Slippery

With the umbilical cord clamped, I placed my left hand just below the abdomen as my right hand gripped the cord, tugging and pulling to slowly liberate the placenta from the uterus. As I held the cord, my glove turned red, covered with blood and other uterine contents from the delivery. With more pulling, the placenta moved closer to the opening the of canal. With a final push (from the exhausted mother), I could see the reddish blue disc-like mass advancing. I repositioned my hand, and pulled the cord.

Before I knew it, the placenta slid out and fell into the bucket that was precariously resting on my knees. As the placenta fell, so did the other bloody and gooey contents- some splashing on to my blue gown.

My first placental delivery. Two words- very slippery.
Mental note- do not wear porous shoes and eye protection is a must.

Just earlier, I watched how the 7-lb baby boy emerged with some assistance and careful maneuvering/pulling from the resident (first the head, then each shoulder and then the body). With the baby in the crib, I was summoned to take over. With the guidance of the resident and attending, I positioned my hands and soon caught the placenta.

Next step (logically at the next delivery) is to catch the baby.

My last trip to labor and delivery was during my first year of medical student. The view was quite different; I stood in the background, awkwardly positioning myself and acting as the mirror girl, holding up the mirror for the patient to see. Things have changed since then. Today, I had a closer view and was able to finally take an active role in the delivery.

The one draw-back to being closer- you will walk away covered in some sort of fluid. A small price to pay for what you see- the process of birth.

***
As week 4 nears an end- I'm really appreciating the scope of Family Medicine. In this last week, I've gained a spectrum of experiences. I spent some time in my continuity clinic, the ED, labor and delivery, gyn clinic and pediatric clinic.

We even found time to visit the Sonoma County Fair, where I got pet a llama (I think I was the oldest one in the petting zoo), taste my first funnel cake and people watch. The fair is an interesting cultural experience filled with bright flashy lights, intoxicating smells of fried food and lots of overpriced rides. It was a flashback to my last childhood fair visit in Fresno, CA...

The diversity of clinic is both rewarding and challenging. Every day is so different-you work with all sorts of patients. But at times, it feels like you are always switching mental gears. With different patient populations, there are different considerations, although the bottom line really remains the same- PREVENTION.

With kids, we immunize and educate about diet and exercise. With adults, we still educate about diet and exercise and try to reduce the risk of developing hypertension, diabetes, hyperlipidemia and other chronic diseases (or we just continue to treat the best we can, when prevention has limitations).

The experience so far has been interesting and look forward to the learning opportunities in the last two weeks.