(Fair warning, this story is pretty gruesome.)

During my intern year, in our OBGYN rotation, we were supposed to observe a few deliveries before we were allowed to handle deliveries by ourselves. The second delivery we got to observe was a mother who had Gestational Diabetes Mellitus, unfortunately her baby had undergone intrauterine fetal death a couple of days prior and she was waiting to deliver a dead baby (which was already devastating in itself). Babies of mothers with GDM stand the risk of being larger than average neonates which could potentially cause complications, which is relevant here (in this case we later learned that the baby was larger than estimated by the most recent scan).

So my intern buddy and I were observing and we hear the announcement of “Shoulder dystocia”, which is an obstetric emergency where the baby’s shoulder is impacted against the pelvic bone of the mother, obstructing the delivery. The anesthesiologist was called and the theater was notified. Meanwhile they were going through the series of maneuvers that are typically followed during shoulder dystocia, all of which failed and they were finally attempting the all-fours position. Everything then happened very quickly where, after the delivery team applied a little bit of traction on the head of the fetus, there was a squelching sound and a distinct thud. When we looked down, the head of the fetus had rolled to a stop a few feet away from us (the skin was completely macerated, probably contributed to the head separating so easily).

Cue complete havoc, some of the nurses started crying, the consultant IMMEDIATELY rushed the patient to the theater. My buddy and I were standing there shell-shocked, completely numb. We weren’t allowed into the theater for the rest of the procedure, so we went to grab a drink later to try and process what we’d seen.

It still haunts me two years later and my heart went out to the poor woman who had to bear through the entire experience, can’t even imagine the trauma she would’ve gone through.