The baby's chances were not good: his mother was 14 years old, which immediately increased his chances of being born prematurely, underweight, or dead; and his mother was suffering from toxemia, a form of hypertension associated with pregnancy and a condition that can seriously jeopardize the life of the newborn.

As is the policy at Columbia Hospital for Women, a fellow in neonatology - a fully-trained pediatrician doing further training in the care of the newborn - and an intensive care nursery nurse were standing by in the delivery room during the young woman's emergency cesarean section delivery.

In addition to the personnel in the first floor delivery room Monday morning, a new piece of equipment stood by, ready to be used for the second time since its recent purchase by the hospital's Women's Board.

The $15,000 machine, which sits on a rolling stretcher, is a portable intensive care unit bringing all the major capabilities of the fourth floor Intensive care nursery into the delivery room.

The 200-pound package with its tinted clear plastic hood and array of gauges and monitors, include an electrocardiogram, a respirator, a pump to regulate intraveneous medications, a suction pump to clear a newborn's lungs, a heated cover that can be partially raised to allow doctors to work on the infant without it getting cool, and monitors to measure heart rate, respiration rate, blood pressure, skin temperature, internal temperature and rate of body heat loss.

When the 14-year-old mother gave birth "the baby was received in a very asphyxiated condition," said Dr. John Scanlon, chief of neonatology at Columbia. "There was only a flickering heart beat.

"The baby was immediately resuscitated, first by (hand respirator) and then with the respirator on the machine. Monitors were started and the kid was resuscitated and transported in his 'cadillac' to the ICU," Scanlon said.

Because of the machine, the infant was on the respirator, receiving careful regulated oxygen, 120 seconds after birth.

Without the machine, such babies would be "bagged by hand," said Scanlon, a process thattt involves placing a mask over the infant's face and hand pumping oxygen into his or her lungs. "You don't know what you're doing" by hand, Scanlon said. "With most of the bags you can't even measure pressure, let alone volume.

"Nowhere else in the metropolitan area is this kind of sophisticated care available in the delivery room," said Scanlon.

The ability to get a newborn on the respirator at once is particularly significant because "deaths from asphyxia and asphyxia-related diseases are the single highest cause" of mortality in the newborn, and "asphyxia aggravates every single disease in the infant," said Scanlon.

In addition to having the machine, Scanlon has developed a so-called "code pink" system at Columbia. Like the "code blue" teams which respond to cardiac arrests in virtually all hospitals, the code pink team responds to emergencies on the delivery rooms.

One intensive care nurse and one neonatology fellow are always ready to report to the delivery room after being alerted by means of a direct intercom system between the delivery area and the fourth floor intensive care nursery.

Within two minutes of receiving the alert, the nurse and physician can be in the delivery room, with equipment and the new "life island," ready to care for a newborn who otherwise might die in the 5 to 10 minute interval between birth and arrival in the nursery.