Monday, October 6, 2008


It was a busy weekend followed by a conference today...I'm so tired I could.......zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz.................

Oh, sorry! Well you know how it is. I made up in one weekend for the awful slow month I had last month. I did 9 deliveries last month which is pitiful. I did five this past weekend....course my student caught four of those :(

Baby number 3 arrived in the wee hours of the morning (don't they all?). The student talked her out of an epidural at 7cm...I disagreed with this decision but went along with it. Her theory was that the patient was going quickly and she wouldn't get much benefit from it. My theory was that the woman had no desire to go natural because she wanted that experience. She was going natural because she was scared she would be paralyzed by the epidural (a common misperception among many of our Hispanic women). I therefore felt it was a little unethical to withhold the epidural. I don't know - tough call there.

Baby number 4 was my lady that I sent home after the failed induction...she prodromaled...came in the day before with no change. Naturally I was getting ready to go home to bed when she called to say she was on her way. Fortunately this looked like the real deal - 5/100/-2. She labored fantastically and we had a mild shoulder dystocia that lasted to the belly button! The baby was 10-2. Great apgars and no problems... later she tells the student she had the same problem with her last one (which was close to 10 pounds). Um, ok, that would have been nice to know prior to delivery - not that we weren't prepared as I knew this was a big baby and she had a history of big babies (smallest was 9-7 I believe) but that kinda info should have been all over the chart. It wasn't. I looked to see who had done her initial OB visit - one of the WHNPs - and not the one I think highly of if you get my meaning. Figures.

Baby number 5 was actually a doctor patient but when she was informed that her doc was not on call and that it was Dr Greedy from another practice covering...she promptly said she would take the midwife (me of course). Apparently she had started prenatal care with Dr Greedy and transfered to our practice. She had a great delivery. I had the student watch me do this one because I wanted her to check out the differences in our styles. Her style is ok but just not what I had envisioned a homebirth midwife to be doing. I don't know what I expected....maybe zen mantras being chanted and incense burned, etc....:)

There was actaully another baby I caught...Dr Greedy had a patient there who was a gravida 4 para 3. She went from 7 to complete +2 in maybe 10 minutes. The nurse asked me to come in for delivery as Dr Greedy was not going to make it. The patient was fine with this - she didn't care who caught she just wanted to push! Delivery went smoothly, even with the triple nuchal cord! I was going to grab a billing sheet when the doctor who had since arrived saw me with it and flipped out. There was no yelling but the atmosphere was tense as Dr greedy told me he wouldn't bill for doing a favor...blah blah blah. I informed him in polite words that he was full of sh*t and had done it to me a few weeks previously. He said he didn't ask me to do the delivery...I said that a resident would never have made it, the other doctors would all prefer a midwife to having the resident or nurse attend the delivery (no offense intended to either parties btw). Not to mention the hospital policy states the nurses should make every attempt to have a provider present if the attending MD can't get there. You see, Dr Greedy is...well...greedy. He will try to take deliveries from other docs and bill for them...he gets to bill if a nurse or resident catches the baby. I told him that I would never catch another baby for him. I feel bad for the patient who gets burned for his greedy selfish behavior...

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