Demise
My OB clinical has finished and I'm a little relieved. Not just that I get an extra day off and don't have to be anywhere at 6:45 in the morning - although that's nice too. And witnessing labor and birth, participating in patient care, teaching new parents how to care for the kid was all amazing. OB is just too emotionally draining.
One day at clinical there were three separate fetal demises, including two term pregnancies that just ended for no apparent reason. The patients in each case had to come into the hospital and go through labor to deliver the dead baby. In one heartbreaking case, the couple had conceived via in vitro fertilization and to imagine how excited they must have been - all the effort and money, the wait and anticipation - on their way to the hospital, thinking that it had all finally paid off and they were about to have a baby. Instead, they were faced with the choice of spending money out of pocket for an autopsy and chromosomal study versus spending it on mortuary services.
There's a symbol they put on patient doors when a demise occurs to alert other providers and I learned that the symbol is also put on the clean utility room so you're not surprised to walk in on the dead baby. The one I saw looked perfect - perfectly formed, all the fingers and toes. But said fingers and toes were white, totally drained of the blood that had pooled in her head in the hours after her death, suspended head down in mom's uterus.
I attended another labor with a family that already had a child. Their second pregnancy was diagnosed with down's syndrome and they made the decision to abort. The woman delivered the third pregnancy - one with a normal karyotype (no down's) - the day I was there and we noticed immediately that the baby had some congenital malformations. I looked up the deformities once I got home and gather (though I'm not the pediatrician and this could be totally wrong) that the child is in for a long tough haul with a disfiguring condition that may also cause other physical and mental problems. Imagine what those parents are going through now.
And my professor reminded me again that I need to document what I saw the day those twins were born, in the event.
My classmate M is going to be a midwife and she's been really beside herself at all of these bad outcomes. "Pregnancy and birth is normal. It's healthy and normal and normally there are no problems," she keeps reminding us. During her report, another classmate remarked that after seeing a vaginal delivery that day she's "still not scared to get pregnant." I think that sums up all of our feelings (hopes?) at the end of our clinical on the labor and delivery floor.
One day at clinical there were three separate fetal demises, including two term pregnancies that just ended for no apparent reason. The patients in each case had to come into the hospital and go through labor to deliver the dead baby. In one heartbreaking case, the couple had conceived via in vitro fertilization and to imagine how excited they must have been - all the effort and money, the wait and anticipation - on their way to the hospital, thinking that it had all finally paid off and they were about to have a baby. Instead, they were faced with the choice of spending money out of pocket for an autopsy and chromosomal study versus spending it on mortuary services.
There's a symbol they put on patient doors when a demise occurs to alert other providers and I learned that the symbol is also put on the clean utility room so you're not surprised to walk in on the dead baby. The one I saw looked perfect - perfectly formed, all the fingers and toes. But said fingers and toes were white, totally drained of the blood that had pooled in her head in the hours after her death, suspended head down in mom's uterus.
I attended another labor with a family that already had a child. Their second pregnancy was diagnosed with down's syndrome and they made the decision to abort. The woman delivered the third pregnancy - one with a normal karyotype (no down's) - the day I was there and we noticed immediately that the baby had some congenital malformations. I looked up the deformities once I got home and gather (though I'm not the pediatrician and this could be totally wrong) that the child is in for a long tough haul with a disfiguring condition that may also cause other physical and mental problems. Imagine what those parents are going through now.
And my professor reminded me again that I need to document what I saw the day those twins were born, in the event.
My classmate M is going to be a midwife and she's been really beside herself at all of these bad outcomes. "Pregnancy and birth is normal. It's healthy and normal and normally there are no problems," she keeps reminding us. During her report, another classmate remarked that after seeing a vaginal delivery that day she's "still not scared to get pregnant." I think that sums up all of our feelings (hopes?) at the end of our clinical on the labor and delivery floor.
posted by Imle at 9:56 PM
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