Labour of Love

Forte, Milena

I had only been back at work for a couple of weeks. To say I had the last nine months “off” (as people sometimes did), was to seriously misrepresent the life of a new mom. As amazing as it had been to spend every day with my new son, in many ways coming back to work was a “break”. It meant a return to an environment I had some semblance of control over. I did what I was trained to do- and the vast majority of the time, that seemed to work. Patients responded, students progressed, and the day generally proceeded smoothly. When things didn’t run smoothly, there was usually some discernable answer…some logical reason that needed only to be uncovered, then addressed. Life with a new baby can only be described as intense, unpredictable and life-altering. Intensely beautiful and intensely grueling all at the same time, unpredictably unpredictable and life altering to the point that every experience you ever have after the birth of a child is experienced inexorably differently that you would have experienced it before.

…Which brings me back to my story. I had only been back at work for a couple of weeks when my pager went off in the middle of dinner. I had rushed home desperate to see my son, and famished from a day of work punctuated by “pumping runs” to my office where I kept my hand held Avent. All I wanted to do was sit and eat, but the pager was insistent and needed to be answered. It was a pavlovian instinct- to answer it immediately …even though my home had been devoid of its sound for the better part of the last year. I knew what it signaled. Someone was in labour. I had been delivering my own patients for the last seven years or so and found it extremely rewarding both personally and professionally. When I returned to my practice, I discovered that many of my patients had become pregnant, and that one in particular was due any day now. I had delivered her first baby a couple of years ago, and now her whole extended family was part of my practice. There was no question that I would go in.

It was only as I got in my car and started the familiar trek back to the hospital that I began reflecting on how this time would be different. It would be the first delivery I attended since my own nine months earlier. So much had changed. For starters, I was functioning in a chronically sleep-deprived state. The thought of being up all night with a delivery, then working the next day, then being up the next night with my son (who apparently had never heard of the PAIRO call guidelines) made me feel slightly nauseated. But beyond that, I was nervous as to how I would function. Would I be able to recall my knowledge and skills? Would I be able to inspire confidence in the resident on call with me? (I quickly decided that it was best not to let her know that it was my first delivery in almost a year). Would I be able to be objective? I knew from previous conversations with my patient that this time she intended to “go naturally”; i.e. forego all pain relief and opt for an unmedicated delivery. While I admired her determination and respected her decision, my body was gripped with memories of searing pain. Could I stand to watch another woman endure that and remain unmoved? Could I proceed to calmly coach her; seemingly impervious as I had done countless times before? Could I harness my professional training and block out my now visceral understanding of her experience? Time would tell.

As I arrived on the labour floor, I couldn’t help but notice that my name appeared on the board twice, once as the attending for my patient, and once because a patient co-incidentally shared my last name. Well this is fitting, I thought to myself- there it is in black and white. All right, it was time to see the patient and I needed to get a grip. When I walked into the room, I saw that she was doing beautifully; contracting regularly and progressing well. She was in obvious pain, but had already gotten to eight centimeters dilated and was committed to the course. During each contraction she looked hard into my eyes, obviously focused on her breathing despite the pain that her body language belied. Somehow, I managed to summon up the strength to support her. After a few contractions a realized I needed to change as things were progressing quickly. As I hurried to the locker room, I noticed there was some food perched on the counter of the nursing station. I absentmindedly grabbed some chips and “dip” as I played over scenarios of various obstetrical emergencies in my mind. I was recalling the steps of the resuscitation of a patient with post-partum hemorrhage and struggling to recall medication dosage when a familiar feeling gripped my throat. “Oh no, not now, this can’t be happening” I thought to myself. I started to feel panicked as I realized that there must have been sesame seeds in the dip I had just inhaled. I am allergic to sesame seeds. “Crap”. I hurried to the charge nurse who promptly stabbed my left arm with 0.3 cc’s of 1:1000 epinephrine. “You’ll need to lie down for a while” she informed me. “We’ll put you in a back room so you can rest”. ‘Julia, Dr. Forte’s in room 15- get her name up on the board”. What?! I was horrified, but too tachycardic and lightheaded to do much about it. This was ridiculous, here I was, (with my name now on the board for a third time) laying in a bed two doors down from my own patient whose delivery was imminent. While there were certainly other qualified people available to help, I couldn’t imagine her reaction upon hearing that I had suddenly become incapacitated and would be unable to attend her delivery when only moments earlier I had been in her room examining her. All I could do was page my resident and hope that the patient’s labour would last just a bit longer than the residual effects of the epinephrine.

Fate obliged, and what seemed like an eternity later, both the resident and I were at the patient’s bedside as she pushed out a beautiful baby girl. Despite my reservations, and my untimely allergic episode, everything fell into place, and I was able to once again have the privilege of sharing such an intimate moment with a family. The birth of a child is a momentous event- one that many of us are lucky enough to call “work”. As I prepare for the birth of my second child in a few weeks- my collective memory of all the births I have attended once again are running through my mind. I have tried to learn from all of them, and to respect the process that I have participated in as a spectator a birth attendant and a mother.

Theme: Birth | Naissance
Theme: Physicians | Médecins
Theme: Teaching and Learning | Enseignement et apprentissage

Stories in Family Medicine | Récits en médecine familiale [Internet] Mississauga ON: College of Family Physicians of Canada. 2008 --. 




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