "Fast, fast, fast, Ike! Cut! Cut! Cut!"

Rahn and Bingham make the first cut at 10:44 PM. A pair of pediatric nurse-practitioners are standing by with blue surgical cloths, ready to receive the baby. Rahn works the little boy free at 10:46:30 -- just over five minutes from the time the stat was called, just over two minutes from the moment of the first incision, and seven minutes after the previous crisis: Baby Sanchez number two.

"Look at you!" says one of the pediatric nurse-practitioners to the baby boy, who emerges pink and squalling. He's 6 pounds, 12 ounces. "You had us worried." In fact, he's fine.

The Parkland Way
It's hard to find much excellence and inspiration in corporate America in these dispiriting times. Organizations are retrenching, employees are feeling betrayed, and CEOs are being handcuffed and led to jail. Some of the economy's most high-profile figures -- giants like Warren Buffet and Alan Greenspan -- have gone public with their feelings of disgust about the current state of business. Leadership? Innovation? Passion? Joy? They are all in depressingly short supply.

And then there is Parkland Memorial Hospital. Last year, Parkland delivered 16,597 babies. Not only is that more babies than any other maternity ward in America, it's also more babies born in one Dallas hospital than were born in 10 of America's states, as well as the District of Columbia. It's a whole new 1,000-student elementary school every 22 days. Indeed, it's 4 out of every 1,000 babies born in the United States.

But what's most impressive about all of those babies is how good Parkland is at getting them born safely. On neonatal death rates -- how many babies die within the first month -- Parkland beats the national average. For African-American babies, Parkland's neonatal death rate is roughly half the national average. Parkland's rate of stillbirths is lower than the national average, its rate of very-low-birth-weight babies is lower than the national average, and its C-section rate is 21%, compared with a national average of 24.4%.