Obstetrics

I'm doing obstetrics at Moffitt-Long, the academic hospital which handles high-risk antepartum patients as well as the usual labor and delivery; here, we do fewer C-sections and more forceps assisted deliveries. In our orientation, we reviewed pelvic anatomy, suturing, how to deliver a baby and assist a C-section, and the breast and pelvic exam. Then we were sent off to our labor and delivery floors.

The team composition for L&D here is different and makes sense for obstetrics. There is a day team and a night team whose shifts overlap slightly for patient sign-out. This is in contrast to the call team and nightfloat system seen in medicine. Having two consistent teams is great for laboring patients; they know all the people that may potentially be involved in their delivery, day or night. It's also nice for continuity for the medical student. I think the residents work really long hours compared to other services though; plus, being on all nights is brutal. I really like my team; resident and intern teaching are outstanding and rival the teaching I've gotten on any other rotation.

We have didactics every Tuesday morning which approximates the lecture time on other rotations but is really tiring since it's given as a bolus. Otherwise, most of my time is spent on labor and delivery. We take four overnight calls, but we get the following day off.

We see four types of patients. Antepartums are pregnant patients admitted for issues from preterm labor to twin-twin transfusion syndrome to maternal arrhythmias. They're very interesting medicine-like patients. We then have triage which fields ob related urgent care like mastitis or possible labor or pre-eclampsia. We have our laboring patients, which I'll write another post about. And finally we have our post-partum patients who have already delivered and are similar to post-surgical patients, low-maintenance and recovering.