long day

Today was my last day of OB/GYN. It was great for the most part. However, I was traumatized from watching my first circumcision. It was horrible! I felt so bad for the little guy. Who would want their two day old baby strapped to the table and screaming like that? So sad!!

One last day...

So tomorrow is my last day of my OB/GYN rotation, which I am very sad about! It has been a really great rotation with both positives and negatives but mostly positives. I am exhausted but not wanting it to be over yet! My doc and I had a great explanation of VBACs today. He is one of the only doc's around the area that will do them (at another hospital!). A woman actually came in today with a very early pregnancy. She had drove about 45 min to come see him. Together they discussed and planned her VBAC. After she left I asked him how he feels about VBACs. He said that he has done about 200 and he has not had anything go wrong yet. He feels that he can do VBACs as long as he is really comfortable with it, which in most cases he is. He even said that in most of these cases, he felt that the first c-section was not necessary. He said this ,"Most of these sections were just done so someone could get to their golf game probably". This made me laugh but it is probably very true, which is sad.

Holy Batman!

So tonight I went and heard Gloria Steinem give a speech..it was amazing! She is so fantastic and there were so many people there which surprised me! Our little group of medical students for choice got a picture with her at the end which was great and can't wait to get a copy of it! I even got the nerve up to stand up and ask her a question. I asked something like what she thought about medicine restricting the birth rights of mothers in the country (aka blocking vbacs and vaginal breeches etc) and how important it is to support the birth rights of women in this country as well as the rights of abortion. She gave a good response, mostly I can't remember right now but she did say that it is a very important part of the feminist movement and always should be. I am so tired right now..maybe I'll right more later.

ohhhh and I did my first vaginal birth today!!! So AWESOME! The mom did a fantastic job.

pressure

Today I was in L % D with my doc checking up on a patient and another physician came in. This physician is one we assist on almost all his surgeries with because he broke both wrists in a freak racquetball accident (dont ask me!). Both of them are pretty cool but the other one, not my doc, is pretty old school about things. Both of them were looking at the monitoring of all the patients on the computer monitors and he asked my doc if he would help him do a section on one of the women there. My doc looked at the girl's strip and proceeded to talk the other doc out of sectioning her and said that she would deliver naturally and the decelerations on the strip were nothing to worry about..he was 100% sure that she would deliver vaginally if he just gave her the time to do so. He actually talked the other doc out of doing a c-section..pretty cool! However, it is kinda sad because this shouldn't be a cool or different thing to see...this should be the norm..not doing sections..ugh.

Sorry if this doesn't make sense..I am exhausted and awaiting yet another phone call which is sure to come in the middle of the night. Sad that OB/GYN is coming to an end this week!

One more week to go

As I sit here waiting for a phone call from my doc to come in for a delivery (hopefully!) I am realizing it is my last weekend on call for OB, which is making me sad. After I switched doctors I have really enjoyed my rotation. I like both the OB and the GYN part, I love doing procedures in the office, I love all the baby stuff (esp the ultrasounds my doc does!) and I like the surgeries. So, it is good that I switched so I wasn't dreading everyday of a rotation that I could potentially love. My new doc is a world difference then the old one. In fact, after discussing things with my school I think they are planning on removing all students from future rotations with such doc. Yay! No one should ever have to learn from such a person!

Anyways, my new doc and I had a good conversation on Friday about fetal monitoring during labor. He actually said as good as it is he feels like it hasn't really decreased fetal death rates that much or decreased cerebral palsy rates that much either..it has only, in his opinion, increased c-section rates which is not beneficial to mom or baby. He talks a lot about how things have changed since he started practice and how things are now and this is just another one of those topics. He loves to teach and I really am happy that he is so good with his patients and has some of the same opinions as I do on the birthing process!

Also, I am trying to read as much as I can..but it is sooo hard when you don't have tests! haha

I am site representative for my hospital site, that means if anyone has a problem they can talk to me first before the school or if any second years have questions about coming here then they can email me and I'll figure out the answers for them. UGH it is becoming really annoying! I can not believe some of these second years. They are really freaking out about this decision. I have finally emailed most of them saying you will get what you want to get out of your rotations, they are what you make them! Any place you choose to go will good docs and bad docs, you can't avoid that! They are driving me nuts.

Fall seems to be here but it is rainy and cold outside and almost feels like winter...besides it is supposed to snow here tomorrow! booo! Even though I love winter, I would like some nice fall days and nights too!

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.