Thursday, May 7, 2009
Thankfully Malin's been keeping our blog the past couple weeks. Since my parents left one week the business of work has been pretty tiring. And I realize I really miss having other colleagues to discuss interesting/challenging cases with. Sometimes I just want the assurance that I'm doing the right thing. For example, most babies under 30 weeks don't survive here. So when a mother arrived with ruptured membranes for 4 weeks at 27 weeks in breech presentation rather than do a C/S (which would be the standard of care in the States) I discussed with her a vaginal delivery that would probably lead to a stillbirth. The baby actually came out crying, but died subsequently in the NICU. And I do believe this was the right decision. However, we're taught in medical school and residency to have evidence to back-up and make our decisions. But most of the statistical evidence just isn't here about preterm birth survival. So a lot of my decision making is based on what I've experienced and I hope that the more I experience the easier and less stressful these decisions will become.