Research Assessment #2 

Date​​:​ ​September 14, 2018 

Subject:​​ Obstetrician and Gynecologist 
MLA Citation:​​ Morris, Bonnie Rothman, and Photodisc Blue. “A Day in the Life of an 
Ob-Gyn.” ​Parents,​ Parents, 
www.parents.com/pregnancy/giving-birth/labor-support/a-day-in-the-life-of-an-ob
-gyn/​. 
 
Analysis:3 
Many OB/GYNs don’t have time for their family and friends since there always 
on call. So knowing what the day to day schedule is like ahead of time gives me a 
insight of what to expect for the future. OB/GYNs are always on the hook, they can be 
in need at any time of the day. 
This article really helps me learn how my future will be when I’m an OBGYN. I 
have really high hopes for my family, I want to have a big family, but as an OBGYN you 
won’t really have that “leisure” time to spend with your family. Every second you get to 
spend time with your family, those will be the everlasting memories you tend to 
remember. After I read this article, the only thing I could think about was the amount 
of time I’ll be able to spend with my family. 
As an aspiring OB/GYN, you will come across many cases dealing with 
postpartum complications to preterm births to C-sections. You most likely can’t 
expect these outcomes, you have to prepare and know how to handle the situation at 
each moment and stay calm cause those few seconds could save a life or two. 
This day-to-day article brought out many significances as an OB/GYNs that 
many people weren’t aware of. Every second you have a break or lunch break, you 
could be called in the middle for childbirth and you would have to leave in that 
moment. OB/GYNs don’t have a time where there specifically open, they have to be 
available 24/7 in order to help assist the mother and help during childbirth. 
 
 
Article:  
At 11:45 on a sunny September morning, Linda Missry, 36, is lying in a bright room at
Mount Sinai Hospital in Manhattan, completely and utterly focused on her task. She's
about to ​give birth​ to her fourth child.

"I'm not so comfortable anymore," she says plaintively. Linda's doctor, Jonathan Scher,
M.D., an esteemed New York ob-gyn, infertility specialist, and author of ​Preventing
Miscarriage: The Good News​, offers her the only help he can: encouragement. "Push,
push!" he says, with genuine excitement. On his orders, Linda bears down. Her legs
shake.Any minute now, I think, flashing back to the final moments of my own delivery
six years ago, when my second daughter's birth was attended by an obstetrician so
blasé I swear he stifled a yawn during my 17 minutes of pushing. I wish I'd had a
cheerleader like Dr. Scher by my side.

After three decades of practicing and teaching medicine on three continents (Dr. Scher
is a board-certified ob-gyn in the U.S., holds medical degrees from the University of
Cape Town in South Africa, and is an honorary fellow of the Royal College of Obstetrics
and Gynecology in London), he still clearly adores his work. That passion bubbles over
to his patients, some of whom travel from as far away as France and Italy to see him.
Over the years, he's come to view women as his partners in the ​prenatal​ process.
"Obstetrics is not a disease," he says. "It's a natural function just like eating, sleeping, or
drinking -- you shouldn't even call ​pregnant women​ patients!"

Though it's not yet 9 a.m., I can barely keep up with the very fit Dr. Scher as he dashes
up three flights of stairs (hospital elevators are notoriously slow, he explains) to visit with
patients recovering in the maternity ward. To keep up this pace, he works out five days
a week and watches what he eats -- that is, when he has time to eat, which during a
typical day at the hospital may be never. "I order a salad for lunch and at 4 o'clock it's
still sitting there," he says, pointing to a table in the residents' lounge as we hustle by.

In quick succession, Dr. Scher visits four new moms. With his South African accent,
he's not only a medical authority, he's a class-A charmer. (Think a shorter Cary Grant
with a wall full of medical degrees.) After gushing over the women's newborns, he asks
how they're feeling. One second-time mom, in a room stuffed with "It's a boy!" bouquets,
has severe pain under her right breast. "I'm worried it's my gallbladder," she says.

"Sometimes when you're pushing the baby out, you strain your intercostal muscles," Dr.
Scher explains, pointing out the line of muscles located at the base of her rib cage.
These muscles can become tender during a woman's last trimester, when they're
squeezed by her expanding uterus, and again when she crunches up her body during
delivery. Examining her, he asks, "Is the pain getting better? You're not coughing up
blood or anything like that?" She says the pain has been lessening and there's no
blood. "Then forget about it; just take the painkiller," Dr. Scher says, assuring her that
the pain will abate as her body heals. Her baby cries, loudly. "What a beautiful boy!" Dr.
Scher exclaims. "Whenever you get the pain, think of him!" He hugs her and we head
off to the next room.

His rounds completed, Dr. Scher heads downstairs to check on his three -- excuse the
term -- patients who are in ​labor​. In addition to Linda, there are two first-time moms:
Janet*, a 30-year-old who went into labor naturally, and Marcia, 42, who had been
induced that morning.He leaves each woman comforted by his sure knowledge,
genuine warmth, and a piece of advice: to spend at least 20 minutes each day lying on
her stomach or side. The idea behind this is simple: When a woman sits up in bed
cradling her newborn, gravity pulls the extra fluid she's retained from the ​pregnancy​ and
intravenous line, if she had one, to the lowest point in her body -- the vaginal and rectal
area. When she turns over, the fluid that's accumulated will "drip, drip, drip" away, says
Dr. Scher, to be absorbed back into the circulatory system and eventually excreted,
helping the swelling go down.

Dr. Scher is also scheduled to perform an ​amniocentesis​ in the hospital's clinic at 10:30.
At 9:36, however, Janet is already 10 centimeters dilated and pushing with the help of a
nurse. Next door, Dr. Scher breaks Linda's amniotic sac. With her last delivery, ​labor
had proceeded so quickly there was no time for pain relief. Because the same thing
might happen again, she received an ​epidural​ early, just in case. "Okay, you're going to
go fast," Dr. Scher says to her. "I'm not leaving the floor!"

As we walk out, I start to worry that both women are going to deliver at the same time.
Dr. Scher assures me that has never happened. "Never," he repeats, dashing down the
hall to the nurses' station to fill out some charts in the little window of time he has before
the real action begins.

When Dr. Scher first started practicing medicine in London in the 1970s, he kept track of
each baby he delivered by slipping a ​birth​ announcement or photo under the piece of
glass that topped his desk. Two years later, the desktop became so crowded he could
add no more. He's now lost track of how many babies he has delivered and no longer
saves each and every announcement, but he enjoys receiving them nevertheless. After
all, who wouldn't want to be thanked for a job well done? Today, some of his babies
have become patients as they grow up and start families of their own -- perhaps the
biggest thanks of all.

In the doctor's unassuming office on Park Avenue, a ​bottle​ of champagne -- a gift from a
patient -- sits on the desk he shares with one of his partners. Next to it are stacks of files
of patients he'll call to report test results or give advice on hormone replacement
therapy. A people-oriented doctor, he's perfected the art of dispatching each call quickly
without seeming to hurry a patient off the line.

About half his patients come in for gynecological exams; the rest are ​pregnant​ or hoping
to be soon. Women call all day, too, with a grab-bag of questions: what to do about
excessively heavy periods, whether to be concerned about ​spotting​ during pregnancy,
and which psychologist he would recommend for marital problems (his truly empathetic
personality makes him a natural confidant). Today, a woman in her 33rd week calls to
say she's no longer feeling her baby move. Though Dr. Scher is pretty sure that
everything is fine -- by 32 weeks, babies usually start running out of room to squirm
around -- he schedules a sonogram just in case, but mostly to allay the woman's fears.

His first patient of the day, Sharon, is six weeks ​pregnant​ with her third child. She's
been ​spotting​ and has a cramp in her left side. Sharon fears she's having an ​ectopic
pregnancy​, in which the fertilized egg implants outside the uterus. Though they're real
and dangerous, ectopic pregnancies are rare. But Dr. Scher is used to worried patients
self-diagnosing, so he uses an ​ultrasound​ to check her womb.

"Just look at that great picture!" he exclaims. "Here's the yolk sac feeding the baby. It's
excellent!" The bleeding and cramping are fairly common, he explains, and nothing to
be concerned about. The worry lines on Sharon's face smooth out. Patients arrive
happy too. Elizabeth Neidell, 30, who's in her 38th week, wants to know when she'll ​give
birth​. The baby's head isn't in her pelvis, where it needs to be for delivery, Dr. Scher
says. "Judging from experience, you're going to go a few days past due," he predicts.

Soothsaying is another requirement of an ob-gyn's job. Many women want to know

when -- exactly -- their baby will arrive. By noting the baby's position and checking the
mother's cervix for dilation and effacement, obstetricians can make an educated guess
about when that moment is likely to be. But even after all these years practicing
medicine, Dr. Scher admits that predicting nature is an imprecise science at best.

Because he specializes in high-risk pregnancies, Dr. Scher must deliver the news of a
miscarriage​ more often than he'd like. Today is no exception. A patient early in her first
trimester has just miscarried for the second time. Dr. Scher orders a D&C -- a dilation
and curettage -- for the next day. With the patient under mild sedation, a sterile plastic
tube with a sharp end will be inserted into the uterus. The doctor will use this tube,
attached to a suction machine, to lightly scrape and empty the uterus. A chromosomal
analysis will be conducted on the fetal tissue samples to discover what went wrong.
"That way we can try to fix the problem," he says, noting that ​miscarriages​ occur for
many reasons, including chromosomal abnormalities, a weak cervix, and insufficient
amounts of progesterone.Conducted in the doctor's office, a D&C takes only a few
minutes, but it can be emotionally wrenching. The woman whispers the sad news to her
husband in the waiting room and asks him to accompany her during the procedure the
next day. He holds her hand and nods.

As men have become more involved in their wives' ​prenatal​ care, Dr. Scher has
developed empathy for husbands as well. In fact, he likes having dads around. "It
makes them appreciate their wives for the rest of their lives," he says. "It's good for
them to see what women go through!"

Dr. Scher says he loves working with women, and it really shows: He is utterly devoted
to his patients. "There's no area of medicine more emotional than having a baby," says
the father of two grown daughters. He's there for the pain and ecstasy of delivery and
the trauma of ​miscarriage​. He carries women through the mounting excitement of
normal gestation and reassures those experiencing a high-risk ​pregnancy​. "We want a
healthy mother and a healthy baby" is the mantra he repeats as he goes about his work.

Karen, 40, is the 14th of Dr. Scher's 19 patients for the day. The two are disagreeing --
not about healthcare but about which salon in Manhattan gives the best ​bikini​ wax. On
this topic, too, Dr. Scher is an expert. After all, women who get cesareans must have
some of their pubic hair removed. Dr. Scher doesn't mind if his patients take care of that
part of the preparation at salons, rather than in the operating room, where the
mother-to-be would be inelegantly shaved by a nurse. Then the conversation turns
serious. Karen is adorable but tremendous. She's gained 90 pounds at 38 weeks, a time
in her pregnancy when she should have put on only 25 to 30 pounds. Though Dr. Scher
advises his patients to take ​prenatal​ supplements, eat healthfully, and ​exercise​, "I was
so hungry!" Karen says.

Dr. Scher measures her beach-bronzed belly to assess the baby's weight and size. "It's
humongous!" he says. "Don't flip out, but I'm going to book you for a ​cesarean section
next week."
This is Karen's first child, and though she wants to ​give birth​ soon, she's still a bit
stunned upon learning that her baby is going to arrive two weeks earlier than she'd
expected. And butted up against her desire to get out of her maternity jeans is, quite
naturally, a bit of apprehension. She's worried about the maturity of her baby's lungs,
but Dr. Scher assures her that most fetuses' lungs are sufficiently developed by 38
weeks' gestation.

Karen is also concerned about her recovery from the cesarean and how bad the scar
will be. Dr. Scher assures her that the horizontal incision he'll make along her bikini line
-- the most common one performed for C-sections in American medicine today -- will
likely heal by ski season and will be low enough not to disrupt her passion for
bikini-wearing. Dr. Scher later confides something else: Should Karen carry her baby for
a full 40-week term, he fears it will be well over 10 pounds and at high risk for stillbirth.
Because he's already settled on the cesarean, Dr. Scher decides not to alarm Karen
with this possibility. But he does let her know that such a large baby could sustain
injuries during delivery and may stretch her vagina permanently, possibly causing
urinary incontinence problems and inhibiting some sexual pleasure. Karen's surgery --
and her bikini-wax appointment -- is scheduled.

At the hospital, Linda is nine centimeters dilated by 10:04 a.m. "Another half hour or so,"
Dr. Scher predicts. He heads to the door and notices Linda's worried look. "I'm not going
away!" he assures her. He checks on Marcia in the next room. She's been suffering
from elevated bile salts, a rare gall-bladder condition brought on by ​pregnancy​ that
makes her feel itchy all the time. Though uncomfortable, it's not life-threatening. But
Marcia has researched the condition online and found studies suggesting that it can
cause stillbirth.
"Having a high-risk pregnancy does not mean that the delivery will be high-risk too," Dr.
Scher says, trying to calm her. Though he appreciates when patients show interest in
their own care, he's wary of medical information they cull from the Web -- while some is
helpful, much of it is not. "People can get the wrong perspective on a condition, which
causes them unnecessary worry," he says. Marcia is bearing the pain stoically, but Dr.
Scher encourages her to get an ​epidural​ now. He explains that if the anesthesiologists
are needed for cesareans and other emergencies, they may not be able to attend to her
precisely when she needs them, and she could end up laboring in pain until one
becomes available. Dr. Scher believes that suffering is not a necessary part of the
birthing experience and counsels his patients that wanting pain relief is nothing to be
ashamed of.

Dr. Scher says more than 80% of his first-time moms choose to have a "​walking​"
epidural, in which a cocktail of pain medication is injected into the lower spine. Unlike
paralyzing anesthesia, this medication masks pain but not feeling, so a woman can
experience the sensations of childbirth without the agony. Though laboring
mothers-to-be are technically able to walk around while on this medication, Mount Sinai
does not permit them to do so, a practice that's followed by many hospitals for liability
reasons.

He rushes into Linda's room and determines that though she may want to, she's not
ready to push just yet. He dashes back to Janet. I feel as if I'm in a hospital version of a
Marx Brothers movie. For a few minutes, I'm convinced that today is going to be the day
that two women deliver at exactly the same moment.

No dice. At 10:44, Dr. Scher delivers Janet's baby boy with great joy. As he's finishing,
Linda's nurse interrupts him again: "She's bursting at the seams!" He ensures that Janet
is all right and is back with Linda by 11. She starts pushing, and this time Dr. Scher is
staying put."You're just about there," he says.

"I want it to come out already," Linda moans. But then her contractions slow, and she
begins to lose steam.At 11:30, Dr. Scher checks in on Janet again. He then heads over
to the nurses' station, where he fills out a ​birth​ certificate for Janet's baby, makes a call
to the office to pick up his messages, and phones his wife, Brenda, letting her know that
he has delivered one baby and is waiting for two more to arrive.

Finally, at 11:51, Linda takes a breath, pulls in her chin, and bears down. As I watch, the
baby's head emerges. It's covered with a mass of dark hair! One more push and the
shoulders are free. Then the legs appear -- they're long and skinny. "Mazel tov! It's a
boy!" crows Dr. Scher. The baby wails, getting his first gulp of air. I wipe away my
tears.A baby has just been born. It's the most natural thing in the world as well as one of
the most extraordinary. And even though the doctor has witnessed this too many times
to count, he agrees. "I still get a kick out of it," he says.Leaving Linda to enjoy her baby,
he's now 90 minutes late for the ​amnio​. After performing it, he spends the rest of the
afternoon monitoring Marcia's progress.