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In the March 13 episode, a woman — played by Enuka Okuma of “Rookie Blue” and “Workin’ Moms” — carrying a baby for her best friend and his husband, experienced complications during the birth. 

Some aspects of the scene were “kind of funny” and “a little ridiculous,” said Sahil Gupta, an emergency physician at St. Michael’s Hospital in Toronto. 

In the scene, doctors encircle the pregnant woman named Natalie. Viewers can see the vaginal canal and baby’s crown as the infant is pushed out.

But then things start to go wrong; the baby’s shoulder gets caught on Natalie’s pelvic bone (a “shoulder dystocia”), causing the baby to retract up the birth canal. The baby boy’s breathing starts to slow; he is delivered not breathing, turning blue.

To viewers’ relief, the doctors are able to revive him. But the drama isn’t over yet; after Natalie delivers the placenta, she starts to bleed. The viewer can see that she’s losing a lot of blood. 

To pull off the scene, the “Pitt” crew created a custom rig with a silicone prosthetic of a pregnant belly, legs and a vaginal canal anchored on top of a gurney, according to . As cameras rolled, Okuma stood behind the props and leaned over. Meanwhile, two puppeteers were at work adding blood though a tubing system and pushing the baby out of the vaginal canal. 

“Precipitous” births like this come through the ER sometimes, said Gupta, but generally, pregnant patients are sent directly to Labour and Delivery instead of being treated in the ER, as Natalie was in the show.

In the scene, the ER doctors manage the birth, while the obstetrician makes a brief appearance and leaves shortly afterward.

“That just would never happen,” said Gupta. He found it somewhat amusing that the obstetrician wasn’t called earlier and that she left so soon after the birth. Emergency medicine is extremely collaborative and is rarely about one person. 

This points to a broader issue with the show, he said. The episodes are very centred around the main character, Dr. Robby (Noah Wyle). But perhaps the creators made the choice deliberately, to showcase how the pressures of ER medicine affect the individual, he added. 

The series creator, R. Scott Gemmill, has said its main purpose is to showcase accurate medical scenarios. 

Like Gupta, obstetrician-gynecologists, and labour and delivery nurses have praised the prosthetics in the birth scene but weren’t all satisfied with its veracity. A shoulder dystocia is way more stressful for doctors than it is portrayed to be, said .

“A shoulder dystocia is an incredibly dangerous situation, one that is my biggest nightmare every day that I walk onto the labour deck,” she said, adding that the scene portrays it as a relatively calm moment. “It downplays the severity of pregnancy and childbirth.”

A shoulder dystocia is considered an “obstetric emergency,” according to Edmonton labour and delivery nurse Tina Bitangcol, who  was downplayed in the series, according to a YouTube video. “That was one of the calmest shoulder dystocias I have ever seen.” 

Still, the TV drama, which airs its finale Thursday night and has already been renewed for a second season, does get a lot right, said Gupta. As he watched, he thought, “Oh man, this is kind of cool.”

The show mirrors his workplace in many ways: patients complain about wait times in the crowded waiting room, doctors grapple with complicated diagnoses, patients are treated in the hallway and everyone works together as a team: doctors, nurses, social workers and other staff. “It’s definitely a team sport,” Gupta said. 

“The Pitt” showcases the challenges ER staff face every day. “They did a really interesting and good job talking about end-of-life discussions,” Gupta said. The series also shows patients abusing doctors physically and emotionally, which is spot on, he added.

He has found the experience of watching the show cathartic and a little anxiety-inducing. It offered him the unique opportunity to show his loved ones what he does at work — although the acute cases, like cardiac arrests and intubations, while realistic, are far more frequent in the series than in real life. 

The piece does “a pretty good job overall” of showcasing a day in the life of an ER doctor. Like Dr. Robby, Gupta and his team rarely know what cases they’re going to see on a given day and deal with a lot of unknowns. 

“This is still a piece of fiction,” he said. “The issues that they show are things we see come up, but shouldn’t be taken up as medical advice or standard of care.” 

“The Pitt” can be streamed on Crave.