I’m really happy to report my growing competence in the arena of obstetrics. I am on my 2nd OB rotation now, doing a week of night float to start it off. It is easier to manage the administrative and clinical tasks, so much so I’m starting to wonder why it was so hard before. I can check cervixes like a boss now and though I still can’t interpret sutures to determine fetal position, I actually believe it is a skill that is possible for a human to acquire.
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Yesterday I had a patient who was laboring on hands & knees and was nearly complete. We all wanted to know if it was time to push. She really didn’t want to get on her back (it hurts a lot, I don’t blame her). So, being the game OB I am, I offered to check her in that position. Honestly, not only could I not evaluate her cervix in that position, it took way more work to find her introitus (opening to her vagina) than I care to admit. The shape change of the anatomy was so striking.
Within the “natural” childbirth community (more on my hatred for that term at a future date) there’s a lot of disdain for physicians wanting women to be in particular positions for birth. As someone who birthed on her hands & knees and no way in hell was I gonna go on my back, I empathize a lot for that position. As someone who just experienced a very unexpected (mercifully quickly resolved) shoulder dystocia, I intimately understand the origin of the OB discomfort with trying new birthing positions. There is muscle memory, application of anatomy & physiology, tried techniques and a variety of experiences that we are building on to take care of our patients. I want my patients to be able to deliver on hands & knees, but I know that if I were to have a patient try that now, I’d be very uncertain about what to do with my hands during that delivery.
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I did a really good job of protecting my kids from a lot of the fallout of their father’s choices when we were married. I mean, we were still suck ass broke and that has left its mark, but they really didn’t understand all the problems that were the root of our separation. The mechanics of what was causing discontent in our marriage were pretty complicated and above the radar of even my savvy young teens.
Some things are happening right now that are causing me frustration and bringing me to the realization that one of the downsides of divorce that I had not foreseen is that I am at a diminished capacity to protect my children from their father’s choices. I can’t keep him from messing up things that matter to them. It makes me angry, I feel helpless and frustrated. I will try not to stress about my children’s disappointment before it happens and when it does happen, I will sit with them and just love the hell out of them. And the optimistic part of me says maybe THIS is what needs to happen for him to get his shit together. Fingers crossed, silver lining, all that jazz.
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Night float is dangerous! On my penultimate morning after I was bringing a load of laundry down to run while I was sleeping (that my mother wonderfully put in the dryer and folded for me while I was sleeping!). Unfortunately the added complexity of holding something while walking down the stairs seemed a bit much for my exhausted mind. I lost my footing and missed a step, falling quite hard on my backside on the hardwood stairs. Fortunately I fell to one side, not smack in the middle because I think I would have broken something if I had. As it is, I have a colorful 7-8” bruise on my left hip that is painful enough that I need regular naproxen to navigate my day.
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My mom stayed with us after thanksgiving to be here with the kids while I was working nights. They were quick to assert they didn’t need Grandma to take care of them and I’m sure that they would have eaten a LOT of frozen pizza and been just fine without her. However, she was able to drive Ainsley home from rehearsal (she’s an assistant stage manager for The Christmas Carol with some significant responsibilities over crew & props) everyday and even my independent kids agreed that the pork chops, hamburgers & spaghetti were worth the hideous intrusion of a foreign responsible adult. I know it was so much easier for me to focus on my work and not worry about them knowing my mom was around if they needed anything. She was here for my last week of nights because it was around the time school started and she was here to help with that. I will have another week of nights later in 2018 on my 3rd OB rotation of intern year. Maybe I’ll stock up on frozen pizza and let them try that one on their own.
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