That was a fast 5 weeks...

Well, my maternity rotation is over and now it's on to pediatrics. Tomorrow is my first day on a new ward at a new hospital at a new time and at a place where there is no street parking on weekdays and a parking garage that costs $24/day. On the other hand, it only slightly interferes with my tennis schedule but leaves me free to worship at the church of Kelly on Sundays. Why, hello, leisurely breakfast with Michael and the Sunday Times and a trip to the market followed by tennis and the remainder of the afternoon spent in my backyard. How I've missed you.

Anyway, maternity. There are lots of good things to be said about my rotation but seeing the birthing process from start to finish was not one of them. Durr. It was a great hospital and the labor and delivery nurses were awesome. The midwives were awesome. There just weren't any women in stage 2 labor while we were there. The darned babies would always come out at like, 3 am or 5 am or something. You know, when we weren't there. Seriously, I was about to stand on the street corner shouting to pregnant women about eating some indian food for dinner, having sex with their partners and then coming to us in labor. I don't even know if eating indian food works, but whatever.

Overall, it was good. It was a really different experience to work with women and their families and the fact that there is a constant rotation of patients is nice. There were always new moms and babies when we were there unlike in med-surg where we saw patients who were there before we started the rotation and were still there when we left 10 weeks later. And while there was poop, it was meconium and it came out of the behinds of tiny babies. And let me tell you, it's a lot easier to wipe poop off of a baby than an adult. But that meconium? Yeah, it sticks like crazy to skin. That stuff is like wallpaper paste.

But it isn't always sunshine and rainbows. There are lots of ethical dilemmas and internal conflicts to deal with. Like the 16 yo who already has a 2 yo and encouraging her to breast feed even though she doesn't want to. Internally, you're thinking "dear god, put that girl on Depo, stat!" and you're also thinking "breast feed!" Here's the thing: studies support the "breast is best" idea but it's not for everyone. But just trying it is so important even if it's only for a few weeks. My job is to support mom in whatever her plan is but it's also my job to educate mom and encourage her to breast feed. If she's got her mind made up to bottle feed, well, so be it. If she's on the fence, it's my job to help her decide what will work best for her and the baby. But it doesn't always work out and formula is a nutritionally-adequate substitution. Did I mention the support thing? That's always the most important part.

Then there are the other issues: sending a baby home with parents who may or may not be fit to parent (CPS and the hospital social workers make these decisions but the nurses and MDs alert them based on certain evidence); adolescent moms; moms with histories of spousal abuse. Those things are hard to deal with but all we can do is act within our capacity, alert the authorities when abuse is suspected or evidenced, be supportive and keep our mouths shut re: everything else.

In L&D, you have those issues but also the labor and delivery part. The hospital where I was stationed is great if you want the natural childbirth experience. Laboring women are not on a time clock and the staff are super supportive and let you do your labor thing. But sometimes birth plans have to be pushed aside because of fetal intolerance and moms suddenly find themselves having an emergency c-section. And, man, those moms are pissed. This hospital has a 3% c-section rate and they're only performed if it really is necessary (not just b/c the doc wants to go hit a few rounds of golf on the way home). It's not like in the documentary that R. Lake produced (which was really good, btw). But there was a mom who came in 3 times during labor and 3 times checked herself out against medical advice because she really wanted to have a home birth and did not want the emergency c-section she needed and...ultimately her baby died. She finally agreed to the c-section but the baby had been in distress for so long that she died 3 days later. It's really, really sad. But it goes to show you hard this can be sometimes. You really want moms to have the childbirth experience they want and deserve but sometimes it can't be the experience they planned and hoped for.

But I don't want you to think that maternity is a huge downer experience because it's not. It's a wonderful and beautiful thing to watch families get to know their newest additions and to help moms prepare for going home to raise their babies. And those babies are just precious. It's a privilege to be a part of that experience and maybe someday I'll be back as a maternity nurse. For now, onward to pediatrics.