http://www.cnn.com/2009/HEALTH/10/15/hospitals.ban.vbacs/index.html

To induce or not to induce

Today my doctor and I had a discussion on when to induce and when not to. I feel like I am in learning a lot from him, both in things that I don't want to do as a doctor and things I do want to do (if that makes any sense!). Today he tried to talk two women out of induction. Both women are in their 39th week of pregnancy and are having a miserable time, at least that is what they both said last week and this week. In fact, one of the women starting crying today saying she just wanted the baby already! Both asked him if he could induce them. With both he told them he would rather wait until the baby came naturally on its own terms. He told them that natural labor compared to induction is easier and better for mom and baby. He said if natural labor is 100% good then induction is only about 30%. He said some other things to them but it didn't matter. Both wanted to be induced, so I have two inductions tomorrow! Afterwards we discussed the whole induction thing. He says he tries to talk women out of it but what can you do when a woman, your patient, is asking you and begging you to induce her. The hospital I am at has an induction rate of ... 80%! He said that is just crazy and doesn't understand why it is so high. He says he does his best not to give in. He says if a woman really just wants to have the baby because she is being 'broken down' by the pregnancy then he will but only after 39 weeks. He says anyone who does anything before that point is really endangering the baby and its health. We even read an article together on induction and elective C's before 39 weeks and how much worse the baby's stats are compared to after 39 weeks. He says he is really ashamed of some of his fellow OB's. I can't blame him. I feel like he is a good doctor and does the best that he can but in the city we are in/state we are in the people are just a certain way and follow tradition..or what they see everyone else doing. If everyone else they know got induced, they want that too. It is frustrating but you need to make your patients happy as well as healthy which is a balance in this case. I just hope I can be firm in not allowing this when I become a doctor and have my own practice but I know I will have to be able to make money and I hope that not inducing will not be a problem.

my first call!

Today I was called to the hospital for my first emergency. A 35 year woman in labor at the hospital, I was so excited! She had had two previous vaginal births both almost 9 pounds. However, she was breech in this delivery. Our hospital doesn't allow breech births really unless there is "no way to stop it to do a c-section"..sucks I know!! Well, they let her labor for awhile but off to the OR she went eventually. The c-section went great. When the doc pulled the baby out I was like WHOA that is a big baby! Almost 10 pounds! Crazy! Too bad she wasn't able to deliver vaginally because of the breech (stupid hospital rules!). Even my doc says the hospital rules really bothers him sometimes because he feels like a lot of his patients could deliver vaginally (he means mostly VBACS I think) if the hospital would allow it. I think the other hospital in town does offer VBAC deliveries but I am not sure...but a lot more people deliver there I know.

a complete 180

yes! the school is great and has given me an OB that is great. He has his negatives too but I really am enjoying him. He loves to teach which is great.

My current OB/GYN attending did his residency at Yale and was even chief resident there so he knows his stuff and loves to teach which is great. He told me he agrees with VBACs but he can't do them at the hospital since they don't allow them. He has said to me a lot that labor is natural and should happen naturally...but his patients ask him so much to be induced that he does but not til 39 weeks...ugh I can't believe the patients that do this! I can't believe he does it and lets his patients do it too! He does not do elective C-sections. He actually had a woman last week who was in labor in +1 that would not push. She actually said no when he asked her to push..he said you can push this baby out in like three pushes or less and she said nope I will not push. He said well I will have to section you and she said yep I know so do it! ahhhh I couldn't believe it! He is also very pro breast feeding and has no information in his office for formula or anything like that which is great! He has a great relationship with a lactation consultant in the same building as well. I am doing so much better in my new office and am loving it! We have a lady in labor now..she has been for almost 3 days! I am hoping she will deliver tonight so I can see it!

New, Fresh Start

My school has decided that this is not the best situation for me. They are moving me to a new physician tomorrow! Yes!! Hopefully tomorrow will be a lot better..I just hope this next doc doesnt suck..but I must stay positive!

Tonight I wanted something sweet...so I made the best chocolate icing ever! yummy

I also had an amazing weekend with the boyfriend..it is so nice when he comes to visit!

I dont even have words..

of how disappointed I am! I am currently on my OB/GYN rotation. I love OB...it is what I want to be I think. I, however, am hating my rotation. It has nothing to do with OB itself. It has nothing to do with OB itself...it has everything to do with my attending. I can't stand him and it has only been 4 days! So here it is

The second I walk into the office on Monday morning I smell something weird but don't think anything of it at the time. I wait around for an hour til my doc finally shows up...why no doctor can be on time is beyond me and why all of them are at least 30 min late! I hope I am somewhat on time! Anyways, I start talking to my doctor, he seems okay. We go to see a patient and he...no joke...says to the patient "well, you know women can't do anything without a man so...". I say to myself okay is this doc going to be one of those guys? The day goes on, he pimps me a lot, I talk to the staff etc. Pretty normal stuff. Then I am talking to him in his office and he LIGHTS UP A CIG and starts smoking. In his office. in his OB/GYN office! No wonder I smelled something! This is a. illegal b. unethical c. not safe for his patients or office workers! I get up and leave the room. Since then he has said stuff like Male docs are superior to Female docs blah blah blah. He also told an 18 year old today ..who has 2 kids already that she should get preg and not take birth control because he doesn't think women should take BC since they are meant to have children! Who would advise that??? Who??? So frustrated because I cant do anything. Can't say anything. AHHHHH. This is horrible. I want to tell someone but who? I need to talk to my advisor about this to see if I can somehow switch to someone else's service. I hope I can. I also want to tell on him..but how and to whom? He should not be smoking.

any advice?

surgery...surgery...surgery

So I have one week down on my surgery rotation and three to go! I actually relaly enjoyed my first week and was not as stressed as I belived I would be. I like seeing the surgeries too. Next up I have OB-GYN which I can't wait for!! Should be really great!

I dont understand what the big deal is with the President's speech to school children. I heard that my childhood school is not showing it which I think is just crazy. I know that is just because I live in a republican area. The school said they are taping it but I have heard from several sources that is a lie and the school will not tape it and not permit teachers to show it to their classes. A speech to children about the importance of education and hard work should not be political..and it should not be someone's own political views that diecide whether or not the child hears our president speak to them on such matters. What is the big deal? Why shouldn't children hear their president speak to them? What is wrong with a speech on education? ugh...http://i2.cdn.turner.com/cnn/2009/images/09/07/obama.school.speech.pdf . One of my parents' VERY conservative friends even said this - who gives the right to schools, school boards and teachers to override what the president thinks is best! He said he didn't see any agenda being pushed and didn't see anything wrong with talking to them about education. It is just so sad to me that our country is so polarized that conservatives won't even let their children hear a speech from the president. So Sad!

Ps. I just watched Oudin play and she is just really great!