MS-3 · OB

Babies everywhere!

C. and I were hanging out in OB Triage the other day.  It was slow.  We were bored.  There was just one patient, who was sent up from the ER with a chief complaint of constipation (seriously?), and we had to wait to see her until the nurse was done taking her vitals.

Then the nurse poked her head out the door.

“Um, we need a delivery kit in here, because … I can see the head.”

Everyone went running into the room, including the two of us med students.  The patient was chilling in the bed, grinning and apparently unaware that she had a human being stuck in her vagina.

One of the nurses spoke fluent Spanish and got the story as we pushed back the patient’s legs and the resident shouted “Empuje, senora!” in a thick German accent.  Turns out the woman had managed to carry a baby to term without having any idea that she was pregnant.  No prenatal care, no idea how old the fetus was.  Said she’d been getting her periods regularly, but had been constipated for weeks.  When the nurse informed her that no, that pressure she was feeling was actually a baby, she shrugged and asked for her phone. And an enema.

She managed to have the most painless labor I’ve ever seen.  Except for a little gasp when the baby was crowning, she seemed to have no awareness of the process at all.  She just kept grinning at everyone.  At one point, she did turn to me and say “Me duele,” but with the oddest smirk on her face.  I began to wonder if she’d taken something more psychiatric than the IV morphine they’d started in the ER. (Well done, ER!)

The baby arrived, eventually, covered in foul, watery discharge that was neither amniotic fluid nor meconium.  “Smells like infection,” the resident commented as he handed the child to the pediatrician, who wrinkled her nose and whisked the kid away to the nursery.  The placenta separated just easily as well and went off to path, and there were only the most superficial lacerations to be repaired.  A little lidocaine, a few stitches, and she was good to go.  The pediatrician came back during the repair to give an update on the baby.  The patient said, literally, “Whatever,” and went back to her phone call.

We cleaned her up, put her on a new bed, and sent her straight to Post-partum — it seemed a little silly to admit her to L&D after the delivery.  Last I heard, she was still hanging out, not really taking an interest in the baby, asking how long until they give her an enema so she can go home.


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