OB/GYN

Institute policies to proactively support physicians who are breastfeeding

Physician
April 16, 2021

I’ve been speaking with women physicians about the top challenges they face today. I’ve learned there are many—which honestly didn’t surprise me, given that 48 percent of women physicians report burnout symptoms (compared with 37 percent of their male counterparts).

Several have mentioned the challenge of breastfeeding while working—rather ironic considering what is known about the health benefits for mother and infant. Maybe their colleagues and …

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It’s time to curb rising C-section rates in Canada

Conditions
January 30, 2021

Even during the pandemic, labor and delivery are the most frequent reasons for hospitalization in Canada, with over 350,000 births per year.  That’s happy news.  But of these births, nearly one third are by Caesarian section (C-sections).  That rate is far too high – and rising.

C-section is the surgical procedure to deliver a baby that involves an incision in the mother’s …

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Infertility as a physician: the gift of perspective

Conditions
October 3, 2020

As physicians, we know all too well how life can change in an instant.  How tomorrow is never promised.  This knowledge can sometimes feel overwhelming, but it is also a gift.

Because we know how precious life is.

I am a physician—but I am also a patient.  An infertility patient, for whom each passing year can feel like a lost opportunity.

Because my eggs don’t have the perspective. They don’t see the privilege. …

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My rose-colored glasses are my secret instrument for survival

Physician
April 30, 2020

A dear midwife teacher of mine, during my intern year as an OB/GYN, told me, “You need to stop wearing those rose-colored glasses.” She told me I had to take them off to be able to understand the depth and breadth of what my patients were telling me, so I could read between the lines and become a well-trained clinician. In the years that have passed since my first year …

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The moral and ethical dilemmas of COVID-19

Conditions
April 13, 2020

In all of my thirty years of medical practice, I have never encountered the degree of moral and ethical dilemmas as those created by COVID-19. None of us has experienced anything like this. At no time in our history has all of humanity been at risk for contracting the same potentially deadly disease. And never in my entire career could I have imagined that we would be so woefully unequipped …

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What happens when abortion services aren’t available

Conditions
February 17, 2020

In my very first job as a doctor — working in a London hospital in the 1980s. I always took a ridiculously detailed past medical history for every patient I saw. I started to notice how many elderly women had had septicemia, a life-threatening infection in which enormous amounts of bacteria enter the bloodstream.

The neighborhood surrounding the hospital had once been the worst slum in London. And it didn’t take …

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Cervical cancer guidelines leaves women confused about annual pelvic exams

Conditions
February 11, 2020

There is good news and bad news in the world of women’s health.

The good news is that women do not need annual Pap smears. The bad news is that, upon hearing the good news, many women incorrectly assume they no longer need annual pelvic exams, either.

Historically, Pap smears were performed annually, and during the same time as pelvic exams, so it is understandable why women would conflate the two. But …

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Doing extra for a patient or overstepping boundaries?

Physician
January 9, 2020

I wanted to go the extra mile for my patient. The resistance I found was unexpected.

She was young. Her life — an incredible journey in diplomatic circles — was crippled too soon by a recurring disease that would ultimately prevail. Day after day, I’d round on her in what seemed like a pointless exercise, waiting for the inevitable to come. Another round of chemotherapy would have to wait for her …

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The excitement of clinical rotations: Not just learning medicine but doing medicine

Education
December 27, 2019

The first time a woman went into the final stage of labor, I watched from a corner of the room. As a third-year medical student, I was on my six-week clinical rotation in obstetrics and gynecology, and it was day one of the two-week portion on the labor and delivery floor. As a loudspeaker announcement projected over the woman’s screams, and nurses and doctors rushed in response, I instinctively clasped …

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Choosing family over medicine: Why I decided to leave clinical medicine

Physician
November 19, 2019

When my obstetrician told me I was not going back to my clinic that afternoon due to severe preeclampsia, I was so indoctrinated that my first thought was of the inconvenience to my patients who would need to be rescheduled. Only a few minutes later did it register that I would be giving birth sooner than I had anticipated, and my new life as “working mother” would begin.

I was due …

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The medical illiteracy epidemic

Physician
October 14, 2019

This past August, I attended the American College of Obstetricians and Gynecologists (ACOG) District VI meeting in Wisconsin. The theme of this year’s meeting was “Bringing it Back Home,” with a keynote presentation focused on developing the emotional habits to influence others and “embody the inner attitude of a leader.”

After a day of much self-reflection, I decided to stop by the poster presentations during a break between the major talks. …

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Advice to a pregnant surgical resident

Physician
October 6, 2019

As a profession, we’ve yet to standardize maternity leave and breastfeeding allowances for women. Given the length of medical training (seven-plus post-graduate years), timing (prime reproductive years) and slow increase in the ratio of female to male surgical residents, females choosing to start families during training are particularly afflicted.

We just celebrated my son’s first birthday. I had him during one of the busiest years of my surgical residency, and it’s …

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Is it physician burnout or perimenopause?

Conditions
September 20, 2019

I am an experienced OB/GYN, well-versed in obstetrics, infertility, gynecology, surgery and — yes — menopause, or so I thought. So why was I so blindsided by my own menopause transition?

I thought I was going through burnout, with anxiety, anger, mood swings, irritability, and depression. I was at a point in my career as an OB/GYN of 20-plus years that patients flocked to me because of my reputation and expected …

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How nurse practitioners can expand abortion access

Policy
September 1, 2019

It has been a savage few months for reproductive rights, with 12 states passing 26 bills to ban abortion, including measures that ban abortion as early as six weeks into pregnancy, as well as attempting to outlaw safe methods of abortion. In the face of this extreme, unprecedented wave of attacks, several states pursued an alternative route, passing laws that expand the scope of abortion providers …

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Will separating obstetrics from gynecology help specialist burnout?

Physician
August 30, 2019

At the end of a long table covered with hors d’oeuvres and a birthday cake, I struck up a conversation with three primary care physicians.

I was hungry for their opinions.

Inside the crowded apartment, we spoke for some 20 minutes about the systemic and cultural causes of burnout in primary care—a conversation that informed the first article in this series.

As I was about to leave, I …

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A surprise pregnancy in medical school

Education
August 28, 2019

“You’re 27-and-a-half weeks pregnant.”

As I lay on the exam table, time froze.

How can this be? I wondered dazedly. I’m a second-year medical student. I’ve just completed a course in female reproduction and endocrinology. How could I have missed the signs?

I attribute my obliviousness to the surgery I’d gone through only months before: the removal of a 27-pound, mucus-filled ovarian cyst. My lack of menstrual periods was nothing new; they’d been …

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MKSAP: 25-year-old woman with chest pain after a motor vehicle accident

Conditions
August 17, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 25-year-old woman is evaluated in the emergency department for chest pain after a belted motor vehicle accident. She is pregnant at approximately 23 weeks’ gestation. She reports no additional symptoms and is otherwise well. Her only medication is a prenatal vitamin.

On physical examination, the patient is afebrile, blood …

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It’s Dr., not Mrs.

Physician
July 15, 2019

I’m a physician married to a physician. Initially, I did not think I would face obstacles because of our dual career paths. I would soon learn; however, professional and personal sacrifices would be necessary for us to achieve our goals. This is my story as a training physician and a “single” mom, including some of the challenges I experienced being married to a physician.

I met my husband in the first …

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Career or the egg? Is it time to put pregnancy first?

Physician
June 17, 2019

Whether to have a child before becoming an attending physician is a personal choice, but as a fertility specialist, I’m concerned that many people — including physicians — overestimate the effectiveness of today’s fertility treatments.

In the U.S., the average age at which women have their first child went from 21.4 years in 1970 to 26.6 in 2016. Experts attribute that in part to more people seeking advanced education and taking …

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