Not meant to be? (details from L and D)

I'm not sure what God has in mind for my 3rd month on labor and delivery, but it sure doesn't have to do with getting a lot of vaginal deliveries. I've been on for nearly two weeks and my grand total of NSVDs this month is.... hold your breath... drumroll, please..... six. Yes, that is exactly six. Now, this puts my total so far this year around 50 (around half of those were in my first month!), but I don't think it's nearly enough. Maybe it's because I feel like deliveries never get old and I could just catch babies all day and be totally content with that (Phi, who I see a lot because he is concurrently on his Newborn rotation said, "You will never feel like it's enough! You could get 20 deliveries a day and you'd still want more!" This is true.) However, I'm sure some of my OB classmates have upwards of 100 (they do rotate through high-volume Kaiser) and this worries me because I will have to be supervising interns as well as my own R2 FP classmates as an OB resident next year. As I've gotten more comfortable, I've been experimenting with some new things, such as not breaking the bed down and delivering onto the bed or sitting rather than standing, and I like those methods a whole lot more, but I want to get more practice with the new techniques.

I have made the "white board" of records in the OB board room (has things such as "Oldest patient-- 62 [!!!!!], most nuchal cords at delivery-- 5, largest C-section baby [6300 g or something-- that's like a toddler!], last vaginal breech delivery-- 3/12, etc., earliest triage visit for decreased fetal movement - 16 weeks) as the R1 with the "whitest cloud" (meaning, i.e. that things are slow when I'm on.). TRIAGE isn't slow! Just vaginal deliveries are slow!. Grr. This is a BLACK cloud if you ask me.

Granted, I am on days right now (more deliveries happen at night) and there are a lot of people wanting a piece of the pie-- another FP intern on with me, as well as med students and new attendings that, themselves, have to get "proctored" to have privileges to deliver here. However, I was on BY MYSELF on Saturday 29 hour call (well, I guess it was more like 28 b/c of daylight savings) and here's sort of how things went that night.
1. G1P0 induced for mild preeclampsia .... 4 cm --> 6 cm --> 7 cm -> 7 --> 7 --> 7 --> primary C -section for failure to progress
2. G1P0 admitted with rupture of membranes: 2 cm---> 6 --> 8 --> 10 --> pushing --> pushing --> pushing ---> primary C-section for failure to descend
3. G5P4 with rule out labor for fetus with encephalocoele (brain herniating out skull)..... delivered 1 hour after I left

See a pattern? I felt like I admitted the whole city of Sacramento but none would get their babies out on my watch! Yesterday, Wednesday, when I had OB conferences in the a.m. and family practice clinic in the p.m., there were like four deliveries. Aargh! I think I should put my name up on the record white board for highest hours worked/delivery ratio (with about 150 hours in the past 11 days with 6 deliveries, the ratio is 25!).

So what am I doing on L and D when babies are NOT being pushed out of women on L and D? Well, there's always the joys of triage. But I've actually gotten to go into the OR several times this week. I've been a part of a couple of C-sections (which I may have to start doing soon!)-- today we had one for twins. I did a tubal ligation earlier this week. And then, today, I did my first D and C (well, suction and curettage) for a poor woman whose baby died a couple of weeks ago (she had a D and C scheduled) but who came in to triage today bleeding, with a 15-week size fetus being expelled from her uterus onto the triage bed, and with retained placenta/products of conception.

I'm really loving the procedures. I've also gotten to do more transvaginal ultrasounds to feel more comfortable at those-- I was asked to switch patients with someone yesterday in clinic and ended up diagnosing an early twin pregnancy that I hope to try to follow if able. BUT I WANT MORE VAGINAL DELIVERIES!!!! I actually have Saturday off this weekend (!Yay! Time to spend with Vanessa who will arrive tomorrow night) but work a 24 hour call Sunday going into nights and I hope, being on my myself, I will get some more. Please pray with me for NSVDS. :)