I think I have grown as a person from working in maternidad. I am still surprised that I am now able to watch vaginal exams, vaginal births, episiotomies and other goings on at the hospital without feeling uncomfortable. I have come a long way since the first week. So, I am thinking that my parents were right when they said that doctors are able to get used to seeing everything (and it is normal to feel squeamish around blood at first but you get over it). But today proved that in some cases, you just can't wrap your mind around what you are seeing.
We entered the clinic as a woman was being pushed on a gurney to delivery, I could see the baby crowning as she was wheeled by. Then we entered and I noticed that it was an unusually slow day. Where there are normally 20 plus women in labor there were around 8 today. Maybe chief Webber on Grey's Anatomy was right-a calm day is a bad sign. The first four patients had preeclampsia. They were induced using a medication that is inserted into the cervix to begin dilation. When we got to the final bed, I noticed that the woman did not look very pregnant. I heard the doctors explain, in spanish, that she was 27 weeks pregnant and that they would be inducing labor in this woman (who was only 20 years old). I did the math and started to feel panicked...that is only 6 months and three weeks gestation. I don't know much about fetal development but I was pretty sure that there are serious risks to delivering a baby so early and I could not, for the life of me, figure out why they were doing a vaginal birth rather than a cesarian section in such a risky case. Then the doctor that I am shadowing, Dr. Marques, explained that the baby was dead. He didn't know why, but the fetus was no longer viable. I felt a pit in my stomach and started to tear up. This woman would be forced to endure labor and would not be rewarded with a healthy baby. It was too much and it just seemed too cruel. Whenever I see a woman in labor, she is in the worst pain she has ever experienced. There is often crying out for "mi madre" or "ay dios mio" or "yo no puede". But at the end of it all they have a child to take home and I am able to remind them of this when they are enduring contractions, cervical exams, and labor. But this woman was being forced to go through all of this and she would get nothing in the end.
Then we were led into a room that I thought was postpartum. I thought this because the women did not look pregnant. Wrong again. This room was for all of the women who were under 15 weeks gestation and did not have viable fetuses. Two had moles, which were described as abnormal growths rather than babies. I watched each of these women undergo ultrasounds. Then I watched a 13-year-old have a D&E (dilation and extraction/dilation and evacuation). This is a procedure where the cervix is dilated and the contents of the uterus are scraped out. The patient is fortunately put under anesthesia for this barbaric process, but I could not stop thinking about the fact that I was watching a 13 year old on the operating table, After this, we had had enough. It was already 11:15 and we usually work until 11:30 but you can only take so much. Tomorrow we are going on a peds rotation so we can play with the babies, hopefully this will be easier than what we had to see today. As much as it was awful and emotional, I can respect that today was a very valuable learning experience.
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