In the wake of the worst humanitarian disaster in years, post-earthquake Haiti could be one of the most hostile places on earth to give birth.
On Sunday morning, ABC News senior health and medical editor Dr. Richard Besser found himself faced with a woman in labor. She was 25 years old and a first-time mother, and she was going into labor in a park. Even in the best of circumstances, the relative lack of medical infrastructure in the tent city where Besser attended to the woman made dealing with such a case a challenge.
This, however, was not the best of circumstances. The baby appeared to be in what is known as a transverse position – one in which the baby is oriented with its back or shoulder toward the cervix instead of the head. A foul smelling, brown discharge had already emanated from the mother. And no movement or heartbeat could be immediately detected from the baby.
At 11:26 AM, using his BlackBerry, Besser contacted several obstetricians for advice in dealing with the problematic case. Dr. Jacques Moritz, director of gynecology at St. Luke's-Roosevelt Hospital in New York, was one of these experts. Moritz, who was in upstate New York for the weekend, responded to the call. And as Besser's texts revealed more and more information, Moritz said the situation quickly appeared to go from bad to worse.
"My fingers were kind of trembling on the BlackBerry," said Moritz, who in the past has provided medical services in Haiti. "Even if I had been there myself, it would have been a bad situation."
The foul-smelling discharge, Moritz said, indicated than an infection was possible, even likely. But more troubling was the reported orientation of the baby.
"In the transverse position, it is impossible to deliver vaginally," he said, adding that the only option would be to perform a c-section. "Without the medical ability to do a c-section... the baby would die in labor, and soon enough the mother would die."
The only hope would be to get to a hospital. And time was running short.
Even before Tuesday's massive earthquake, statistics had shown that Haiti is a dangerous place to give birth. According to the United Nations Children's Fund (UNICEF), Haiti has the highest rate of infant, under-five and maternal mortality in the Western hemisphere.
Out of every 1,000 children born alive, 57 die before their first birthdays in Haiti. By comparison, in the United States the rate is 7 per 1,000. And according to the UNICEF's 2005 statistics, the maternal death rate stood at 670 deaths per 100,000 births -- a rate that puts it closer to countries in Sub-Saharan Africa than neighbors in the Americas. Just across the border in the Dominican Republic, only 150 women per 100,000 births die.
Other statistics are equally grim. A woman in Haiti has a 1 in 44 chance of dying from childbirth in her lifetime, according to the World Health Organization. The comparable statistic for the United States is 1 in 4,800.
Part of the problem may be that even in the best of times, medical resources may not be accessible to many Haitians.
"About 80 percent of the population delivers outside of the hospital on a good day [in Haiti]," Moritz said.