Thursday, May 7, 2009

Preterm Birth

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. 


Anonymous said...

Hugs and prayers for you Sara. I know that you face so many heartbreaking situations in an environment where, as you have shared, there just aren't the statistics or colleague support to assist your decision. I know that the Great Physician is right with you though and that you are making the best decision you can at the time.

I love your stories, even the ones that have me crying with you.
Jesus loves you and so do I,
Hope we can meet sometime in the not too distant future. Until then, here is a big hug,
Bend, OR

Christina said...

Sara - I don't know if you remember meeting me at PFR last October. This is Christina Francis and I am also an OB/GYN and will be headed to Kapsowar through the PRP in August. This entry expresses what I'm sure I will also face. Once I get there, we need to bounce ideas off of each other.