When most people think of the labor and delivery department (L&D), they probably have thoughts of babies, laughter, tears of joy, happiness, and pink and blue onesies. My experience on L&D was quite different.
A woman who was 26 weeks pregnant walked into the hospital at 10 p.m. on a Monday night, claiming that her water broke.
But how could that be? She was only 26 weeks along. It was determined that she had preterm premature rupture of membranes and would need a C-section immediately. On our way to the OR, she confided to me that her name meant “father’s joy.” She chuckled and said, “I never had a father, but my baby will.”
A couple of hours later, the baby was doing well in the neonatal intensive care unit. While reviewing the patient’s chart, I noticed domestic violence listed in her past medical history. It made me wonder if her baby really will have a father.
That same night, a Spanish-speaking woman in her 20s came to the hospital because she hadn’t felt her baby move for two days. Fetal demise was diagnosed on ultrasound examination; she was 18 weeks along. She agreed with her doctor’s advice to undergo amniocentesis to help determine why this happened. I watched the procedure, while her 5-year-old son played in the hallway, not realizing that he wasn’t going to be a big brother anymore.
Monday night was still not over. We received a transfer from another hospital, which coincidentally was the same hospital at which I was born and volunteered at while in college. She was a 30-year-old woman with lupus and hypothyroidism. She was confused because one doctor told her she had preeclampsia, and now she was being told she had placental abruption which had progressed to disseminated intravascular coagulation. I watched her doctor break the bad news that the pregnancy would have to be ended for her safety. She couldn’t understand why this was happening so quickly, especially when she previously gave birth to two healthy boys. She was given misoprostol injections to induce labor, and at 24 weeks along she delivered a nonviable baby two nights later.
On the next night, we received a page from the triage unit. I ran there to find a gurney carrying a 28-year-old woman covered by a blood-stained sheet. She was diagnosed with placenta accreta, a complication that in her case required emergency C-section. I accompanied her to the OR. The baby was doing well despite being delivered premature at 25 weeks, suffering only a minor scalpel laceration on the cheek from the procedure.
On Wednesday night, I watched a 22-year-old woman go into premature labor at 31 weeks. She screamed in pain as the contractions intensified. Her mother and I were the only ones who comforted her, because the baby’s father was in jail.
Several nights later, I delved deep into a patient’s history and realized the tangled life she was trapped in. She was only 20-years-old and already married. She was 28 weeks pregnant. She did not know the father of the baby because her brother and cousin had raped her. Not only that, but her ultrasound revealed her baby had a cystic hygroma, a birth defect commonly associated with, but not indicative of, genetic abnormalities.
Despite the tragedies I encountered, I also witnessed the delivery of many healthy babies whose mothers experienced uncomplicated pregnancies. It was amazing to introduce a new life to the world. That was one of the best experiences of medical school. I learned that pregnancy can be difficult, disappointing and devastating, but it also can be beautiful, exciting and life-changing.