We are expected to conduct at least 5 deliveries on our own in this posting and you can probably imagine our anxiety when we see a good opportunity come by the labour ward - a multip (a woman who had previous childbirths prior to this) whose childbirth will most probably be faster and easier, or a primip (a woman who is having her first childbirth) where an episotomy cut is quite likely during labour. Sometimes we make a 7 o’clock cut (episiotomy) at the edge of the vaginal opening to facilitate passage of the baby’s head and to prevent severe, jagged vaginal tears. This is usually performed on a primip and an episiotomy means an opportunity to give local anaesthesia, cut at the appropriate area when the baby’s head is crowning at the vaginal opening and later on an episiotomy repair - administration of local anaesthesia and suturing.

I was exhausted by the 20th hour of my labour ward on-call when a primip turned up with a cervical dilatation of 6cm indicative of impending labour. Determined to deliver her baby, I clerked the lady, performed the necessary physical examination, monitor her contractions and baby’s heartbeat via the CTG machine and closely follow vaginal examination reviews. At 7am, I mustered all the energy and passion for obstetrics that’s left in me for the delivery when her cervix dilated to 10cm.

Come on, baby… it’s time for you to come to this world and I shall receive you with my very own hands! The mother was anxious and in pain, leaving me with multiple fingernail imprints around my wrist and forearm as “souvenirs” whenever she could reached over the bed rail to grab hold of me as I check the CTG machine by her side. With approval by the house officer, I dutifully prepared myself - wore the apron, put on sterile gloves and got ready the delivery set by the bed, swabbed the labia and introitus and taught the woman how to breathe properly and when to strain. A staff nurse willingly stationed herself by the side of the woman to be “gripped” at each uterine contraction.

Soon the perineum began to bulge and the vaginal gaping enlarged. I was elated to see the baby’s hair and felt its head pushing forward. It shall be an easy delivery with a possible episiotomy, I thought. I could get my log book signed for another self-conducted delivery and go back to my room for some much needed rest - yippie!! I was still smiling to myself when the medical officer sauntered in, saw what was happening and put on gloves to check the progress of the delivery. I stepped aside to make room for her, eagerly waiting behind her to allow me continue with what I was doing.

Episiotomy. Baby. Happy mother. Episiotomy repair. Log book. Sleep. Hehe…

A few minutes passed by. She was still there. I inched forward but she didn’t acknowledge my presence. The labour was in good progress. An episiotomy was inevitable and I was told to prepare the local anaesthesia. After the episiotomy, the medical officer still refused to budge and give me a chance. The next instant, the mother gave a full effort push at the peak of her contractions and the baby’s head, shoulders and the rest of the body was delivered! Not by me, but by the medical officer who nicely came by, took over the case from an exhausted by enthusiastic medical student and enjoy the climax of the entire labour process herself!

Who clerked the patient? Who stayed awake to monitor her progress and report to the house officer in charge once every half an hour? Who got gripped once every few minutes by the patient until the hands turned red? It’s me , myself and I!! But I was denied the chance to deliver the woman’s little prince… argh…

7am. The medical officer finally acknowledged my presence and said, “MS (medical student)… please weigh the placenta, clear the mess and repair the cut.” All I could do was to nod and comply. Then she turned and left. I continued standing there trying to stay calm.

Baby. Happy mother. No self-conduct delivery. No log book signed. No sleep anytime soon.

I smiled back at the mother who thanked me profusely for god-knows-what. I was perched at the side watching the baby being delivered into the hands of another person. Well, at least there’s a baby and a happy mother.

Everything was completed by 9am long after the next on-call group came in for their duty. A 25 hour on-call. Exhaustion, no sense of accomplishment plus frustrations. Some nice feelings to start my Sunday.

Sigh… Wish me good luck for my on-call tonight: Self-conducted delivery. Baby. Happy mother. Signed log book. Sleep Ok, I can trade my sleep and rest for that.