Do medical students still need to attend a certain number of births?

[asIlayfrying]

Was thinking about this today as I sometimes do, because I remember having my first baby and a number of medical students traipsed in right at the end to watch.

It still bothers me that they all came in - I don't even know how many there were and can't remember their faces or anything. But I remember reading somewhere that as part of their training they 'need' to see a certain number of women give birth.

But why? I get that it's exciting and amazing to watch, and if you do go into obstetrics then you need to be there, but why do medical students - most of whom will never deliver a baby in their future careers - 'need' to be there? Surely with YouTube etc there are plenty of opportunities to see a baby being born without having to crowd into an already fraught room simply to stand around staring.

Looking back I wish I'd said can all these random strangers leave, but I was too exhausted and afterwards too busy with the baby to bring it up.

I know that many women will say they don't care who was there, but it does feel to me like an old-fashioned and somewhat entitled practice that doesn't serve birthing women and isn't that necessary from a learning perspective anyway, unless people go into that field. Or at least, should the learning value be balanced against the right to some privacy for the mother.

I know you can say no and I did for my second baby, but I did feel a pressure to be OK about students for my first, and looking back, I just don't think they would have learned much from simply watching anyway, or could have learned just as well from other sources that didn't involve me!

[PaperMonster]

I don’t know but I had one with me a lot through the birth who was blooming amazing and we’re still in touch!

[TheVeryHungryTortoise]

Not at my London medical school, no. I think some places have different policies though. We are taught to never crowd a patient, if we have asked them and been given permission to watch a certain procedure/talk to them then it is max of two students (better if only one though) to ensure the patient is comfortable. I'm sorry that you had such a bad experience, I would be mortified if a consultant suggested a big group of medical students gather around a patient without asking them first!

[TheVeryHungryTortoise]

Not at my London medical school, no. I think some places have different policies though. We are taught to never crowd a patient, if we have asked them and been given permission to watch a certain procedure/talk to them then it is max of two students (better if only one though) to ensure the patient is comfortable. I'm sorry that you had such a bad experience, I would be mortified if a consultant suggested a big group of medical students gather around a patient without asking them first!

[TheVeryHungryTortoise]

Not at my London medical school, no. I think some places have different policies though. We are taught to never crowd a patient, if we have asked them and been given permission to watch a certain procedure/talk to them then it is max of two students (better if only one though) to ensure the patient is comfortable. I'm sorry that you had such a bad experience, I would be mortified if a consultant suggested a big group of medical students gather around a patient without asking them first!

[TheVeryHungryTortoise]

Wow, sorry about the triple post there. My app has been very odd recently!

[asIlayfrying]

That is reassuring to hear that you are taught not to crowd a patient at your school HungryTortoise

A midwife did say later it shouldn't have happened like that and she would bring it up. But thinking back I do wonder why they needed to be there at all.

[Seventytwoseventythree]

I had to deliver ten babies as part of my training 8 years ago. In common with many things in medicine you need a general grounding in everything just in case, e.g. I have studied psychiatry despite never doing a job involving it and never having much interest; and I was glad because it was really useful when I worked in A&E.

We were assigned shifts on the labour ward shadowing the midwives so we went and went and introduced ourselves to the patients at the start of a shift just like the midwives did, and asked if they were ok with us being there. Some said no, which was no issue. We were involved the whole time, I did a lot of fetching water and sick bowls, the midwives taught us what was going on and why they were doing various things so that we learnt, we didn’t just come in at the end as wouldn’t have learnt much from that. So in summary yes medical students still study normal (and complicated) labour in a clinical setting but I don’t think your team went about it the right way (didn’t even ask your consent!) and you have every right to be upset about that.

[pandafunfactory]

Medical school is about training them to treat all aspects of the human body so yes they need to be there. You could have refused. Believe me they won't have registered much about you, been far too busy trying to remember everything they ever knew in case anybody asks them something.

[asIlayfrying]

But no trained doctor treats all aspects of the human body once they specialise, and very few go on to deliver babies is my point. What they saw by coming in at the end is no different to what they would have seen in a video.

"Believe me they won't have registered much about you" - that is what I'm getting at. It is a significant life event, why should someone who isn't even going to register much about the women because they are too busy worrying about being asked a question even be in the room?

[QueenofLouisiana]

I had one in for the birth of DS, he was cabbage-green by the end. He did say afterwards that it was the first birth he had seen, we’d all guessed that!

[GreyBow]

My DD saw two C sections just on work experience. I really heavily grilled her before and afterwards to make damn sure permission was both sought and given. She said she just kept herself very quiet and unobtrusive in a corner during the op.

It made a lasting impression on her. She saw both a very poorly premie born plus a complicated twin delivery.

[Haffdonga]

DS is a med student and he recently missed his obstetrics placement due to Covid, I've just asked him and he says he has to follow one woman all the way through from antenatal to clinics to post natal and attend at least 2 C sections and 2 vaginal births. I can assure you that it absolutely isn't anything to do with it being 'exciting and amazing'. It's completely to do with learning to be a good all round doctor and one of many many placements a med student has to do before deciding what area of medicine they might specialise in. Respect and dignity for the patient are massively important and the students are there to learn not to watch a show.

One day that med student might be the only doctor available when someone goes into labour. You wouldn't want them to only ever have seen a birth on You Tube!

[PanamaPattie]

Work experience? That's shocking. Birth isn't for randoms gawking, even if she is sat in a corner.

[Babdoc]

When I was a medical student, we had to actually deliver six babies, after sitting with the mother throughout labour, monitoring her and recording obs.
The evil midwives gave us all the first time mums with unfavourable inductions, so we were stuck there for 24 gruelling hours before the mothers inevitably were taken away for a Caesarean section, meaning we missed out on the delivery. They gave all the spontaneous labours in multiparous women to their own midwifery students, who were cheerily popping out babies after really short labours!
That was nearly 40 years ago, though. Feeling v old now...!

[fromheretonowhere]

It’s funny you mention this as I have also been thinking about this a few days ago; I had my first and only DC nearly 6 years ago and during the last few hours of labour I was almost completely out of it with pain (epidural didn’t work) - couldn’t even see properly, but in one lucid moment I started to panic when I managed to count 11 people in the delivery room, excluding DH.

Two were the midwife and student midwife, and when I managed to say to DH “what’s wrong, why are all these people here,” it turns out that the obstetrician was doing the rounds with 8 medical students. They just stood staring at me while he talked, and then left. I have no idea whether I consented to this on admission forms etc, but I certainly was in no position to do so during the final stages of labour.

At the time I didn’t care once I knew who they were, and that there wasn’t a problem with the baby or I, but in hindsight I feel that I was in no state of mind or awareness to consent and therefore they should not be allowed in to the delivery suite unless the woman has full awareness.

[Galaxxy]

I had two students attend my homebirth, it was their first. I was asked permission first and I'm so glad I said yes. One of them made me beans on toast and the other fork fed me between contractions! They were genuinely helpful and lovely and respectful. What you describe though, OP, is a completely different scenario. You should have been asked for permission and it seems horribly clinical and insensitively handled. As you say, what can they possibly have learned from the snapshot of your birth? I feel really cross for you!

[nocoolnamesleft]

When I was a medical student (and dinosaurs roamed the earth) we were meant to observe 10, assist at 3, deliver 7. Hardly anyone achieved the full numbers. And even in those archaic days it was only 1 student per delivery, permission had to be obtained, and you were in there through the labour, not just waltzing in at the end.

[asIlayfrying]

fromheretonowhere that's how I feel re consent.

I remember the room being full of people and looking back I don't think there was any learning value in it at all, and it was intrusive and distressing for me.

[asIlayfrying]

thanks Galaxxy. I'm glad you got fed beans by yours, that is very sweet!
nocoolnamesleft good to hear training can also be more respectful of women.

[AmICrazyorWhat2]

I had my DD at a teaching hospital and two medical students assisted. One put the epidural in the wrong place, resulting in a spinal headache; the other took 1.5 hours to see up my third-degree year, resulting in a hemorrhage and me ending up in hospital for five days. With hindsight, I had a case to sue, but I’m not a fan of that.

I went to a different hospital for my second birth....

[AmICrazyorWhat2]

*sew

[kursaalflyer]

If you are booked into a teaching hospital it's par for the course. Although I was asked at every stage if I was happy for students to attend. At dd2's birth I was asked if a student could stitch me up, closely watched obviously. She was so nervous, poor thing! I had a myriad of problems with dd3's birth, an emergency c-section that went wrong and months of after treatment. I was contacted and thanked for allowing students to observe me and use me in their case studies as it was a rare thing to witness apparently. I was happy to help. But if it doesn't feel right for you then it is your right to say no and your decision respected.

[ChicCroissant]

One of my relatives is a doctor and had to observe a set number of births - places must do it differently as she had to approach the mothers-to-be herself and ask them if she could observe.

[reluctantbrit]

But won't it be students who still haven't specialised yet? So they need to see the actual thing happen, be it a surgery, a birth, A&E or just a bog standard treatment. How are they supposed to learn?

I very much doubt a video will do it. Can you imagine the women being asked "Oh, can we film you giving birth for a medical student video, from different angles, close ups, asking you questions and how your birth partner faints?" I doubt this will come up very well.

I had a student midwife, so great and she was lovely delivering DD. I wouldn't have had any issues with a medical student but obviously that is personal choice. I came from a country where you have cervical checks by an gynecologist every 6 months when you are on the pill and once a year if not. More than once I had a student or a junior doctor doing it. You learn fast that it is nothing to worry about.

[WiserOlder]

a group of them traipsing in to watch would be horrendous but if you were going to give birth without a partner or if your only support had to mind an older child, then if one or two students met you beforehand, then i would not say it was a bad idea. I think two (not more) medical students who'd met me beforehand, chatted to me, got to know me a little and read my file, that would have been better than my x who was a narcissist