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!

🤣 At the idea we can learn things by watching a YouTube video... I know let's scrap med school for our doctors of the future and just make them watch back episodes of casualty and YouTube videos of procedures.
Honestly OP I do feel sorry that you weren't properly consented for students and you felt this was invasive.. But it may be time to stop dwelling in it, accept that med students need to see stuff first hand and if you ever need an operation or your dc needs medical procedures such as sutures for an accident think about how you'd feel if the doctor said "oh I learnt about this by watching a YouTube video"

Yes OP, stop dwelling, it's not about you, it's all about accepting that medical students need to learn. Your wishes, dignity and informed consent are not important. 🙄

I didn't say that... But yes our future doctors do need to learn and they can't do it watching YouTube

Cus I can just see the AIBU thread titled "AIBU that the junior doctor who came to assist at my delivery had never seen a baby born before and only learnt about it on YouTube"

Honestly OP I do feel sorry that you weren't properly consented for students and you felt this was invasive.. But it may be time to stop dwelling in it, accept that med students need to see stuff first hand and if you ever need an operation or your dc needs medical procedures such as sutures for an accident think about how you'd feel if the doctor said "oh I learnt about this by watching a YouTube video"

How dismissive and rude. Yeah op and all the other woman who have offered their experiences of traumatic birth made worse by med students gawking. Just get over it. Completely cunty thing to add.

There were 3 when I had mine.

I said no students on my birth plan, I’m quite private and it was a twin c section, so there were already loads of people in there. but they asked my exH when I was being prepped and he said ok.

They introduced everyone in the room and said How great it was for them to watch a prem twin c section. Half naked on the table, drugged up to my eyeballs, worried sick about my babies, I just didn’t have it in me to tell them to get out.

I can’t say I was affected by it at the time or afterwards, there was a lot going on. I only really thought about it a few years later when I was at my smear and they asked me if the student could observe. I said no then, but it got me thinking about how I was put on the spot when I was in a really vulnerable state.

I’m no shrinking violet but it takes a lot to say no, whilst the eager fresh faced youngster is right in front of you. I think they rely on that.

@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...!

🙄 not really surprising when the midwifery students have to deliver a considerably larger number of babies than you and are aiming to make this their career, not just ticking a box

We are taught to never crowd a patient,

Wish the surgical teams that come on to my ward would learn this. They bring about 8 people with them. And we still can't get the jobs and TTO's done in a timely manner. Drives us insane. And they've also been told not too due to Covid but it's falling on deaf ears.

@Haffdonga

Yes my point (which some have missed) is that if a student is literally just standing there a baby come out, why not watch it on a screen somewhere and spare the woman the audience?

Because this not what they are doing. They are not just watching the baby come out. Among other things the medical students are watching:

• how the team works together (including midwifes, doctors, anaesthetists, birth partners AND the mother)
• the decisions made, at what point, why, who by
• the observations and monitors - heart rate, blood pressure, how many cms etc
• what medication is given, when, why etc
• what interventions are given and how (from palpation to C sections)

Really they just could not experience all this watching videos and I honestly don't think most women would be happy about giving birth with a qualified doctor who'd never seen a birth in real life before.

Absolutely this. Even though the majority of med students will not become obstetricians, plenty of them will look after pregnant/postnatal women in one way or another, and it's important to know what it's like to go through what is one of the biggest, riskiest events of a woman's life. You can't get that from YouTube.

We were supposed to see/ assist at 5.
Unfortunately I did my obs and gynae placement less than a year after a very traumatic and badly mismanaged birth, and the first time I saw another woman in labour I had a full blown panic attack and it triggered PTSD. So after much to-ing and fro-ing I was excused from getting those particular sign-offs . I did manage to find my way out of the delivery room and back to the desk before collapsing in a heap at least. Unlike one of my friends who fainted into the middle of a hernia repair...

Anyway, I've since managed to gain some experience of delivering (other people's) babies without having hysterics, which is lucky as I've got an obs and gynae placement next year...

You should have the right to be asked and to say no. Personally, however, I always try to be as accommodating as possible for med students and med residents. It's in the interest of other patients to ensure that our doctors have as much experience as possible of everything that they might be expected to handle.

A friend of mine had a vaginal breech birth and said it was like a circus in there, as doctors get few opportunities to show their med students breech births these days!

Yes OP, stop dwelling, it's not about you, it's all about accepting that medical students need to learn. Your wishes, dignity and informed consent are not important.

How does the OP dwelling on this help her I would like to know. It happened, maybe it could have been done better, but it's time to let it go and stop obsessing about it.

Incidentally I'm looking forward to coming back to MN in a few years to read all the complaints about medical procedures being performed by doctors who learned how to do it on YouTube

How does the OP dwelling on this help her I would like to know. It happened, maybe it could have been done better, but it's time to let it go and stop obsessing about it.

Would you say that to someone who had been in a traumatic incident? Or someone with an illness which had left lasting damage?

Incidentally I'm looking forward to coming back to MN in a few years to read all the complaints about medical procedures being performed by doctors who learned how to do it on YouTube

I hope to read that women who haven't consented have had it forced upon them. Plenty still will be more than happy for them to observe, but for those that aren't it's a disgrace, and of course women are meant to feel it's their duty and they're letting others down if they don't.

@Haffdonga

Yes my point (which some have missed) is that if a student is literally just standing there a baby come out, why not watch it on a screen somewhere and spare the woman the audience?

Because this not what they are doing. They are not just watching the baby come out. Among other things the medical students are watching:

• how the team works together (including midwifes, doctors, anaesthetists, birth partners AND the mother)
• the decisions made, at what point, why, who by
• the observations and monitors - heart rate, blood pressure, how many cms etc
• what medication is given, when, why etc
• what interventions are given and how (from palpation to C sections)

Really they just could not experience all this watching videos and I honestly don't think most women would be happy about giving birth with a qualified doctor who'd never seen a birth in real life before.

That is all useful information and I understand that if you are going into obstetrics, general practice, emergency medicine, rural medicine etc then yes you need to observe births, but there should also be a balance between that need AND the rights of women to dignity and privacy, not being put on the spot with a group of students, and not treated as a procedure to observe. Childbirth is not like other procedures, it's a significant life event and I think the idea of 'needing' to observe a number of births is dated and disrespectful to women, many of whom have commented here that they felt uncomfortable/ put on the spot.

Of the doctors I know, all are now so specialised in other areas they would never be around labouring women or need to deliver a baby. Maybe it is something that should happen much later in training if it's clear those skills are actually going to be used?

Of course you want a doctor delivering a baby to have real life experience, that goes without saying, but my point is that so few doctors go on to deliver babies so I don't think every student need to observe births, and as can be read here some shouldn't be in the room at all as they aren't mature/empathetic enough to handle it.

if you are going into obstetrics, general practice, emergency medicine, rural medicine etc then yes you need to observe births

@asIlayfrying Did you know that something like a third of medical students become GPs? Add in the numbers who might work in the other areas you mention and at a guess you'd pretty much cover 80% of med students. It just wouldn't be workable to separate some few students out who probably wont go in that direction. Frankly most of them have no idea what area they want to specialise in until they've graduated and worked in a good number of hospital departments.

That doesn't negate what you're saying about dignity and respect though but that should apply in every area of medicine. Obstetrics is not more special or the patients more worthy of dignity than any other. area.

DS has been on a placement in an oncology clinic where he has had to watch the consultant explain to patients that they were dying - another momentous occasion in someone's life worthy of respect and dignity. He has had to learn, watch and do many prostate exams (finger up the bum) on patients even though the area of medicine he hopes he'll go into is totally unrelated and he may never have to do this again for the rest of his career. Do you think he shouldn't be allowed to do those things because he might not specialise in those areas?

You should have been properly asked for your consent. You shouldn't have been made to feel as if you were on show. But every patient deserves dignity and respect and this is a different issue from the way med students get experience.

haffdonga Of course all patients deserve respect, I have never said otherwise. What I am saying and what is clear from some of the posts here is that that doesn't always happen on the labour ward. There have been some really interesting comments here from women and also from doctors and other HCP's I think it's a conversation worth having in an anonymous forum.

And there is a big difference between a male student giving a man a prostate exam with consent and a male student or group of students standing and watching a women give birth when the woman was deep in labour, when she was asked if that student could come into the room (as has happened to a lot of women on this thread alone).

Yes we do. It's crucially important to see all types of birth so that we have a basic understanding, can understand what has happened to our patients, assist in deliveries if required, help on a plane or in the street (!) if the call goes out,understand the impact the childbirth can have physically and emotionally. I never thought I would be involved after medical training but as a GP trainee I am currently "the paediatrician" who gets called to complicated deliveries, CS, ones they are worried the baby may be very unwell. Having my medical school understanding of what the O&G team are doing helps me to be prepared and anticipate what problems the newborn may have from different deliveries/presentations.

I'm sorry you felt you weren't consented properly, I wonder if you could feed that back to the team? I would hate to feel that any of the women whose deliveries I attended felt like that.

endothermichands you sound lovely and if you are thinking of how women feel then i'm sure you are one of the good ones! I was lucky in general with my births and I did feed back to the midwife at the time, it''s just something I wonder about sometimes.

I also read The Millstone by Margaret Drabble recently which is all about having a baby as a single mother in the seventies and the character in that really was treated like a specimen by an all-male group of medical students in the relatively new NHS - wonderful book and makes you realise how much times have changed.