Just when I think I grasp a little of what to expect from the human body, patients come along and totally surprise me.
Tonight, I delivered a sweet little boy - not too surprising. His mom, though, had to be induced because of pre-eclampsia, a dangerous condition in pregnancy that can result in seizures, stroke, and even death to mom, and numerous complications in the child. We made the decision to induce after a lot of deliberation this afternoon - she was only 35 weeks along, but seemed to be worsening, and we felt the risks of keeping mom pregnant outweighed the risks of preterm delivery. I started her induction this afternoon by placing a medication in her cervix to make it softer, so hopefully tonight I could start a second medication to open it.
As I placed the medicine in, I knew, I just knew without a doubt, that this induction was not going to go well. Everything from her exam indicated that we might have a difficult time getting her delivered. I had already decided that either late tonight or early tomorrow something would happen - baby wouldn't tolerate the medicine, she wouldn't change her cervix, that her pre-eclampsia would worsen further, necesitating rapid delivery, and we would have to do a c-section. I was convinced that there was almost no chance of vaginal delivery.
Around 8pm, a mere 6 hours after I put in the medication (a medicine that doesn't usually make the cervix open), I was called to evaluate the patient because she was in lots of pain and contracting every other minute. The nurse pulled out the medicine, I checked her cervix and she was 6cm dilated. The CRNA came in to give her an epidural and 15 minutes later(!) I was called back in as we were ready for delivery. 1 slow, steady push later, baby came right out and quickly let out a strong cry.
The longer I am in medicine, the more I realize that we are beautifully and wonderfully made, and that our amazing creator knows a lot more than I do about his very good creation.