Being present at a birth isn’t just a tickbox exercise for medical students, but an opportunity to see a different side of medicine
“Every birth that I am part of I still get that sense of excitement . . . it still moves me.” Lucy Chappell, consultant obstetrician and obstetrics research professor, joined the Sharp Scratch panel to share her reflections on a career helping people during pregnancy and birth. New medical students might worry about their first experiences with death (which Sharp Scratch has discussed in episodes 13 and 14), but perhaps less thought might be given to the complex emotions that can arise from attending someone in labour, and particularly attending your first birth.
Lucy, Anna, and Chidera all recalled the first time they had attended a birth and all the surrounding emotions of seeing new life come into the world, with Chidera describing how she had cried at her first birth (and subsequent births she attended during her obstetrics rotation!). Lucy explained that part of the reason she loved obstetrics as an undergraduate, and into her career, was the different approach to medical care in the specialty: “Pregnant women are generally not patients as such, they are well women who come into contact with the healthcare system at a really pivotal moment in their life.”
Nikki spoke with guest medical student Oli about his experiences as a male medical student, and the stereotypes around obstetrics and gynaecology being unwelcoming to male students. The panel discussed the challenges of balancing medical students’ learning needs with patient consent and comfort. Lucy agreed that it is the responsibility of the whole medical team (and, indeed, our wider society) to ensure that women feel comfortable to have students with them during a time when they feel vulnerable. “Many doctors won’t go on to be obstetricians or gynaecologists,” she said, “but they need that exposure—arguably, even more so as that is their only experience of birth, so it’s important to put yourself in the shoes of the woman, and then as healthcare professionals making sure we do everything we can to include medical students as colleagues.”
Chidera and Anna shared their advice for medical students who might feel nervous about intruding during such an important moment for someone and their family: take the time to build rapport and provide support during labour if you have the opportunity, and don’t think of seeing a birth as a tickbox exercise, but as the culmination of a nine month (or longer!) journey for a person and their family. Lucy agreed, reflecting on her time supervising medical students and junior doctors working in obstetrics: “You may often have snapshots of that pregnancy journey—we might say, ‘quick, room seven, she’s about to have a baby’—but we need to see this in the bigger context.” Nikki spoke about reaching out to mothers who had given birth: “Quite a few said they couldn’t remember if a medical student had been in the room!”
In a specialty that deals mostly with people who are in good health, it can be especially challenging when things go wrong, particularly if students find themselves in attendance during high stakes emergency situations. Lucy explained the value of an extra pair of hands in an emergency, saying that in her experience, “in the huge majority of situations it is appropriate for a medical student to stay in the room”—you could run blood bottles, or note down a timeline of events, or even just observing can be useful. The panel emphasised the importance of recognising your own emotional needs and seeking out support if needed, with Lucy adding that there are often team debriefs for obstetric emergencies. Anna recalled a time she had been at an obstetric emergency and her own personal reflections on the leadership shown by the consultant. Pregnancy loss and other poor outcomes are still somewhat of a taboo topic in medicine, and Lucy encouraged students not to shy away from observing difficult conversations around these topics where appropriate.
In their final reflections, both Chidera and Anna encouraged students to try to make the most of their obstetrics and gynaecology placement, no matter what their specialty interest. Lucy agreed, advising students to “embrace the obs and gynae block as an extraordinary opportunity to gain an insight into one of the most special parts of a woman’s life. As medical students and doctors we are privileged to be there at really major moments, whether it’s birth or death. And those are extraordinary moments.”
Anna Harvey, final year medical student, King’s College London, and past editorial scholar, The BMJ.
|The Sharp Scratch Panel:
Nikki Nabavi, The BMJ, University of Manchester
Anna Harvey, final year medical student, King’s College London, and past editorial scholar, The BMJ
Chidera Ota, junior clinical fellow in neurosurgery at Charing Cross Hospital, London.
Lucy Chappell, professor in obstetrics at King’s College London and honorary consultant obstetrician at Guy’s and St Thomas’ NHS Foundation Trust
Oli Simms, medical student, University of Leeds
Follow us on Twitter:
Sponsored by: @MPS_Medical