Birth BB

A coworker's daughter was laboring, and everyone was on high alert to give her the best of the best. An Attending with whom I have had mixed interactions whispers in my ear during rounds, "Make sure they call me for the delivery." I whisper back, "Okay," knowing that I will have nothing to do with this woman's birth given the current set-up.I meet her during bedside rounds, and greet my coworker. The Residents take control over her labor management, and I care for my patients as usual.One of the Residents is in a birth when my coworker steps out, saying she is feeling more pressure. I check her, know she has some laboring down to do. I encourage her to listen to her body and let me know when she needs to start pushing. She is in great hands with the family around her to get her through the last bit.I call the Attending, who is unable to leave clinic for the birth and asks me to attend. I enter the room and find one of the Residents pushing with her, and encourage her to continue as she was doing great.Just as the baby emerges, another Attending enters the room and takes over. I suggest to the Resident to place the baby directly on mom and wait to clamp the cord. She looks at the Attending, who shakes her head. The Resident clamps and cuts, and hands the baby to the nurse. The Attending signs the birth papers, pats the woman on the shoulder, and leaves.I took a deep breath, congratulated the laboring mother on her work, said a 'happy birthday!' to the baby, and gave my coworker a hug. In the threshold, I discussed the evidence behind delayed clamping and skin-to-skin with the Resident. She responded, 'I know that's what you do, but it's not what they teach us to do.' I replied, 'You can do it too. I do it because it's evidence based.' She shrugged.Birth.

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