Monday, March 3, 2008

A Night of Obstetrics Call


PHOTO: Remember the "first day of school" photos that you usually had taken? Well, this is my very nervous, I-think-I'm-going-to-vomit, "first day of being a doctor" photo.
Again, I'm post call and thought that I'd write. I'm currently on obstetrics and had an interesting night.

My first patient came in and we began web-casting...to Iraq! The woman's husband was stationed in Iraq and could not be here for the delivery, so the hospital helped set up a webcast to his station in Iraq for him to watch and participate in the birth "real time." She did an amazing job, going "all natural," and he did an amazing job coaching her from afar. When the baby was finally born, you could hear the dad's sobs of joy mingle with the new mother's tears. Then he announced the name of the baby to everyone. It was a very special moment (as all births are) and I felt blessed to be a part of their experience by delivering their baby girl.


My next patient was a Thai woman, a culture that tends to labor very stoically and quietly. The Thai culture views things in terms of temperatures. Labor is a "cold experience," whereas post-partum recovery is a "warm experience." She had a bulging bag of waters, so we decided to rupture them to increase her contractions. At the same time, she asked for ice to bring on labor (part of the Thai "cold experience" of labor). I'm not sure which worked (the ice or the rupturing of membranes); but VERY suddenly the baby was crowning and I wasn't quite ready. I had to throw on gloves and climb onto the foot of the bed to deliver the baby, just barely making it and getting covered with all the messiness of delivery in the process! Afterwards, she was continuing to bleed too much for my comfort. So, medically trained, I gave her a few medications to firm up her uterus and stop the bleeding. However, she calmly asked for hot tea (part of the "warm experience" of Thai healing). Shortly after, her bleeding decreased. So, I'm not sure if it was the ice or the rupture of membranes that brought on her labor. And I'm not sure whether it was the medications or the tea that stopped her postpartum bleeding. It could really be either, and who am I to say. There is much mystery to medicine and health.
My third delivery the dad wanted to be involved - not just "cut the cord" involved, but "get in there and help deliver the baby" involved! I was excited about helping him have the experience of joining with his wife to deliver their baby together. He was a very "tough" Marines guy, but when she started pushing and he saw the head coming down the birth canal, I thought I was going to lose him to the floor. We were standing side-by-side and I took his hand and placed it on the baby's head, at which point he relaxed but also started to tear up at the wonder of it all. I placed his hands on the baby and guided him as he delivered their baby immediately up to mom's chest. They both dissolved into tears of joy and I couldn't help but water up. I quietly delivered the placenta, cleaned up, and left the room; leaving mom and dad alone with baby. A while later, the dad approached me at the desk and was profusely thankful for the experience. It has motivated me to try and get the dads as involved as they want to be in the birthing of their child.
During the final delivery of the night, after the head and shoulders of the baby were delivered, I took the mom's hands and placed them on the baby's body. She then pulled the baby out from herself onto her chest, delivering the baby herself. I talk to the moms beforehand and offer this option (if all is going well with the delivery and the baby) - many get excited about the idea.
Ultimately, it is always the mom that "delivers" the baby. I just feel lucky to share in the moment by facilitating the process.

4 comments:

Kim said...

Wow, Dr. Jen. Way to make me tear up at work. ;o) I loved hearing about all three deliveries. They are very lucky to have such a competent, compassionate doctor. Proud of you Missy. Looking forward to see y'all in July!

--K--

Anonymous said...

Dr. Jen -- Medicine Pirate! You have every right to be proud of yourself. Those are the coolest medicine stories I've ever heard. I'm sharing with others! Thanks.
Bev

DBR said...

Great start on the blog! Thanks so much for sharing it with us. Nice to hear what you've been up to recently.

Our updates are available on our blog at http://reisefamily.blogspot.com/.

Hope you're able to keep the blog somewhat updated as you fill up those 80-hour weeks. It sounds exhausting!

Be sure to visit once you find yourself in the Twin Cities again one of these years!

Derek Burrows Reise

Anonymous said...

Good call on the bulging water. I had a lady try that once at the jail. I just booked her and her new kid.