What I didn't deliver

Chen, Julie Y

It was late, probably after midnight by then.

From the frenzy of the labour and delivery suites I was called to the ward on a quiet floor of the hospital. The lights were low and all was quiet and I was wondering why I, the Family medicine/ obstetrical intern on call, was paged to come here. The ward clerk directed me to a room further down the corridor. I could hear the familiar sounds of a woman in labour as I entered the dimly lit room. There was a nurse gently encouraging the woman in the bed to bear down and push. Still flushed with the enthusiasm and excitement of delivering slippery and loud bundles of joy into happy parents' arms I confidently took over from the nurse who gravely told me the baby was stillborn. I felt a lot less confident and quite a bit more disconcerted at this unfamiliar and uncomfortable situation.

Of course I knew about stillbirths but I had never really thought about the process of actually getting the baby out. The mother still has to go through labour and deliver her baby, all the while knowing that the outcome would not be at all what she envisioned. She would still go to the obstetrical ward putting up with innocently playful but unintentionally tactless questions about her impending due date and the sex of her baby. She would still be admitted to her chosen teaching hospital under the care of her doctor and at the mercy of the on-call obstetrical house staff. Tonight, that would be me.

"Push, I see the baby's head", I said, trying to keep my voice even, encouraging. Usually for deliveries I feel like a cheerleader for the winning team, joking, supporting, hollering and congratulating but for this one I consciously tried to be completely methodical, efficient and professional, thinking this to be the most appropriate approach. Only a few pushes, but longer than I had expected, and the baby was out, slippery, and blue like all the others, but quiet. Just like the room. There was no neonatal resuscitation team called, no surrounding commotion, no husband or Family. Just me, the nurse, the dead baby and her.

I am embarrassed to say I don't remember her name and I don't remember her face. I don't even remember if the baby was a boy or a girl. But I do remember helping the nurse wrap up the baby for her to hold. And I do remember the silent trickle of tears as she gazed at the baby in her arms.

I stood there murmuring what I meant to be comforting words; their meaning drowned out by incessant beeping of my pager. I awkwardly excused myself to deal with the other emergencies, not without some sense of relief, but feeling that I was leaving prematurely. I intended to come back to say or do something to ease this feeling of incompleteness but never had, or made, the time.

It has now been over 10 years since my Family Medicine residency and my rotation in obstetrics remains one of the most fulfilling and educational aspects of my training. Subsequent similar experiences have allowed me to learn about the tremendous support programs for patients in circumstances such as these and the nature of Family practice has enabled me to develop as a patient-centred doctor. However, the discontent with this one particular experience sticks with me. The exact details have become fuzzy over the years but what I have retained is a very clear sense of the emptiness, helplessness and incompleteness I felt that night.

I wish I had had the insight then to recognize the power of simply being.

Theme: Birth | Naissance 

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




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