A "Good" Outcome

Yesterday was a slow day on call, so I was entering birth data. As I entered data for 20 normal vaginal births in a row, I was mentally giving myself and my midwife colleagues a pat on the back for our excellent outcomes. Of all the births I entered, not one was a c-section! There were some close calls, but in the end, our patients and their babies came out healthy and with no uterine scars. Amazing, especially considering our nation's 31% c-section rate!

Then I heard a fourth floor stat call, wondered what it could be, and went out to the L&D unit. By the time I got there, they already had the patient I had just admitted in the OR for a crash c-section. She was a preterm patient whose baby had been found to have severe growth restriction and extremely low amniotic fluid on a specialized ultrasound just that day. The little boy's heart tones looked ominous on the monitor, so our OB consultants rushed to deliver him. He weighed just 2 lbs 13 oz at birth, but thankfully, was breathing on his own and the NICU doctors gave him a good prognosis. After a phone call to the patient's husband (trust me, not a fun one to make) and a question and answer session with both parents, I took the dad to see his little boy in the NICU. He was sleeping in his tiny bed, looking like he had some growing to do, but otherwise seemed sweet and angelic and, well, ALIVE. Both parents were relieved, and remarked that it was a good thing she happened to have that ultrasound planned for today, because who knows what would have happened otherwise.

So there you have it: a "good" outcome. When the student who was following me yesterday asked what I like most about my job, I told her it was the excitement and unpredictability of it. Try as I may, I can't control all the forces that make pregnancy and birth happen the way they do. I can only tweak the circumstances slightly in hopes that it leads to a better outcome. And I'm constantly reminded not to get too narrow minded in what I view as a "good" outcome.