advice on delivering babies

[obiwan]

any pointers on what and what not to do?

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[plainolerichie]

Grab the neck when it comes out!

They taught us to go for the shoulders as the head pops out, but I almost dropped my first delivery. The residents say go for the back of the neck to have a better hold (gentle of course).

Another thing, ask private practice doctors if they'll let you catch if you are talking about getting experience (if they work out of your hospital).

 

[DoctorFunk]

One hand through the legs with your palm on their rump forming a loop around one of their legs and the other hand around the back of their neck. Gives you a vice-like grip, you'll never drop one of the little buggers.

 

[Tired]

any pointers on what and what not to do?

My strategy was always this:

Attending: "You think you're ready to do this one solo?"

Me: "No thanks, I'm good."

Attending: "You don't want to do the delivery?"

Me: "I'm fine right here. Do you want a cup of coffee? I can get you a cup of coffee if you like."

Attending: "I know students have to do at least one solo delivery. Did you already get that done at least?"

Me: "The piece of paper I turned in to the Deparment says I did."

Attending: <sighing> "Cream, no sugar. See you in 20 minutes."

 

[BigRedBeta]

One hand through the legs with your palm on their rump forming a loop around one of their legs and the other hand around the back of their neck. Gives you a vice-like grip, you'll never drop one of the little buggers.

After this, "football" them - while still holding on to the nape of the neck, position the baby on your forearm, legs on either side of your elbow, tight against your body (you can even squish - not too hard - their little leg between your arm and your body to keep them from going anywhere). Then use your free hand to suction them out, clamp the cord and cut (if you need to do it all).

 

[marie337]

Just whatever you do, don't say "oops"!

 

[PeepshowJohnny]

My strategy was always this:

Attending: "You think you're ready to do this one solo?"

Me: "No thanks, I'm good."

Attending: "You don't want to do the delivery?"

Me: "I'm fine right here. Do you want a cup of coffee? I can get you a cup of coffee if you like."

Attending: "I know students have to do at least one solo delivery. Did you already get that done at least?"

Me: "The piece of paper I turned in to the Deparment says I did."

Attending: <sighing> "Cream, no sugar. See you in 20 minutes."

*Internet High 5*

Same here, although the residents/attendings were more than happy to hear I had no interest in catching the kid.

"I don't know nothin 'bout birthin no babies"

 

[Ashers]

*Internet High 5*

Same here, although the residents/attendings were more than happy to hear I had no interest in catching the kid.

"I don't know nothin 'bout birthin no babies"

I thought it was just me. My attendings/residents didn't know I didn't want to do deliveries, however I had a lot of deliveries stolen from me by family practice residents, OB/gyn interns (both with quotas), being in C-sections and crotchety old attendings that were like "Well, you can watch from the corner."

My advice. Watch epidurals whenever a birth is eminent, you're still learning, and if it's your patient, it's a valid thing to do, at least where I was.

I avoided a lot of births by being in C-sections which also sucked; however, I never had to do a vaginal delivery by myself. I did have to deliver the placentas.

 

[Doctor Bagel]

Anyone can catch a baby. If the let the med student do it, it's not hard stuff. Just don't drop it -- that's really it. And to follow up on that one, be sure to sit down, so you can hold the baby in your lap once it comes out, minimizing the risk of dropping it. If you work with midwives, it's even better because you can do a delivery where they don't break the bed, which means there's about zero chance of dropping the baby, so you're totally set.

And I'm sure you know the basics -- pull down for like two seconds and pull up for the rest of the time. If you just pulled up, you'd probably be good (an ob intern told me this one).

 

[obiwan]

While I am not at all interested in becoming an OBGYN, it seems like catching a baby is one of those few "becoming a doctor" moments during 3rd year where you feel important. Its a different feeling when you can tell someone "I just delivered a baby" instead of "hey I just took another HPI" or "I got to hold some intestine out of the way for my surgeon"

 

[PeepshowJohnny]

While I am not at all interested in becoming an OBGYN, it seems like catching a baby is one of those few "becoming a doctor" moments during 3rd year where you feel important. Its a different feeling when you can tell someone "I just delivered a baby" instead of "hey I just took another HPI" or "I got to hold some intestine out of the way for my surgeon"

To each his own. As others have alluded to, there's nothing "special" about delivering a baby in a normal labor. I mean, yeah, if you're a guy who knows how to do the varous maneuvers to get a difficult labor done or one of the few who actually knows how to use forceps, that's a source of pride.

But a normal labor? Pfft. I saw our cats and dogs deliver their litters all alone as a kid. Some chick delivering one baby with like four people their to help her ONE baby? Lame. And she doesn't even eat the placenta.

 

[Tired]

Some chick delivering one baby with like four people their to help her ONE baby? Lame. And she doesn't even eat the placenta.

Our great-great grandmothers used to take an hour break from their work in the fields, squat in a hut, pop it out, then get back out to the harvest.

Now we have lamaze, waterfalls, "Birthing Suites", and the choice to do "natural birth" is some kind of a huge deal.

I hate obstetrics. Just hate it.

 

[Ashers]

While I am not at all interested in becoming an OBGYN, it seems like catching a baby is one of those few "becoming a doctor" moments during 3rd year where you feel important. Its a different feeling when you can tell someone "I just delivered a baby" instead of "hey I just took another HPI" or "I got to hold some intestine out of the way for my surgeon"

I prefer the "I made it through med school without ever delivering a baby."

OB/gyn and psych were two miserable rotations.

 

[Gimlet]

I prefer the "I made it through med school without ever delivering a baby."

OB/gyn and psych were two miserable rotations.

I'm working on the "I made it through med school without ever doing a rectal exam."

 

[Ashers]

I'm working on the "I made it through med school without ever doing a rectal exam."

I'm working on that too. However, I still have my medicine sub-I and ambulatory medicine to get through this year. =(

 

[plainolerichie]

I'm surprised so many people do not want to deliver babies in medical school. It was one of those things I was really looking forward to and ended up jumping through hoops to get that experience!

Granted, I don't really care to deliver another one unless it is really emergent!

 

[Doctor Bagel]

I'm glad a delivered some babies just to say I did it and all, but I don't think I gained that much from the experience. I wasn't wowed by it or anything, which is one of the many reasons why ob/gyn is off the table for me. So my advice would be to try to do a few but don't kill yourself and try to do a ton unless you really dig it.

Man, did my first DRE today, and I would have happily skipped that one.

 

[FutureInternist]

I'm working on the "I made it through med school without ever doing a rectal exam."

Although if you do them for residents they will LOVE you for it & you can slack off the whole month, get easy patients etc

 

[aecuenca2]

it's been a while since I delivered, but this might be helpful for some (had a great teacher in residency). First, I'm RIGHT handed, so let's make it easy and have the baby's head facing to the LEFT (your LEFT, as in the direction of your anatomical LEFT):

1. palms on each side of the head, thumbs facing the direction of the nose. (in this case, facing to the LEFT). The bottom hand (your LEFT hand) will eventually be going around the neck.

2. downward pressure until you see the anterior shoulder

3. upward pressure until you feel you can grab a rump/leg with your RIGHT hand and simultaneously slide your LEFT hand onto the baby's neck like you are holding a soda can

4. place the baby's back on your LEFT forearm and swing the head toward the RIGHT so the baby lies flush to your chest. Your RIGHT hand can now be freed because you are holding the baby close. Bonus points for technique if you have the baby's head in the down direction to prevent further aspiration of any fluid or mec. Use your RIGHT hand to clamp and cut the cord (you're a pro now) and hand the baby off. More bonus points if you do this smoothly.

5. Congratulations. now deliver the placenta.

As for the other side, well just it's almost the same. The baby's head is facing to your anatomical RIGHT. You use your RIGHT hand (the bottom hand) to grab the neck, and your LEFT hand to grab the leg. Here's the fancy part...place the baby on your RIGHT forearm then smoothly transfer the baby from your RIGHT forearm to your LEFT forearm, then you know the rest.

And this coming from a sports med doc. At least I'm ready to deliver on the sidelines..just hand me my pocket knife and some shoelaces.