During morning bedside rounds, we walked into the room of a patient I had assumed an MD would be caring for during Board Report, due to some higher risk criteria. Crowded among the Attending, the Residents, and the medical students, I heard my name called with a familiar voice. I looked up and saw one of my favorite patients from a prior clinic, smiling. She looked so different in labor, sweating and laying down, it took me a minute to recognize her. I moved out of the crowd and to her side. She asked if I would be with her today, and I calmly explained that because the baby was so early, likely a doctor would be with her.
I had forgotten our new practice model, enacted only weeks before, that would permit me to be with her in collaboration with my Attending. It was thrilling to find out that I would be with one of my own patients, and that she wanted me with her. Consultation and collaboration completed, I informed her I would be with her when her baby was born.
However, the new practice model also has the midwives much busier, caring for all low-risk patients from our large group of midwives and doctors. I knew that I could not provide the exact midwife care for her that I wanted, a prior midwife patient, that I wanted to: a huge downfall of this model when the days are busy. I kept reminding myself that I would likely provide more midwifery care for her than a non-midwife attendant on that day, and that she was excited to be with me, and both of those felt pretty great.
Thankfully, her labor moved quickly. With some head compression and a change in the sounds of her discomfort, I joined her again. The baby came quickly. The cord needed to be cut immediately and the baby given to pediatrics, per hospital protocol, despite my knowledge of helpfulness of delayed clamping for preemies. The baby was pink and yelling immediately, a great size for dates. I assured her the baby was beautiful. Also acting as interpreter, I communicated with the NICU Attending that she wanted to hold her baby and try to breastfeed, who encouraged us to try. 15 minutes of skin-to-skin and a few latches on made everyone in the room happy. Great work for a hospital that is trying for Baby Friendly status, today right on the mark. My beautiful patient was grinning ear to ear, so proud of her healthy baby.