I Was An Obstetrician Once

You have to be an obstetrician before you can be an IVF doc

Everyone should be an obstetrician once.

When you perform a vaginal delivery , there is a very brief moment, right after the baby’s head emerges, where you and the baby are the only people in the world.

It lasts only a second or so, and when you do your job correctly you make note of it for less time than that. As an obstetrician, you make yourself invisible. You quietly prevent tears and lacerations, react to early signs of hemorrhage, clear the baby’s airway, ensure safe passage of brand new arms and collar bones, and prepare for the separation of the placenta.

You leave profound contemplation to someone else. You collect the cord blood and move on.

Except that’s not really true.

I used to silently whisper “welcome to the world little one” behind my mask, just after the baby’s forehead and eyes emerged. Whether the next minutes progressed to serene bonding of parents and child, or to the havoc of immediate postpartum emergency, there was always time to greet the baby, and hold open the door to the world.

I performed my first delivery as a second year medical student. Fourteen years would pass before I became a parent myself, almost a decade and a half during which I evaluated and treated people for whom either getting pregnant or being pregnant or staying pregnant was the most important part of their lives.

Textbooks and teachers, and the patients themselves sometimes, trained my fingertips to suspect a high risk for a precipitous delivery hours later, on the basis of a single internal exam, and kept my voice soft and heart rate steady when encountering a prolapsed umbilical cord, whose management meant that I had to hop onto the gurney with the patient, hand frozen mid vaginal exam in order to keep the baby’s head from descending and choking off its own blood supply while the two (three?) of us were wheeled into the operating room for an emergent cesarean. But I brought no insights about what would happen in the years and decades after I went off to wash my hands and write the post delivery orders.

Nothing during those fourteen years prepared me for the journey from the foot of table to the Dad-to-be spot at the head of table, from the fleeting irrelevance of an anonymous greeting while holding open the door to the world, to the enormity of the “we’ll take it from here” that Priya and I thought to ourselves as the rest of the room faded away.

I delivered babies for nine years, and stopped long before Nikhil and Tarana were born. I never carried the experience or nascent wisdom of fatherhood into the delivery room. Maybe that was a good thing, making it easier to focus on the purely technical aspects of fetal monitoring dynamics and the subtleties of arrests of descent through the birth canal. If circumstances take me back to the foot of the table I will need to relearn those skills.

It took me fourteen years to get from “welcome to the world little one” to “we’ll take it from here.” Many of the little ones who I welcomed to the world years ago are now parents themselves. Maybe some of them may deliver babies.

I was an obstetrician once.