OBGYNDoc
Minneapolis, MN
Female, 36
I am a practicing Obstetrician and Gynecologist, providing care for women in all stages of life. Approximately half of my practice consists of pregnancy-related care, including routine prenatal care, high risk obstetrics, and delivering babies at all hours of the day. The other half consists of gynecologic care, which ranges from routine annual check-ups to contraception and menopause. I perform many surgeries, including laparoscopies and hysterectomies.
Plenty of physicans realize mid-career that they have chosen the wrong profession. It is a challenging road to change course because by the time you've finished your training, you are well into adulthood. ObGyn training requires 4 years of college, 4 years of medical school and 4 years of residency. In order to retrain in a different field, you would need at least 3 additional years of residency (long hours, inflexible schedule). But I can't imagine what it would be like to practice OBGyn and be unhappy with my decision- the work hours, the call, and the stress would be pretty hard to tolerate if I didn't love what I do!
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If you are an avid runner, then I think it is safe to continue running during pregnancy, with modifications. First of all, you need to stay well hydrated whenever you are exercising and avoid overheating. Secondly, listen to your body; if it hurts or is uncomfortable, don't do it. Thirdly, you are not trying to condition or train, just maintain. So decrease the intensity and never push yourself to the point of chest pains, extreme fatigue or weakness, dizziness or severe shortness of breath. In general, I tell patients if you were previously pushing yourself to 100%, then dial it back to 50%. At some point in the pregnancy, it is likely that you will need to decrease your distance and/or pace. Again, listen to your body. I don't think that extreme long distances, such as marathons, are a wise choice during pregnancy. In general, you shouldn't be running as fast as you can or as far as you can, so I ask my patients to use common sense when deciding whether to continue running during pregnancy. Of course, if you develop contractions, pain, bleeding or other worrisome symptoms, you should immediately stop and contact your physician.
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The joys of bringing new life into this world are countered by the devastation when a delivery does not go smoothly. Regardless of how advanced our fetal monitoring techniques are, we will never be able to prevent all bad outcomes such as stillbirth or birth injury. Not only is this responsibility emotionally strenuous, but there is also the stress that we could be sued over these bad outcomes that are typically not under our control. Unfortunately, we live in a litigious society, and most ObGyns will experience a lawsuit at some point in their career. This can be morally, emotionally, and financially devastating. The work hours of an ObGyn can be physically challenging, and takes away from family and home life. While I feel extremely fulfilled by my job, there are certainly times when I feel the emotional, physical and mental burnout from being an ObGyn.
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I can't imagine how one could do a pap smear on oneself. That being said, I think it is difficult for all physicians to choose the provider for themselves and their family. But, doctors are patients too, and we look for exactly the same traits that everyone else does- intelligence, a good beside manner, and empathy.
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I have never had to break the news to someone that she is HIV positive. I have told someone that she has hepatitis C, which in many ways, is a very similar chronic disease. Fortunately, the treatments for HIV and hepatitis C have advanced to the point where people have the potential to live healthy, normal lives despite having the virus. I have taken care of patients with HIV and hepatitis C in pregnancy. If the viral loads are suppressed enough, and if they take their medications as instructed, these patients can go on to have healthy pregnancies without transmitting the infection to their babies.
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Yes. In very rare circumstances, a "perimortem" cesarean section can be performed. The decision to proceed with the surgery needs to be made immediately, before the loss of maternal blood flow has caused a lack of oxygen to the fetus. In skilled hands, a baby can be delivered by cesarean section within minutes, which may just allow at least one life to be saved.
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Most of the time, when a baby is coming out so rapidly that you don't have time to make it to the hospital (or are on an elevator), the delivery will happen on its own without any need for assistance. Maternal instinct takes over, and the mother will begin pushing when the right time comes. Once the head is crowning, just try to support the head and body as it delivers. Look around you for something relatively clean to dry off the baby and to keep the baby warm. Newborn babies are not able to maintain their body temperatures initially and can develop hypothermia very quickly. The best way to keep them warm is to put them directly skin-to-skin on the mother's chest and cover both up with something dry. If you have a shoelace, you could tie off the umbilical cord. Hopefully by then, help will have arrived!
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