Of the thousands of babies Dr. Emily Norland has helped deliver, this one stood out.
The 5.4-pound newborn was quiet when he came into the world in May. He was wrinkly, with thick skin and covered in dark hair. He was the first gorilla to ever be born by cesarean section at Seattle’s Woodland Park Zoo.
The unusual delivery — followed by a curious postpartum saga — meant bringing in some help from a team of local doctors, including Norland, chief of obstetrics and gynecology at Providence Swedish First Hill. Profound, she and her colleagues called the experience. Unforgettable and sacred.
One of their other biggest takeaways?
Not that different.
C-sections for gorillas are quite rare, largely because birth complications are uncommon and risks of surgery can be high, said Dr. Tim Storms, Woodland Park’s director of animal health. Fewer than a dozen have been recorded globally to date, according to the zoo, which attributed the anecdotal estimate to gorilla experts around the world, like the Gorilla Species Survival Plan.
In the case of Olympia, a 30-year-old western lowland gorilla who’s lived in Seattle since 2022, the emergency surgery brought together a team of animal and human medical providers to serve a critically endangered species and accomplish a feat they’d never practiced.
“We were all just in awe,” said Dr. Suzanne Peterson, a maternal and fetal medicine specialist at Swedish First Hill. “This was a moment that we will have with us forever.”
Woodland Park Zoo, more than 120 years old, has worked with “human-based” medical experts for decades, said zoo spokesperson Gigi Allianic. Specialists in care ranging from cardiac to orthopedic to ophthalmology have consulted on Woodland Park’s animals in the past, including in 2017 when a gorilla received a leg exam from the head physician of the University of Washington’s football team.
Swedish doctors also helped with the birth of another gorilla at Woodland Park in 1996, though that baby was delivered vaginally.
The obstetric providers met Olympia about 16 weeks into her pregnancy, along with Jamani, another Woodland Park gorilla who gave birth around the same time.
Storms said Olympia’s and Jamani’s pregnancies were intentionally timed to happen together, as was the case with their first babies at the North Carolina Zoo, where they lived before moving to Seattle.
Their vast care team here included Woodland Park’s veterinarians and nurses, as well as Norland, two other Swedish obstetric doctors, a labor and delivery charge nurse and a sonographer.
“They were very gentle,” said Nichole Hamilton, a maternal fetal medicine sonographer who took ultrasound scans every two weeks, of the gorillas. “I never felt in danger.”
Prenatal appointments during the gorillas’ roughly 36 weeks of pregnancy went smoothly for the most part, with the help of zoo caretakers who prepared the expectant apes for medical care by practicing with positive reinforcement, like fruit, when they cooperated during health appointments, Storms said.
Taking ultrasound images presented some challenges — mainly figuring out how to get the right angles on animals that are “short, squat and barrel-chested” — but there were many rewarding moments, Hamilton said. There was a thrill in documenting the gorillas’ anatomy, measurements, heart rates and how their babies grew and moved positions.
“They got to know us over time, and we got to know them,” Peterson said. “That was really special.”
Jamani gave birth naturally to a healthy baby, later named Kadre, on May 18. She was probably in labor for under 30 minutes and delivered without any issues, Storms said. He noted it can be difficult to know when gorillas begin labor.
Then Olympia’s “due date” came and went, and zoo caretakers started noticing the first signs of complications, Storms said.
Her baby was sitting lower in her pelvis than usual and, one Sunday morning, she seemed uncomfortable during her ultrasound.
“She kind of turned her back to us and gave us the stink eye,” Norland said.
The ultrasound also found an absence of amniotic fluid in Olympia’s uterus — meaning her water had likely broken. Doctors didn’t know when, but it seemed like labor had begun and yet things weren’t progressing. Maybe it was time for a C-section, they thought.
“This is a huge decision,” Norland said. “It involves sedating Olympia and separating her from her troop, separating her from Jamani and Jamani’s baby, and transporting her across the zoo.”
But the baby’s position continued to shift, and his heart rate had slowed.
These were all criteria the doctors had been trained to watch for in human patients.
“It was time to intervene,” Norland said.
The care team sedated Olympia and took her to Woodland Park’s animal hospital, where they checked her cervix and confirmed the protective sac of fluid around the baby had burst.
Over the next hour and a half, muscle memory kicked in.
Prepping surgical tools. Pausing for safety checks. Carefully making incisions.
When Olympia’s baby arrived, he wasn’t breathing.
That was partially expected since he was still coming off the anesthesia his mother had received for surgery, said Dr. Andrew Beckstrom, medical director of the neonatal intensive-care unit at Swedish First Hill. So Beckstrom took the lead on waking the baby up and getting him enough air through an oxygen mask, while one of the zoo caretakers made sure he was dry and warm.
For about 20 long minutes, they worked and waited. Unlike humans, gorilla babies don’t usually cry when they’re born, so it was hard to tell how the newborn was doing, Beckstrom said.
“That took maybe a year or two off our lives,” he said.
Then, at last, regular breathing came, and eyes opened.
The baby ape looked around, silently, trying to grab anything close, Beckstrom recalled. A few times, he latched onto Beckstrom’s fingers.
Registered nurse Lily Pang, who’s worked at Swedish for more than 30 years, called the delivery “definitely one of the highlights of my career.”
Norland and Peterson, meanwhile, stitched Olympia up, adding more layers and bandages than usual since gorillas are so active. Zoo caretakers painted her nails to distract her from pulling at the sutures when she woke up.
“It was an unforgettable experience to take the skills that we’ve honed through decades of collaboration and put them to good use in that moment when an endangered species needed us,” Norland said.
Olympia received round-the-clock care her first night after delivery as her anesthesia cleared. The following day, she was reunited with her troop and within hours was already back climbing ropes, Storms said. Shortly after, her baby, later named Oku, was introduced to the family.
As Olympia recovered and stayed close, Jamani was quick to bond with Oku, carrying him along with her own newborn and bringing both to bottle-feeding sessions with zoo staff.
Oku thrived in the first week, but another hiccup emerged as Jamani’s baby, Kadre, began to regress. He looked lethargic and underweight, and zoo staff were concerned Jamani “wasn’t quite keeping up with both of them,” Storms said.
Rather than put both moms under anesthesia to swap the babies back, caretakers decided to pair Kadre and Olympia, allowing each mother to raise the other’s newborn.
“They’re very close, and they stay together all the time,” Storms said. “It’s a family situation.”
All four have been doing well since then, he said. Nadaya, the father of both babies, also lives at Woodland Park, which is now home to 13 western lowland gorillas. In all, 17 gorilla babies have been born at the Seattle zoo.
This delivery left Swedish’s providers with deep respect for the vast knowledge of the zoo’s vet team and excitement around what’s possible with medical collaboration.
“It just highlights how similar we are to primates, meaning we actually would have something to offer in their care,” Peterson said. “It’s fabulous we can all have the humility to know that we can use each other to help in this way.”
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