Dec 9, 2012

Misconceptions

People have funny ideas of where miscarriages come from.  A "misconception", if you will.  I suppose it is the natural way of humans to try to assign blame for a bad outcome.  It's difficult to accept that sometimes things just happen, and we can't control them.  Whenever I counsel someone for a miscarriage, I always say that "this is not from anything that you did or did not do.  You didn't cause this."  My personal philosophy is that it is quite amazing that any pregnancy succeeds, given the complexity of things, and it's not surprising that things sometimes don't go right.  And it always breaks my heart a little when I have a woman convinced that y or z made her miscarry.  Here are a few of the things I have reassured women about:

I drank too much chamomile tea, and it made me miscarry.

I spent too long in the hot tub.  Did it cook my baby?

It's a punishment from God.

It's because my pap was abnormal from herpes (All kinds of wrong here.  Paps are not abnormal from herpes).

I ate the wrong food. 

It came out when I went in a bounce house.

I had a massage, and it caused me to start to cramp and miscarry.

I had sex.

The cat licked my belly.


To my patients and women everywhere- I hope that your doctors, and myself, continue to assure you that this is not your fault.  It happens to about half of women.  Please try to not blame yourselves. 

My Term Baby

I haven't delivered a baby who would live for six months.  It's part of the second year of residency- to hand over the term, live babies to the intern and take the more complex, sadder cases.  The little babies are so tiny, their whole body fitting in my small hands.  They are scrawny and purplish, and cool to the touch.  I feel like I've almost forgotten how a healthy baby feels. 

Today the interns were so busy.  I offered to take one of the new patients to help, and I was just tickled with my term young woman without any health problems.  Six months ago, she would have been just another lady on my long list of postpartums to see, but now- she was my reminder as to why I loved obstetrics.  She began to push, and there was a brief moment- right as the head was crowning- that I wondered if I still remembered how to deliver a big baby.  The little ones just kind of come out on their own.  I did, and it was a nice delivery with no problems.  And I held that baby in my arms just a few more seconds than I needed to, as I cut the cord and suctioned his mouth and nose, just enjoying how his weight felt in my arms, how I could tuck him under my arm rather than in my hands.  And I handed him over and I was so happy.  

A lot of the rest of my career will be these patients.  What a good job.

An L&D Story

A recent funny story from labor and delivery...

A questionable pair comes in, with the woman in labor.  She has just been released from jail earlier that day.
Due to years of drug use,  her veins are difficult to start in IV in, and the anesthesiologist has to come in to start it.  The boyfriend leans over and points "that's a good one!  I could get that one for you, if you like."

No thanks.

She delivers quickly.  The boyfriend crows "She held it in!  I'm so proud of you baby, you held it in til you got out [of jail]!" 

The next morning on postpartum rounds, the woman pulls me aside and asks "Does this baby look just a little bit black to you?  I think this might be from someone different than who I thought"   She is white.  I glance over at "Dad."  Also white. 

I tell her that I can't tell any paternity just by looking, there would need to be blood tests to confirm who the father is.

But the kid looks black.