WAILUKU, Maui — Most of the 1,700 births that take place annually at Maui Memorial Medical Center are uneventful, and that's a good thing.

But it also means that doctors, nurses and others involved in the labor and delivery process may not get a lot of chances to work together on problem cases.

Enter Noelle, a $22,000 computer-interactive birth simulator that mimics an assortment of complications, including breech births, placental abruption and shoulder dystocia, which can occur when a large baby gets stuck during delivery.

The Kiwanis Club of Kahului donated $15,000 to help the hospital buy the simulator, made by Miami-based Gaumard Scientific Co. Inc., with the Maui Memorial Medical Center Foundation contributing the remainder.

A Kaiser Permanente team from California visited Maui Memorial last week to train staff on how to use Noelle — renamed "Noelani" by the Maui crew — so they can run simulations for their co-workers at the Wailuku hospital year-round.

Kaiser has been using the mannequin in most of its 30 hospitals nationwide, including O'ahu's Moanalua Medical Center. The Maui hospital is the first outside the Kaiser system to be trained by the Kaiser team.

Team member Dr. Michael Leonard said the Noelle simulations are "as realistic as possible" and are conducted in the hospital's labor and delivery suites "to test the system where everybody works."

A laptop computer runs different childbirth scenarios, triggering changes in Noelle's heart rate, breath sounds, fluid discharges and even cervix dilation. The mannequin also reacts to measures taken by doctors and nurses responding to the emergency. Monitors show pulse, oxygen and heart rates and other readings just as they would for a real-life patient.

The mannequin can be intubated and defibrillated, and provides sites for injections, intravenous lines and post-delivery suturing. Doctors and nurses also can listen for fetal heart sounds before the baby and placenta are expelled.

To heighten the realism, a microphone lets one of the staff provide a voice for Noelle so she can talk with the medical team and express her growing distress as the complications progress.

And hovering nearby is an anxious dad, portrayed by another staff member.

Noelle comes with a birthing baby and an interactive newborn that cries when resuscitated and can change color from a potentially deadly blue, due to oxygen deficiency, to a healthy pink.

Some of the simulated childbirth emergencies happen so fast they have to be handled in the labor and delivery suite, and others require Noelle to be wheeled into the operating room several steps away.

To simulate a Caesarean-section delivery, the Maui Memorial labor-and-delivery team improvised by taping a pouch wrapped in carpet padding onto the belly of another female mannequin. Scalpels were used to cut into the pouch and remove the baby and a bag of red fluid that served as the placenta.

The simulations are videotaped and a debriefing held afterward to review what happened.

Communication is one of the biggest challenges in responding to stressful situations, and Maui Memorial registered nurse Jessica Caudill said the simulations allowed the obstetricians, pediatricians, anesthesiologists, respiratory specialists and nurses to work on effectively interacting with one another.

Registered nurse Carleen Wong said it was helpful to be able to react to life-threatening emergencies in a controlled setting and review the response afterward.

"You don't realize how you look when you're on the inside, and to be able to review it is critical," she said.

Reach Christie Wilson at cwilson@honoluluadvertiser.com.