“And these are but the outer fringe of his works; how faint the whisper we hear of him! Who then can understand the thunder of his power” (Job 26:14)?

It was early Sunday morning at our 110-bed rural Kenyan mission hospital and I was the only doctor on duty. As I woke up, the dreaded summons to the obstetric ward was delivered at my bedroom window by the night watchman. Five midwives did an average of 100 deliveries every month. They called the doctor for breech deliveries and other complications of labor. My internal medicine and infectious diseases training left many general medicine gaps. The total of my obstetric experience amounted to five deliveries done as a fourth-year medical student. I avidly read textbooks and even found useful clues about obstructed labor in cattle from our family reading time of All Creatures Great and Small.

In my first year as a missionary doctor, I felt overwhelmed and frequently incompetent. Beyond challenging medical duties, my wife, three young children, house repairs and hospital administrative tasks all vied for focus and attention. Nightly reading of medical texts became part of a daily survival strategy. Among many other topics, I studied the correct techniques for breech deliveries, the proper use of forceps, and the rarely used symphysiotomy.

This particular Sunday, the summons to the obstetrics ward was due to a combination of difficult issues, a transverse lie and a dead baby. The mother had arrived at the delivery ward after laboring overnight. Friends helped her walk to the hospital. Midwives immediately saw the baby’s presenting hand. Our hospital did not have an ultrasound machine, so using the obstetric cone stethoscope, they searched in vain for a fetal heartbeat. As I arrived, the mother was informed of the baby’s death.

Cesarean section seemed a sad way to deliver a dead baby, leaving more potential complications for future pregnancies. As I stood pondering what to do, I said one of my frequent, pleading, and desperate prayers. My deeply felt ignorance flowed naturally in appeal to the Great Physician. “Lord help me!”

The best option seemed to be an attempt to reposition the baby into a vertex or breech position. In the face of active labor, this presents a huge challenge. With my arm inside the birth canal and the other hand on the abdomen, I worked for over an hour without success. Finally, the tip of my finger caught the angle of the baby’s pelvis and thigh. Slowly it turned into a breech position.

As the mother pushed, the buttocks presented and then the legs. At this point in a breech delivery, there are several rotations and a sweeping of the arms across the chest to avoid hyperextension at the shoulder with potential for brachial plexus injury. I felt exhausted. My impulse was to just pull the baby out and be done with it. But in one of the clearest communications I ever sensed from God, I heard this strong command: “Don’t do it! Do it right!” So, in obedience to the unexpected voice, I swept both arms, rotated the face posteriorly, and lifted the baby out suspended by the feet.

The next voice shattered the gloom with an unmistakable “WAHHHH” after the first breath of the supposedly dead baby. Shocked into action, I called for a suction bulb as everyone animatedly moved into newborn care mode. A completely heathy looking boy was wrapped and placed on his mother’s chest.

I later suspected that the midwives may have missed the heartbeat because the baby’s chest was pressed far posteriorly into the pelvis due to the transverse lie. It is also possible that God chose to act beyond anything I could have asked or imagined (Galatians 2:20).

The delivery of a healthy newborn is one of the most thrilling experiences of medicine. No matter how many times it has happened, each birth is full of mystery, hope, and love that transfix all attention.

I have not done deliveries since leaving Kenya but have transferred one principle from this experience to many other situations. When feeling in a hurry, often tired and obsessed with finishing the job, shortcuts sound appealing. “Do it right” is an often-whispered warning. Time, stress and lack of margin easily squeeze us into efficiency-driven tyranny of the urgent, but it takes time to do things well.

Each of our lives are unique and full of opportunity to see faith, hope and love at work through the power of the Holy Spirit. When you share your medical faith stories with others, the personal and temporary become pieces of the eternal Good News of Jesus Christ. Listen for his voice in the cacophony of daily noise and duties. Then do it right!

About the Author

Dr. Sam Palpant was the Medical Director at a Quaker mission hospital in rural western Kenya for six years in the 1980s. He subsequently worked for 31 years as the Associate Director for the Spokane Internal Medicine Residency training program. He retired from clinical practice in 2018 but still teaches parasitology to medical students. Dr. Palpant has spoken multiple times at the Christian Medical & Dental Associations Continuing Medical Education Conferences for medical missionaries in Thailand and Kenya, and also at the Global Mission Health Conference for prospective medical missionaries in Louisville, Kentucky.