Saturday, May 31, 2008

My First C-Section (as a med student)

The pager beeped and we dropped everything and ran to the labor and delivery room.

After a week of waiting, I finally witnessed my first newborn delivery. The mom was Rh negative and sensitized to Rh factor (which is sort of like seeing an ivory-billed woodpecker because everyone has read about it, but few people have seen such a case in the U.S. now that we are so meticulous about managing pregnant moms), and the baby was Rh positive.

The Ob-Gyn docs tried to pull the baby out using forceps, but baby wasn't coming they took mom to the OR to do a C-section. I saw my first C-section, which was eerily how I imagined it. Save your romantic notions that surgery is a delicate scientific process...they made a transverse incision across mom's lower belly and reached in to grab the baby. There was a fair amount of blood, but it was fascinating how much of the blood was collected by a plastic bag around the incision (will learn more about this later, hopefully), and the tough Ob-Gyn ladies were pulling and rummaging around mom's belly looking for the blue baby. The pediatrics team generously allowed me to hold a blue sterile towel so that I could "catch" the baby. Soon we could see the head, and the Ob-Gyn attending reached in and pulled the baby out of the womb by its head. I held my arms outstretched, holding the blue cloth, ready to receive the baby from the Ob-Gyn docs, and the baby landed in my arms, newly severed from mom -- a big blue baby that was sort of floppy and doll-like. I carried the baby 3 feet to a warmer and we began warming, drying, and vigorously stimulating the baby with towels...he had Apgar scores of 3, 4, and 6.

The baby was taken to the ICN and I watched as the residents put in a central line. I mentioned that it was my first delivery, and one of the residents asked if I was keeping a journal of my third year of medical school. I told him no, but I do keep a blog...

Working in the Well Baby Nursery this week (or Hell Baby Nursery according to some interns who dislike the loads of paperwork, the MS3's LOVE the nursery) was a lot of fun. It was very pleasurable playing with newborns, they are so different from any other patients and a pleasure to care for. The parents are always very excited and grateful, and the dads are amusingly awkward and sort of dazed and eager to help. I learned how to perform a newborn exam, and what things to look out for and what findings are normal in a newborn.

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