We follow the same sort of philosophy here at Kudjip Hospital. I have definitely seen, assisted with, and done some procedures I had only learned about before: pericardiocentesis, bone marrow biopsy, ultrasound, fracture reduction and casting, suturing an ear back in place... just to name a few. This is not the kind of place where you can be afraid to try something new! I am thankful for wonderful colleagues who have shown me the ropes and given me direction over the last year and a half.
The other day I had the opportunity to try another something for the first time...
When I was doing my OB fellowship, I learned about a procedure called breech extraction or internal podalic version. I was never lucky enough to have such an opportunity during my fellowship, but I had heard the procedure described by my attendings on more than one occasion. This scenario is possible when a mother is laboring with twins, the first being cephalic (head first) and the second breech (bottom first). There aren't very many cases where you would do a vaginal delivery of a breech baby on purpose, but this is one of them. In fact, not only is it possible, but studies have shown it is better for the second twin than waiting for spontaneous delivery (less fetal distress).
So last week I had the perfect patients to give this thing a try. The mama had delivered 7 babies previously, and was in labor with numbers 8 and 9. I gowned and gloved, called Sister Sylvia in for moral support. (Sister Sylvia is the head nurse on D-ward and has many more years of experience than I do!) The first twin delivered head first and with ease. I reached in and felt the feet of the second twin through the amniotic sac. I grabbed the feet, water broke, and with a little urging the kiddo began to descend through the birth canal. I went through the maneuvers of breech delivery, ones I had studied many times and even taught to students and residents. And guess what? IT WORKED! The baby slid right on out and gave a little cry. It was amazing! Thanks be to Papa God that mama and both babies are doing well.
"This is what the Lord says--
your Redeemer, the Holy One of Israel:
'I am the Lord your God,
who teaches you what is best for you,
who directs you in the way you should go.'"
~ Isaiah 48:17