Am I Jaded?

Maybe I just don’t trust birth enough.  I think that interventions are good things, particularly when the prevent more interventions or bad outcomes.  I don’t trust that everything is fine until I reassure myself and the patient that things are fine.

I remember one patient in particular would complained of decreased fetal movement in the second trimester.  I saw her in my high risk clinic, did and ultrasound and told her everything looked good.  The baby was normal and appropriately grown.  The fluid levels were good.  The placenta was anterior, but otherwise unremarkable.  Nothing that I could identify was wrong.  I spent a fair amount of time trying to reassure mom the same thing.  When she felt better, I told her to call m office if she had any concerns.

She did call 5 days later, with a scant amount of stopping.  She didn’t have any pain, and she thought the baby was moving.  She was anxious, so I asked her to come in and would repeat the ultrasound.  Unfortunately the scan was not good, the baby was dead.

What was wrong?  Where did we go wrong?  Trusting nature got us in trouble.  Trusting technology had falsely reassured us.

When she delivered, the cord was essentially tied in a tight knot around the ankle.  I looked back at the images from the week before, and the cord was not there – I had incidentally taken extra pictures of the feet to show mom where to feel the kicks.  In between scans, the baby managed to make a loop of cord and slip its foot in.  A tragic accident.

I see the bad things that can happen in pregnancy.  I she moms in subsequent pregnancies and try to reassure them that things are going well.  I quote risks of complications, but due to the volume of my practice, I know that I will see most of these complications at some point.  They are not abstract concerns, I will have tell a mother each time about the complications and implications for themselves and their babies.

I don’t trust birth, at least in the sense that things will always be well.  I have a healthy respect for birth and the potential complications.  I am always looking for them, because I know they will eventually be there in front of me.  I only hope that neither mom nor babe will suffer long term complications.  But I know better.  Don’t trust birth, because birth can kill.

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One thought on “Am I Jaded?

  1. I don’t think you’re jaded at all. I think you’re cautious and that’s a good thing. My pregnancy was mostly smooth, but I never went into labor on my own. When I was induced, nothing much happened, no contractions even after being on pitocin for a good long while.

    Even though there was no overt fetal distress, my OB said that something seemed wrong and we needed to deliver asap. Turns out that I had a fetal-maternal hemorrhage and my daughter was severely anemic and would not have made it through a vaginal delivery. She was very nearly stillborn and needed 2 blood transfusions and a 2 week NICU stay. Today, she is a happy and healthy girl. But on delivery day, she was so sick.

    Had my OB, and the CNMidwife in attendance, not trusted their education and instincts, I wouldn’t have a beautiful 13 month old little girl. I had ultrasounds and fetal stress tests done before delivery and nothing abnormal was noted. I went into my birth wanting a “natural” birth, but I’ve come out knowing that birth is risky. It cannot be predicted and it can turn bad in a second. Birth isn’t a thing to be trusted. It’s not a thing to be feared either. But it’s something to be respected.

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