30 Something Baby Doc

Murphy's Law is the only constant in obstetrics and gynecology. I was staffing labor & delivery today ...oh what joy! I was called to supervise a tubal ligation in the operating room being performed by a second year resident (who's surgical skills I trust). At the same time I was called to a labor room to supervise a delivery being performed by the chief resident (4th year) who I also have confidence in. The patient was pushing, the family and nurses were happy, the baby was close to crowning and all was well. Since the chief resident was very experienced and will be in a practice of her own after graduating in a few months, I decide to leave her alone to complete the delivery and I strolled back to the OR the supervise the less experienced 2nd year resident for the tubal ligation. I hadn't been sitting in the operating room for more than five minutes when I received a phone call. It was the nurse in the labor room I had just left. She was frantic and I heard multiple people screaming in the back ground (as well as the patient screaming in terror) I'm thinking to myself" What the F--K. " The nurse tells me I need to come to the room right away. So I'm running down the hallway dodging pedestrians and other obstacles. I arrive in the room and everyone is still screaming . I see the chief resident pulling on a very large infant's head that won't budge any further. The resident yells that she has a bad shoulder dystocia ( the infant's shoulder is stuck behind the mother pubic bone and only the head has been delivered. If this is prolonged the infant can sustain permanent brain damage. It can also result in prolonged nerve damage to the involved arm). I ran to get some gloves ("Here I come to save the day") I told the resident to cut a very large episiotomy. After she cut it I told her to reach in and grab the other shoulder, she tried but couldn't get a good grip. I made an attempt since my hands were larger (I knew one day they would be good for something) . I managed to grab the other shoulder and pull the infant out. The newborn perked up and started crying after 30 seconds. It was moving all arms very well.

Now if I had stayed in the room, everything would have been just fine and there would have been no shoulder dystocia. OBTW, the 2nd year resident completed the tubal ligation without any problems.