#26 Tales from Labor and Delivery
I’ve read a lot of physician memoirs and there are a lot of good ones out there. Most of them are written by interns and residents who share many heart wrenching and heartwarming tales of training in and around the hospital wards. There are excellent volumes penned by general surgeons, pediatricians, internists, and emergency physicians. Dr. Rebecca Levy-Gantt brings the experiences of an OB-GYN trainee and attending into the genre with wit and candor. For sure, OB-GYNs are also surgeons as many of her stories end in a rush caesarian sections!
The following review of her self-published book: Motherhood, Medicine & Me first appeared in The DO magazine in February 2022. Many of her stories were first published on Medium.com where she shares exciting stories sprinkled with useful advice regarding various women’s wellness topics. As an emergency physician, some of my most exciting experiences include rapid deliveries in some very unlikely places. Details to follow….
My review:
In her follow-up book to A Womb with a View The DO Book Club, February 2021: Womb With a View: Tales from the Delivery, Emergency and Operating Rooms - The DO (osteopathic.org), Dr. Levy-Gantt’s new volume Motherhood, Medicine and Me, picks up where she left off with more entertaining cases from her office and the delivery room. This time she mixes in a bit more of her own experiences as a pregnant resident and as a mother advancing through her training and her time as an attending physician. The stories of her own deliveries highlight how difficult it is to know when labor starts, even as a highly trained professional.
The author uses her wealth of patient interactions to highlight some highly dramatic deliveries, including her own. She discusses what it was like as an osteopathic medical student and then a resident in an OB-GYN training program. Along the way she makes note of what techniques and approaches she would like to incorporate into her own future practice. More importantly, she notes quite a few practices she would work hard not to replicate. For example, she saw the rough and impersonal way women were moved around in the operating room once they were put to sleep. She vowed not to let her future patients get treated that way.
As she progressed into clinical rotations, she observed that motherhood would prepare her for residency. She was working, nursing, pumping, and parenting. “The consistent lack of sleep with combined with constantly trying to learn new things, and putting the needs of others before my own were givens in both arenas. Being a third-year medical student and having an eight-month-old at home was a combination that I at times felt very-ill-equipped to handle.” (p. 116)
Despite the sleep deprivation and the difficulties, she found that the specialty of OB-Gyn kept piquing her interest. When one gifted teaching attending invited her into the operating room to learn, up close the anatomy and approach to a seemingly routine hysterectomy, she fell in love with “the beauty of an exquisitely done surgical procedure.” The special interest of this mentor planted the seed of the future OB-Gyn she would become.
Dr. Levy-Gantt includes many of the nightmare scenarios that surely keep EM physicians, OB-GYN residents, and attendings up at night: retained placenta, uterine rupture, and crash deliveries. In the chapter, “Placentas can be Jerks,” the story was told of one stubborn placenta that kept bleeding and bleeding and seemingly didn’t want to detach from the uterine wall.
In addition to retelling some fantastic stories from the delivery room, Dr. Levy-Gantt uses the chapter “Painful Insertion” to educate and dispel myths around the insertion of an intrauterine device as a methos of contraception. In a specialty where a lot of information and misinformation is passed around the lunch rooms and hair salons of the world, the doctor tries to set the record straight. Her next book could easily address all the misinformation around various contraceptive methods and how they could be used.
The last chapter, “Emthonjeni,” follows the doctor on a medical mission to a remote South African Village where competent gynecologic care is scarce. While a group of dentists worked in folks’ mouths, Dr. Levy-Gantt served as the “lady doctor” so many women in the village so desperately needed. I could have read two or three more chapters about her work there.
Many physicians will recognize their own struggles trying to balance parenthood, childcare, and training. Hopefully, our students and trainees will recognize an excellent role model who demonstrates how it could be done. We can really get to know our patients while we treat them with compassion and respect. At the same time, we can take care of ourselves and experience motherhood while we practice excellent medicine. As the author says, “At the crossroads of motherhood and medicine is a small, strange world.” (p. 112)
