Monday, October 24, 2005

Baby OUT!


During my first day on duty at Dr D’s clinic, I found out that they allowed their pregnant patients to choose who would deliver their babies – either the obstetrician or residents (that was our official title). I never liked obstetrics (maybe I’ll make a post about that in the future) and I always prayed that I wouldn’t be called on to deliver a baby by myself.

The Sunday started smoothly, patients arrived one at a time and there were no difficult cases. Around 6:30pm a car suddenly pulled up at the front of the clinic and out came a very pregnant lady. “I’m going to give birth!” she announced. The clinic had a delivery room on the 2nd floor. Unfortunately, it didn’t seem the baby could wait that long – and I was the only doctor in the clinic!

The patient was brought to the examining table… I sent a text message to Dr D… one of the staff ran up to the delivery room to get instruments… another one ran to get IV fluids… I stepped up beside the patient… she said her last menstrual period was March (that made it just 7 months) – I started to worry… put on a pair of gloves and intended to check if her cervix was fully open… and saw a black mass pushing through the vaginal opening – the head of her baby!… I was still in khakis and a polo shirt… the instruments weren’t available; the IV fluid wasn’t attached yet; there was no time to sedate; there was no time to clean the perineum… in less than 5 minutes, out came all 3.7kg of a baby boy! (average birth weight of a Filipino baby is 3kg)… and then he cried! *sigh of relief*


Did I deliver the baby? Technically I did… well, more likely I just caught him because he was coming out doctor or no doctor. I had conducted the first delivery as a licensed doctor.

Then came the difficult part – oh, the baby was ok – but it became apparent that the mother wasn’t “all there”. She was very talkative, refused IV fluids, refused suture of the lacerations in her vagina – big head+small vagina=big laceration! Fortunately there appeared to be no bleeding. She wanted to get her baby and head home ‘now!’ An interview with her relatives revealed that she had a mental breakdown years ago and never recovered.

The whole night she kept us up. She had a sharp mind – she remembered everyone and called us by our names (I don’t even know all the staff yet)… She wanted to breastfeed her baby – which was not allowed by the pediatrician. She wanted to go home; still refused suturing of the lacerations (we managed to convince her that she needed the IV fluids). She fought off the effects of the sedatives we gave her because she was afraid someone would run off with her baby *sigh*… *sigh*

So much for hoping no one would give birth during my shift.


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In other patient news:
"1 year-old bites penis of his 5 year-old brother!"
*no comment*

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