An insiders guide to obstetrics…
It’s 11pm and I’m 3 hours into my shift as an obstetric registrar. I look up at the lady I am delivering and tell her that I’m putting the ventouse cup on – a glorified sink plunger that’ll hopefully help me get the baby out. I ask her if she’s having a contraction.
There’s a pause as she sucks deeply on her gas and air, before finally replying
“….no it’s gone.”
“Ok. No worries. With your next one I’m going to help you birth this little one.”
Her husband catches my eye. He’s exhausted – his face is full of fatigue, anxiety, anticipation. I hold his gaze and compose my face. The obstetrician’s poker face is well practised. Beep, beep, beep, the baby’s heartbeat ticks away steadily; it’s almost soothing. We wait for the next contraction. Meanwhile, Beth (the midwife) and the neonatologist (baby doctor) are present in preparation for the delivery. My concentration is momentarily interrupted by a fluttering in my belly and I’m reminded of my own passenger. I turn back to the husband.
“You know you’re the only one in the room who isn’t pregnant?”
Everyone, including the birthing lady in front of me, laughs, before our attention is rapidly recaptured by a building contraction; I am distracted from my own pregnancy because I’m managing another.
Beth asked me a shamefully long time ago to put some thoughts on paper about the experience of being a pregnant obstetrician. What insight had it given me? What could I offer my past self in terms of hints and tips? What greater understanding had I gleaned from gestating?
I suppose the first thing to say is that I have found pregnancy and motherhood a surprise. I’ve met a lot of pregnant ladies, felt a lot of bellies, scanned a lot of uteruses and delivered a lot of babies. Grandmother; eggs, I thought. Despite being immersed in all things obstetric, I was astonished by how it felt to be pregnant. Despite almost every woman telling me how tired they were when I met them in early pregnancy clinic, the degree of my knackered-ness was astonishing. I’d arrive in the car park 20 minutes early and set my phone alarm just so I could have a cheeky snooze. Then I’d leap out of the car, dry-heave on the curb for five minutes, explaining to passers-by that, no, I wasn’t still drunk, then sprint to labour ward looking wan and sheepish. Unsurprisingly, pregnancy is hard to hide when you’re surrounded by those in the know. The Eau de Vom doesn’t help either.
To my delight, a colleague (and now great friend) was roughly the same gestation as me, but was unfortunately having a rough ride during pregnancy. We regaled each other with tales from the pregnant trenches. I once had to flee a delivery room – to “get some equipment” – only to be so desperate to puke that I left the loo door open; the birth partner eyed me quizzically from the corridor. My craving for salty carbs was also out of control: one morning I inhaled a packet of ready-salted crisps between every patient on a morning theatre list. There were six patients that session. My friend, however, out-did me by fainting dramatically on a ward round. The consultant, ever considerate, revived her with a playful kick.
By comparison, second trimester was a delight. I stopped feeling sick – hurrah – and started relaxing into the swing of things. I even started to feel more attractive – that ‘glowing’ business didn’t seem to be all nonsense. At least, that was until I mentioned my pregnancy to a colleague.
“Oh, congratulations! Naturally, I just assumed that you’d really enjoyed Christmas.”
Great. Not fit, not ‘glowing’, just fat.
Putting my apparent gluttony aside, I waddled on unabashed.
My husband and I planned a trip to the Brecon Beacons when I was 24 weeks. We hadn’t been before and I thought it would be lovely to see it in the snow. I read avidly about ambitious hikes and told my husband that, no, pregnancy wasn’t an illness and it was him who was going to struggle to keep up with me. Yeah. Near the summit of Pen Y Fan, feeling like a breathless Weeble on ice, I came to the painful realisation that pregnancy does, indeed, c hange your exercise tolerance. A planned 6-hour jaunt spiralled into a 10-hour expedition complete with blizzard, white-out and obligatory marital spat. The conversation had become increasingly terse as our phone compass failed (I know, I know…), we got lost, and I put my foot in a deep, icy bog. He had the temerity to laugh.
My husband requested something less ambitious second time around, so, at 28 weeks, we went away for a more sedate weekend in St Ives. Pottering around shops and ‘enjoying one another’s company’ were the order of the day – it wasn’t just the pasties that were hot. I couldn’t understand why I was crippled by tightenings all weekend, and mentioned it to a senior midwife when I got back. She smiled then gave me a naughty wink. How had I not known this from my job?!
In an attempt to inhabit a more maternal, less obstetric, mental space, I booked NCT classes, and did my best to listen and not interrupt when doctors were portrayed as scalpel-wielding patriarchal butchers. I was only partially successful. Discussion turned to life after the baby, and how we would manage. It still all felt very hypothetical, despite knitted boobies, role-play and swaddling baby Resusci-Ann dolls.
Eventually, around 35 weeks, it dawned on me that this was really happening. Having refused to acknowledge that this pregnancy might actually result in a baby for months, I finally sat down to write my birth preferences. And you know what I discovered? I’m a bit of a hippy. I bought the essential oils, sat on the birth ball, made a playlist (different for 1st and 2nd stage, obvs) and expressed a wish for a normal birth, skin-to-skin, low lighting, Ina May Gaskin and Michel Odent knitting quietly in the corner. Of course, being a massive cynic, I also explained my wishes in event of a Caesarean under general anaesthetic, because failing to prepare is preparing to fail and all that.
In the event, labour was predictably unpredictable, but suffice to say it involved a dog that knew my waters had broken, a husband who was too drunk to drive, and a high-speed trip to hospital whilst alternately screaming and cracking jokes, lying across the back seats of a Mini. Well, we obstetricians do love a bit of drama…
If you had your baby in Gloucester some time between 2014 and 2016 you may notice this lovely lady in the photo (although typically looking more fresh faced in these photos! ) This Obstetric doctor may have come to visit you during your pregnancy, childbirth or even had the pleasure of helping you deliver your baby.
Whilst now on maternity leave she is continuing to provide a service to the pregnant mamas of Gloucestershire and beyond with the shoe on the other foot, with this blog about pregnancy as an obstetric doctor.… You’d think it would be teaching Grandma to suck eggs right?
So here is Dr Medland… at your cervix!