Maasai delivery

4-23-08; A 15 year old female presented to labor and delivery. She is primiparous and comes from Maasai land. She has felt the urge to push since yesterday but is unable to get the baby out. So she travels 3 hours by foot and taxi to arrive at Kijabe. Fortunately the baby is still alive. She is completely dilated, +2 station, and her membranes are still intact. We rupture her membranes and encourage her to push. She delivers a male infant, weighing 3200gm, which is a good size for a Maasai baby. Maasai's are very thin and will eat very little during pregnancy so that they have smaller babies. When you deliver in the bush you can't risk a shoulder dystocia. As they say here when a Maasai comes to deliver at the hospital things are "thick" (i.e. there is trouble). The baby has a heart beat above 100 but is apneic, he had a tight nuchal cord, we bag him for about 5 minutes and I'm thinking about intubating him. Seeming to sense my thoughts he perks up and starts to cry. I'm relieved because we don't have any peds vents available and someone would have had to spend the night ventilating him by hand.