Labor and Delivery

This whole week I have been working on the Labor and Delivery during the day shift which runs from 6:00 am to 8:00 pm and it usually takes a while to sign out to the night team. My job is to basically assist the residents and attending doctors get things done. As I was able to demonstrate my competence in certain procedures I was allowed to take on a more active role. The director of the L&D unit is a big proponent for vaginal delivery and we work to do all deliveries vaginally if it can be done safely. So I was able to help in many vaginal deliveries and I actually got to deliver several babies this past week. I was also able to assist in a handful of c-sections that were considered necessary or emergent. The c-section vs vaginal delivery is another point of controversy in the field of ob/gyn. 

We had one patient this week who presented at 22 weeks with a complaint that she no longer felt the fetus moving. Upon ultrasound we were able to determine that the fetus was not going to survive and the mother was going into labor. I sat with the mother her husband and her mother to discuss the diagnosis and they of course were devastated at their loss and overcome with grief. I answered all of their questions and provided them with as much information as possible. Later in the day we had an active drug abuser mother at 39 weeks start to push and go into the final phases of delivery and everyone quickly scrubbed in to deliver the baby. Another student was allowed to scrub and assist in the delivery so I was not directly involved. The delivery became complicated and more physicians were paged to come and help with the delivery with the hopes of avoiding a c-section. It became very intense and complicated and one of the doctors asked me to page for some back up blood. I left the room to take care of the back up blood. 

On my way back to the room where the delivery was occurring the grandmother of the the women who had the 22 week old dead fetus came into the hall way and yelled to me please come quick my daughter wants to push. I yelled to a nurse to get one of the physicians to come and meet me. I entered the room and the mother was starting to push out the fetus. I tried to tell her to wait and stop pushing as I quickly put some gloves on but she kept pushing. I arrived in time to catch the entire placental sac and fetus. I kept it guarded from the mother as she had said she did not want to see it. Once I got it completely out I took it to the adjoinging room with the infant warmer and cut the sac to deliver the fetus. At this point a bunch of physicians had arrived to take over and run the show. I was able to follow all of my training but I was certain upon seeing the fetus that it was dead and had been dead prior to the delivery.

It happened so quickly that I did not have any time to process it. The family was of course very upset and crying and as the other doctors took over I was able to go back to the family and sit with them and try to comfort them. They wanted to know the sex of the fetus but did not want to see it. I told them it was a boy. 

What an intense experience and it did not hit me until I was driving home late that night. I nearly broke down as I thought about how difficult it was and how fragile life is.