How did Dr. Rose Fuchs manage the prolapsed cord emergency at Katie Gowell's home birth?

When Dr. Rose Fuchs arrived at Katie Gowell's home and found a prolapsed umbilical cord, she first gently replaced the cord inside the vagina to keep it warm, then climbed onto the bed, inserted her hand — and then her entire forearm up to the wrist — inside the patient, and pushed the baby's head back up the birth canal. She held this position continuously for nearly 90 minutes: through the ambulance ride, through the hospital doors, and directly into the operating room at Eastern Maine Medical Center.

The stakes could not have been higher. Gowell's emergency happened just 29 days after Houlton Regional Hospital closed its labor and delivery unit — with only one month's notice — leaving the area without local obstetric care. There was no nearby operating room to rush to. Dr. Fuchs had no choice but to become a human barrier between the baby and catastrophe, monitoring the fetal heartbeat through her fingers and pushing harder whenever she felt the rate drop. The normal fetal heart rate is 120 to 160 beats per minute; during surgery, it dropped to 90 — a level Dr. Shearheart described as a signal of impending disaster.

Penobscot County Dispatch Center coordinated the response, and Life Flight, Maine's air ambulance service, was part of the emergency chain that ultimately brought Gowell to Eastern Maine Medical Center. Throughout the 90-minute ordeal, Dr. Fuchs never once withdrew her hand. The full account of this emergency — and the broader collapse of rural obstetric care that made it possible — is documented in episode 894 of This American Life, "I Couldn't Help but Notice."