Chapter 39 Prolonged Labor

A hurried summons interrupts the visiting doctors' assessment.

Everyone in the meeting room was startled by the news.

The doctor hurriedly explained the situation, and the group rushed downstairs.

Dr. Qian was already in his eighties and could not move quickly. Evan Xu and Oliver Liu supported him as he walked out.

Director Liu was beside them.

No one had time for the woman now. Bewildered by the doctors rushing out, she hurried after them to watch the commotion.

“The couple are from Lixiang Village,” the doctor said as they walked. “She went into labor at home yesterday. It's been a whole day, and she still hasn't delivered.”

Their hearts sank. Prolonged labor. This was bad.

He went on, “When they couldn't manage anymore, they brought her to the township clinic on a handcart. The clinic gave her oxytocin, but it didn't work. They couldn't treat her, so they sent her straight here to the county hospital.

“Dr. Zhao told them she needs a cesarean, but they absolutely refuse. They heard a leading specialist was visiting our hospital and insist that he see her.”^[1]

Everyone frowned. Medical care was still limited in those days. Many rural women gave birth at home with a traditional birth attendant. But now they had a case of prolonged labor to deal with. They were in trouble.

“Hurry! Hurry! Let's go and see her,” Director Liu urged.

Outside the delivery room, Dr. Zhao, the obstetrician, was close to losing his mind over the lean, dark-complexioned man in front of him.

“I'm telling you, in her condition, she needs to be taken for a cesarean immediately. Otherwise it's very dangerous!” Dr. Zhao was almost shouting.

But the man only kept pacing with his arms folded and his head down, muttering, “Is the specialist here yet? Is he here yet?”

“Even if Dr. Qian comes, he'll recommend a cesarean too!” Dr. Zhao said loudly.

The man was frantic, but he still would not agree.

Dr. Zhao stood with his hands on his hips, furious.

Director Liu and the others soon arrived.

“What's happening? What's going on?” the director asked urgently.

The man turned toward them. “Where's the Chinese medicine specialist from the city? Where is he?”

The woman lay on a hospital bed with an IV bottle hanging beside her. She was in a consultation room just outside the delivery room; they had not wheeled her in yet.

She was drenched in sweat and utterly exhausted. Her eyes opened and closed from time to time.

Her breathing was labored, with occasional hiccups and dry heaves.

Without a word, Dr. Qian went straight over to examine her.

Evan stood frozen, breathing heavily. At that moment he seemed unable to hear anything around him. All he could hear was his own harsh breathing and his pounding heart.

He stared at the woman on the bed, on the verge of passing out. His eyes grew wider and his breathing heavier.

“Help! Help! Someone save my dad! Help!”

It had been so long since that cry had sounded in his mind. Now it echoed again. And there was the old man on the ground, reaching weakly toward him, looking at him in despair.

“You! You killed my dad! You butcher in a white coat!”

For a moment, Evan seemed to see that woman rushing at him, her face contorted with rage.

“Ah!” He shuddered in fright.

“Evan, what's wrong?” Oliver shook his shoulder.

“Huh?” Evan came back to himself and looked around in confusion.

“What's wrong? You look awful.”

“I'm fine.” Evan quickly shook his head and went over to assess the woman.

Dr. Qian was examining her himself now.

Evan hurried to look as well.

The young visiting doctors looked grim.

Their own hospital had no obstetrics department. Women did not give birth there, and they had never been through anything like this.

The county hospital's young Chinese medicine doctors were bewildered too. Deliveries were not their responsibility.

A whole day in labor, and only now had she been brought to the hospital. This was an emergency. They practiced Chinese medicine—when did anyone ever ask them to handle an emergency? They were all flustered, unsure what to do.

Only Oliver and Evan were a little more composed.

Evan steadied himself and went on assessing her. She showed signs of counterflow qi and discomfort.^[2] She was exhausted and weak, drenched in sweat, restless and irritable. Thin and frail, she was small and underdeveloped. Her tongue was pale, and so was her face.

Her husband clasped his hands together and watched Dr. Qian anxiously.

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Dr. Qian also examined her pulse. His expression was grave. “In this situation, a cesarean would still be best,” he told the family.

“No. We're not doing it.” The man's face grew paler with fear.

Dr. Zhao from obstetrics lost his temper. “Why not? If you delay any longer, both mother and baby will be in danger. What will you do then? I'm telling you, a cesarean is the best choice right now.”

“No, no!” The man waved his hands in alarm. “How can anyone survive having their belly cut open? No! A pregnant woman in the next village died after they operated on her. We're not doing it!”

Dr. Zhao was too angry to know what to say.

Director Liu tried to persuade him too. “The operation isn't very risky. Your wife's been in labor for a whole day without delivering. If we wait any longer, it really will be dangerous. We strongly recommend a cesarean.”

The woman on the bed opened her eyes. Her voice was weak but agitated. “I don't want my belly cut open!”

The obstetrician spread his hands, at a loss. “Then what exactly do you want us to do?”

Her husband looked cautiously at Dr. Qian, clutching his pocket. “You're the specialist… Can Chinese medicine do anything? We believe in it. When we're ill, we usually just buy some herbs… It won't cost a lot, will it…”

Before he could finish, Dr. Zhao broke in. “What are you thinking? Don't let your own ignorance harm the baby! Obstetrics has nothing to do with Chinese medicine in the first place. This is a difficult delivery, an emergency! Can Chinese medicine treat an emergency? This is absurd! Honestly!”

“Dr. Zhao!” Director Liu snapped.

Dr. Zhao instinctively covered his mouth. He knew he had let his emotions get the better of him and said the wrong thing.

The Chinese medicine doctors looked displeased.

Even Dr. Qian's expression darkened.

Frowning, Evan stepped forward. “Dr. Qian, what is her pulse like?”

Dr. Qian glanced at him. “Deep and thready.”^[3]

“Dr. Zhao, could I see her examination reports?” Evan asked.

Dr. Zhao frowned and handed them over. All the examinations had been done, but the family still refused a cesarean. What a mess!

Evan read through the reports. The baby was correctly positioned, her waters had broken, and her contractions had weakened, yet she still could not deliver.

Oliver leaned in for a look too.

“Dr. Qian, she seems deficient in qi and blood. She hasn't the strength to deliver,” Oliver said.^[4] “Could we try Songzi Tang?”^[5]

“Dr. Qian, could we try acupuncture?” Evan asked.

The husband looked up in astonishment. Now there were two options!

Dr. Zhao rolled his eyes but said nothing.

Dr. Qian looked at the two of them, then at the young Chinese medicine doctors who had followed them. He picked up the treatment plan Evan had written earlier and looked at the acupuncture plan below it.

He put down the notebook, glanced at Dr. Zhao, and turned to Evan. “In an emergency, nothing works faster than needling! Go ahead and use acupuncture.”

“Yes, sir,” Evan said.

Dr. Zhao's eyes widened. They were actually going to treat her? Weren't they making things worse? But Dr. Qian was a leading specialist, and he did not dare say it openly.

Several times Director Liu opened his mouth, then closed it again. He did not know what to say either. At his age, how could Dr. Qian still act out of pique?

Dr. Qian glanced at Oliver and scolded him. “What are you standing there watching for? Go and decoct the herbs! Don't you know we use needles and herbs together?”

“Oh! Right!” Oliver finally caught on and ran to the dispensary to collect the herbs.^[6]

The obstetrician spread his hands and looked wordlessly at Director Liu.

Embarrassed, the director rubbed his broad forehead.

What a mess!

Reader Notes

1. ↩︎ Prolonged labor, oxytocin, and cesarean delivery. Prolonged labor describes a birth that is progressing too slowly; obstructed labor involves a physical impediment to delivery. The account here does not supply enough examination detail to establish the precise cause. Oxytocin is a drug used to stimulate uterine contractions. A cesarean delivers the baby through incisions in the abdomen and uterus, and can be necessary in prolonged or obstructed labor. Surgical risk varies with the circumstances and available care. Sources: WHO — Maternal and newborn care standards, quality statement 1.4, printed p. 31; NHS — Caesarean section; WHO — Caesarean delivery and access to care.
2. ↩︎ Counterflow qi. Chinese medicine describes some bodily functions in terms of qi moving in an appropriate direction. Counterflow means movement upward where downward movement is expected, or an excessive upward tendency. It is a traditional interpretive term, rather than a substance visibly moving through the body. The woman has already been described as having difficulty breathing, hiccups, and dry heaves. This passage does not assign the counterflow to a particular organ or give a separate biomedical diagnosis. Source for the term: WHO — Chinese medicine terminology, entry 422, printed p. 36.
3. ↩︎ A deep, thready pulse. “Deep” describes a pulse that becomes appreciable under firmer finger pressure. “Thready” describes a narrow, fine quality under the fingers. These are separate tactile observations made during a traditional pulse examination; neither supplies a blood-pressure measurement, a heart-rate number, or a laboratory finding. Dr. Qian reports these two qualities here, without adding the “wiry” quality mentioned for the previous patient. Source: WHO — Chinese medicine terminology, entries 890 and 896, printed p. 89.
4. ↩︎ Qi and blood deficiency in this assessment. In Chinese medicine, qi describes functional activity, while blood has a nourishing role. A combined deficiency pattern can include fatigue, pallor, and a pale tongue. Oliver uses that framework to explain why he thinks this woman lacks the strength to give birth. That application is his clinical inference within the story. It does not establish anemia from a blood test, identify the obstetric cause of the delay, or mean that normal fetal positioning rules out other delivery problems. Source for the pattern vocabulary: WHO — Chinese medicine terminology, entries 224–225 and 1122, printed pp. 19–20 and 127.
5. ↩︎ Songzi Tang. This is the formula name Oliver uses. Tang commonly denotes a decoction, a liquid prepared by simmering medicinal ingredients in water. A classical gynecology text lists a similarly named Songzi Dan under difficult labor associated with blood deficiency. That resemblance does not establish that it is Oliver's exact prescription: the novel gives no ingredients or quantities here. The name is retained without supplying a recipe or silently changing Tang to Dan. Sources: WHO — Chinese medicine terminology, entries 2674–2675, printed p. 369; Fu Qingzhu Nüke — “Difficult labor from blood deficiency,” section 56 (in Chinese).
6. ↩︎ Needles and herbs together. In this scene, acupuncture means inserting fine needles; no moxibustion is described. A decoction is made by simmering medicinal ingredients in water to produce a liquid. Dr. Qian is calling for the two approaches to be used together. His claim about speed remains his own: at the chapter's close, no needling, herbal administration, or delivery outcome has been shown. Sources for the methods: NCCIH — Acupuncture: Effectiveness and Safety; WHO — Chinese medicine terminology, entries 2674–2675.