Thursday, March 4, 2010

Catching Up/ or Why Resolutions Fail

Okay, so I'm way behind on my birth stories! I had two more January births. One was a wonderful first-time mom, in great shape, well-prepared, starts labor at around 10pm. I had checked her 3 days before, on her due date, she was 2 cm, 80% effaced, head at 0 station, rope and ready to go. They called me at 1am, to let me know her bag had broken, and the contractions were picking up but they were fine for now. At 3:30am they called again, and said they were ready for me to come, and so approximately 30 minutes later, I arrived at the home with my assistant. The patient was leaning on the table, breathing through contractions, and sounding a little pushy. So I offered to check her, she was 8 cm, but instead of a head, there was meconium and a frank butt! Even though I have delivered quite a few breeches, this was a primip, which makes it more complicated than a quick multip breech. I called Dr. Gomez, my collaborative physician, to see if he wanted me to bring her to him, but since she was starting to feel pushy, and having a relatively quick labor, we decided to go to the nearest hospital, which was Norwegian! So, I called ahead and let them know I was bringing in a surprise breech primip at 8-9cm. When we arrived at the hospital, after the usual hospital bureaucratic stuff (different nurses fighting over who would take us up), stopping on every floor in the elevator, with my poor patient on hands and knees in the wheel chair, because it was more comfortable for her - we finally arrive at L&D, and are put in triage, then moved to a room, then moved back to triage! Finally the attending comes in, and checks my patient, only to find a pair of balls sitting at my patient's perineum. So now we knew we were having a boy! I turn to the MD, and asked if she would consider delivering her vaginally, since the baby was right there. She told me she had never done a breech delivery. So she took my patient back into the OR, let her try pushing once, and then started cutting, Boo Hoo! At the end of the c/s the OB surgeon arrived, they had been calling the wrong pager for her, and wouldn't you know it, she had more than twenty years of experience under her belt, and delivered many breeches.
The good news is my patient feels like she had a vaginal birth and a c/s, and with luck the attending MD will decide to learn how to deliver a breech, especially when they fall into your hands, and especially when even midwives know how to do it!

No comments:

Post a Comment