For months the fragility of a vital air link endangered the health of people across rural Hawaii. The state is still trying to fix it.
Kristen Bettencourt-Pedro bolted awake at 2:30 a.m. and felt her water break. It was Feb. 6, almost five weeks before her baby’s due date.
In most circumstances, a woman in premature labor would rush by car to the nearest hospital, where medical staff would try to suppress labor or, if it couldn’t be stopped, get ready to deliver the baby.
But Bettencourt-Pedro, 34, lives on Molokai, where women with complicated pregnancies must board a plane in order to give birth under the care of a doctor.
The island’s lone hospital doesn’t perform cesarean sections and it prohibits vaginal births for mothers like Bettencourt-Pedro who have a prior history of C-sections. Women who give birth at the 15-bed Molokai General Hospital sign up for an unmedicated delivery with little access to medical interventions if things go awry.
It was just before 3 a.m. when Bettencourt-Pedro’s husband whisked her out of his truck and into the hospital’s fluorescent-lit birthing room. Medical staff ordered an air ambulance to transport her to Oahu while a nurse gave her drugs to slow or stop her body from trying to push the baby out.
Her contractions did not let up. And the state’s only air ambulance company had two other patients to move that morning before it could point a helicopter toward Molokai, just 26 miles southeast of the Honolulu medical hub.
Hours passed and, by dawn, still no air ambulance had arrived. The nurses tried to assure Bettencourt-Pedro that if worst came to worst she could push the baby out with the assistance of a midwife. But she remembers thinking she was going to die.
“It was scary,” she said. “I felt like I wasn’t being treated like a priority.”
Hawaii has one air ambulance provider: Hawaii Life Flight. The private company usually operates seven fixed-wing aircraft and a helicopter, responding to an average of five to eight calls a day.
But its capacity buckled last year on Dec. 15, when one of its planes crashed in the ocean, killing a pilot, flight nurse and paramedic. The company grounded its aircraft on every island except