Gamer’s Guide to OB, Part V of V (final installment)

OK, if you’re really interested in delivering babies on your OB rotation, the first thing you need to know is that “pushing” starts once the cervix is comletely dilated at 10 cm. If there is still cervix left (less than 10 cm dilation), you risk tearing of the cervix, possibly affecting future pregnancies.

Well, last night, a “grand multip” meaning that she had delivered 7 babies v a g inally in the past, came in at 4 cm of dilation. We were sure she would go through labor fast and we’d have a baby by about 11 AM. Well, it was 6pm, and she was still only 9 cm. But she wanted to get that baby out of her belly, so the chief goes in to examine her, and decides to let her push to see if he can push the rest of the cervix out of the way. Well, we all knew she would go fast, but this lady went form 9 cm to delivered with a baby on the bed in about 30 seconds. The chief didn’t even have both hands gloved! (Remember the first rule of protecting yourself!) That was a delivery I was counting on doing, and he knew she’d go fast. He could of at least waited until I was gowned before he asked her to push. I got to delivery the placenta. Ugh. Great learning experience, huh?

Baby #1 of the day, I gave to the medical student, because we still had 2 additional deliveries waiting, and I knew I would be doing one of them. Baby #2 I was gowned and gloved for, and then the chief stepped in with the vacuum extractor, so I didn’t get to take part in that one either. Baby #3 was a C-section so I did not deliver that baby. Baby #4 was the 30 second delivery mentioned above that I SHOULD have been doing, not the chief. Babies #5 & 6 both delivered at about 1:30 AM within 10 minutes of one another and within 5 minutes of each lady getting admitted to the service, so there was no time for anyone to wake me.

SIX deliveries and I did not participate in any of them. Since the triage nurses pretty much ignore the rotating residents and grab the interns, the only choice is to stay awake all night just in case someone comes in who might deliver quickly. Or you can just go to bed.

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