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!

I had 2 with DD and a student midwife, DD was coming out in the wrong position and I ended up having an assisted delivery so I had a obstetrician delivery and he brought 2 students with him.
At the time I just wanted the baby out but in hindsight I hated it, these 3 men just walked in, no introduction and started barking at me and put me in stirrups. I really should have complained but I just wanted it over with.
It’s the reason I had homebirths with DS 1&2.

@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.

This makes sense. ONE person approaches you.

When I had to have a mammogram 3 years ago, I was asked if a student could watch. He was about 22 and looked like he had walked off a tommy hilfiger advert. I said no sorry. I realise they have to learn but I had allowed a group of students to watch when a cosmetic surgeon stitched my lip back together.

I had a student midwife when I gave birth to DD2. I didn't mind her being there but was asked and definitely would have said NO to a group being there, I'm not a fucking zoo exhibit.

If on ob rotation they need to attend births but they are drs not students at that point. I had a student midwife who delivered me as one of her births, she thanked me afterwards as it was her first - I was asked permission

reluctantbrit there are loads of childbirth videos on youtube and I know of at least one midwife friend who watches them to learn.

I am not talking about a genuine interaction with a student throughout a birth, I am talking about box-ticking student groups arriving at the moment of birth. It feels like an old-fashioned tradition that no longer needs to happen.

When I trained (a long time ago) we had to observe five deliveries including sections then deliver ten babies. We had to ask the mother's permission and attend the whole labour and then follow up postnatally. Strictly only one student. I was incredibly grateful to those women who allowed me to be there.

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.

To be fair, @babdoc, they surely can't have been that unfavourable if those mums were taken for c section after only 24 hours? I mean, you could have been kicking your heels a lot longer.

I had to see some as a student. Videos are not the same as being there. Though consent was always obtained well in advance.

Now as a paediatrician I go into a lot of rooms as the baby is being born (high risk ones where I get summoned last minute). I'm pretty sure that parents aren't consented to my presence as mostly by the time people decide I may be needed everyone's distracted with end stage pushing/foceps etc.

Yubaba I can imagine. Mine was instrumental too and that's scary enough without an audience. I didn't have a homebirth for my second but i did make it clear all over my notes that no students were to traipse in and none did.

I had a student midwife at DD2s homebirth- asked in advance. She was very helpful.

DD1 (in Germany). I definitely remember there being students at the scans with their Professor. 3/4 of them. The scans took twice as long, including 3D, as he had to explain everything to them in English and German. I think they were there for the aftermath of the birth as well- there were loads of people there but I only have hazy memories of it (long story short... I wasn't considered to be in advanced labour, suddenly pushed out a baby with no one else in the room, then had medical staff descend on me as I went into a shock state as they (and I) were not expecting the arrival). Basically everywhere the Professor went, his students went. But I saw them 2/3 times pre birth.

It's not an amazing life moment to medical students. It's a rather mundane medical procedure that they need to understand so that if and when called upon they can do what's needed. By all means don't have them in the room but they do have to learn and a video won't cut it.

I didn't have a med student at the births - ( although at my first one - who knows? Its was a bit of a free for all by the end!) I did have a Med student at my 6 week check for me and baby post section. The Dr was running incredibly late which wasn't ideal but because of the med student the Dr did a full check of me and baby, explained all the tests etc, took a long time making sure we were OK. It was great and a massive contrast to the 6 week check at baby 2 - Dr who was younger than I was asked if I was OK, didn't even pick up or look at the baby and in and out in less than 5 mins, most of which was taken up with obligatory talk about contraception.

It varies between medical schools. When I did my obs placement 12ish years ago we had days allocated on labour ward but did not have to attend a set number of deliveries, but friends at other universities still did have to get a certain number "signed off." I went to quite a few because I was a keen bean and loved obstetrics, but I got permission really on and stayed with them all the way through, not just popping in at the end!

When I had DS1 I had a med student in there and she was very encouraging.

@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....

Those won't have been medical students. Junior doctors in training (caveat - I'm a "junior doctor" with 6+ years experience in my specialty and have put in hundreds of epidurals independently, but am still in training), perhaps, but nobody would let a student put in an epidural unsupervised or suture a complex wound. I'm sorry you had such a bad time though.

I once had to have a Bartholin's cyst drained. I said yes to a student watching only to discover it was a team of students. And then the doctor wasn't used to the procudure so asked someone else to come in and help. I think about 6 people were staring intently up my foof as green gunk was drained from it.

@SockQueen This was was in the US and they were supervised by a consultant. They were residents- not sure if it’s the same terminology in the UK.

I’m all in favor of hands-on training but these two weren’t ready to treat patients ( in my non-medical opinion). Doctors here start their residencies during the summer and DD was a summer baby...think I got some newbies.😂 Personally I think the consultant should’ve taken over when it took so long to sew me up.

Well when I scream “any doctor to room XYZ” three times by the way. That “any doctor” has better well have covered all aspects of care. Maternity, newborn resuscitation or post operative hemorrhage. And some times any body is better than no body. Yes I’ve had orthopods show up and anaesthetist not sure why those type are always hanging around. BTW, the South African doctors cover it all!

I had either a medical student or a junior doctor present at my birth. It was a bit of an emergency job, the midwife pulled the red button and warned me that there would be a lot of people coming in. One of which was the student/junior doctor. The consultant wanted to go to theatre but there wasn't time, baby was in distress, heart rate dropped to almost nothing and they couldn't get it backup.
I had an epidural, hormone drip, my labour had unknowingly progressed significantly but the trace wasn't picking up any contractions. I couldn't feel bugger all, midwife told me when to push and consultant went in with forceps without episiotomy as no time.

The student/junior doc was my entertainment. He stood quietly and observed. First he went green, then he went grey. It was clearly his first delivery, bless him

I have no issue with students, in fact I'm happy to give them the chance to learn and progress. My GP surgery is a teaching surgery and often have 2 students doing joint consultations for those who are happy to see them. I've always found them to be very thorough (OTT thorough even) and then they have to run it all by the supervising GP too.

I had student midwives at every one of my prenatal appointments and a student radiographer at my scans. I was asked if I consented to them being there beforehand for all of them.
A student midwife delivered my baby and as I was transitioning the midwife asked if a minded a few medical students in to observe. I said no, I was already providing a learning experience to one student and I was in no mood to be observed by a whole group. I appreciate they need to learn, I'm a nurse so was in their position myself, but I just didn't feel comfortable at that point.
I did however let a very junior (it was literally her first week) doctor come and examine my back passage when they were assessing my tear and she observed the stitching.
I think for me it was about having too many people in the room whose only business was to watch.
I was born in front of a whole room full of students because I was double breach so not something they would see everyday. My poor mum still talks about how crap it made her feels to be an exhibit for a load of men (as it largely was back then).

In my medical school we needed to attend a certain number and then deliver a certain number of women, too. We were required to introduce ourselves, seek permission from the woman, stay with her during labour, help where we could and then watch or help deliver the baby.

To the PP who thinks a medical student put in her epidural or sutured her after her delivery - these were not medical students but qualified doctors. Medical students are at most allowed to site a cannula, not perform epidurals which is a very specialised procedure done by an anaesthetist.

And OP, your experience doesn't sound right at all, it shouldn't have happened that way. It sounds extremely archaic and I really wish you had complained at the time. However, insisting that medical students ought to just "watch a YouTube video" is incredibly naive and surely just a little bit silly? And insisting that it those wanting to specialise in the field should do it? Again a little daft. It's as simplistic as saying school students should only learn algebra if they want to become an architect, or study French if they want to live in France. When you qualify as a junior doctor you are expected to have wide training on the basics of all the specialities, which also helps you to choose your speciality later on. There is also a lot of crossover between multiple specialities.

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.

But they still get trained in all general aspects of medicine first, and surely most then choose what to specialise in. Surely it's time for you to move on from this.

[quote AmICrazyorWhat2]@SockQueen This was was in the US and they were supervised by a consultant. They were residents- not sure if it’s the same terminology in the UK.

I’m all in favor of hands-on training but these two weren’t ready to treat patients ( in my non-medical opinion). Doctors here start their residencies during the summer and DD was a summer baby...think I got some newbies.😂 Personally I think the consultant should’ve taken over when it took so long to sew me up.[/quote]
My understanding is that a US resident doctor is the sort of equivalent of our junior doctors so an fy1 or fy2.

@PicpouldePinet. Fair enough, residents are qualified doctors, but they were under a consultant’s supervision- so why was it so botched? I was in hospital for five days recovering and then had to go back for a spinal tap due to the botched epidural- (a second epidural was administered in the right place by the consultant).

I assumed they were students as it was such a disaster!

The hospital didn’t charge us for the first epidural not the spinal tap, whereas normally they charge for every plaster.🤣. That was an indication that things didn’t go well.

I had a (male) student doctor in with me for my induction. I was the first birth he had seen and he stayed after his "shift" had ended to come into theatre for my section. He was amazing and even came to say a quick hi to us and baby on the ward the next day