No Issues

No Issues

A student writes about OB clinic

The sky was a pristine cold blue, and the temperature made me cross my arms as I walked across the hospital parking lot to the obstetric office for my afternoon in clinic.  It had been thirteen months since my last birth working as a doula, and I was excited to be with pregnant women again.  I was handed my first chart of the day, and my preceptor gave me the one line summary of the patient: “18-year-old G1P0 at 35 and 6, no issues, here for her prenatal visit.”  I opened the chart, quickly glanced at the patient’s blood pressure and urine dipstick results, and made a mental note about them being normal as I walked down the hall.

Stopping at the bright blue clinic door, I knocked gently.  Inside was a small-framed Hispanic woman, with a belly that looked as though it was just as much in control of her balance as she was, seated on the exam table.  She had a short hair cut and one gold tooth in the front of her mouth.  Her boyfriend sat in the chair beside her and looked at the floor.  I washed my hands, introduced myself as a medical student, and sat down on the stool.  “How are things going?” I asked.

She excitedly showed me where she was feeling kicks and told me that he liked to move every time she lay down.  Then, with hands that look like they move with more experience than they actually possess, I began feeling her melon-shaped belly.  I felt a firm, round mound slightly left of center and followed it down to a point just above her pubic bone, hoping that I would actually be able to tell whether or not a head was there.  I breathed a sigh of relief when, more due to her small frame and less due to my skill, I felt a round hard shape between my thumb and forefinger and confirmed the baby’s vertex presentation.  Then I pulled out the measuring tape and explained that the length of her belly should be close to the gestation age in weeks.  I began to get lost in facts I needed to review later when she interrupted my thoughts with another question:  “So, how big do you think my baby is?”  We launched into a new talk about how big babies usually are and how much they grow, and I was very glad to be able to rely on some of my knowledge from previous childbirth educator training.

Then came the moment of every prenatal exam when I hold my breath.  I felt confident that I should be able to find fetal heart tones on this patient, but I knew that if for some reason I did not find them it would leave these parents-to-be in panic until someone who could find the heartbeat arrived.  I set the lavender probe halfway between the patient’s protruding belly button and her blue jeans and applied more sonogram jelly than I could ever possibly need.  Immediately, a loud heartbeat filled the room.  I let out a quiet breath that I had been unconsciously holding.

As we ended the visit, I returned to the stool so that I could sit and talk to the patient.  Once her questions had been answered to the best of my ability, but not with the precision that she would have liked, I left to find my preceptor.

When I returned to give her the next appointment slip, I again asked if she had any other questions.  She looked at me and with a sincere voice of gratitude said, “You are a great doctor.  Thank you for explaining things to me and answering all of my questions.”  She had no idea how my heart soared when I heard her words.  There was nowhere else I would rather have been at that moment.  She didn’t just think I was kind; she thought I was a good physician.