Off Duty, Twin, Breech Birth, with CPR | Ricky Smyth QAS

Ricky Smyth, Critical Care Paramedic, Queensland Ambulance Service (QAS).

Off Duty, Twin, Breech Birth, Lovesets Manoeuvre, Mouth-to-mouth and CPR

In the above video, Ricky Smyth, a Critical Care Paramedic (CCP) from Queensland Ambulance Service (QAS), talks about the amazing story of an off-duty, twin, breech birth, with CPR, resulting in the successful resuscitation of one of the babies.

Ricky Smyth lives semi-rural in the Gold Coast Hinterland, it’s about 30 minutes to the closest hospital. His neighbour, who already had 5 children, was pregnant with twins. The neighbour, having experienced 5 safe and normal births prior had organised a home birth with her twins. Although she had organised a midwife to be present, she was Multipara and Multigravid (meaning she has had multiple pregnancies and multiple births). This meant that this labour and delivery had the potential to develop quite quickly.

Twin number 1, delivered safely.

It was after midnight when Critical Care Paramedic Ricky received a call from the women’s partner to say she was in active labour. Things were moving very quickly, so Ricky ran over to assist right away. Baby number 1 was delivered quickly and was a normal cephalic delivery, which means the baby was in an ideal position to be delivered.

Twin number 2, a breech birth, requiring CPR.

The second baby, twin number 2, on the other hand wasn’t in as good of a position. Twin 2 was in a breech position, which means the babies head was not facing down. This is considered to be a more risky delivery.

Ricky goes on to speak about the pressure he felt in that moment. Not only was this a high-risk situation, but given he was off-duty assisting in a community where people knew who he was, he felt a heightened sense of pressure. At this stage, he was considering all the possible critical situations that can arise from a breech delivery, especially in a home environment, not in a hospital.

Ricky performed what was called a “Lovesets Manoeuvre” on the breech twin, which involves rotating the baby for a safe delivery. Although the manoeuvre was successful, the baby was delivered very “flat” and came out with a low APGAR score.  An APGAR score is a clinical indicator of a baby’s condition shortly after birth. The score is based on 5 characteristics of the baby: skin colour, pulse, breathing, muscle tone and reflex irritability. Ricky knew right away that the newborn required mouth-to-mouth and CPR, prior to the arrival of the Ambulance, which was on its way.

The arrival of the Ambulance.

Ricky reflects on the fact that the Paramedics on their way were nervous about what they were about to enter into, but felt relieved on arrival, seeing that Ricky was there, with two babies already delivered and in his care. Luckily, the Paramedics also were able to bring an Obstetrician and a Nurse to the scene, to facilitate the safe transport of the mum and both twin babies.

A happy ending…

After the mum and babies were transported safely to the hospital, Ricky recalls crying, with his wife, trying to process all that had happened. They were so glad that it was a happy ending. Ricky is still in touch with his neighbours, who are happily living with their 7 kids, 6 boys and 1 girl (who was the miracle baby that survived all odds)

Despite all odds, Ricky managed to successfully complete an off duty, twin, breech birth with CPR – what a story!

The Changing Lives Podcast

The video above is a snippet from an episode of the Changing Lives Podcast.

You can watch or listen to the full episode here:

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