Part of what made Obstetrics so challenging is that pregnancy and giving birth is of course a wonderful, natural process than women have been experiencing since the dawn of the species. It is also a potentially dangerous process, sometimes fraught with complications (though rare) affecting a woman, and her family when they are the most vulnerable.

Balancing this was one of the greatest challenges of Obstetrics. For me, other parts of medicine are a little bit different, generally you are dealing with a pathological process that has been affecting a patient, either coming on rapidly or slowly, sometimes immediately fatal if untreated, or it may be a process that may tolerate some begin neglect. Pregnancy is different.

Pregnancy is a normal, natural process that sometimes, without warning, turns ugly. We try to avoid this fetal ultrasounds during pregnancy and fetal monitoring during labor. When things are not progressing in a way that we feel comfortable with, either for the health of the mother or of the infant, we intervene in the pregnancy. But most of the time, we are just observers of a natural process that we do not have control over.

Dealing with this ambiguity is sometimes the hardest and most courageous thing you can do. Watching the physicians and midwives deal with this uncertainly with courage, not just for themselves, but also for the women (and families) they are attending…is nothing short of amazing.