- [Surgeon] Asphyxia.
- [Nurse] Hold her hand.
- (laughing) I can't.
There are so many things wrong with this.
No wonder you guys wanted me to comment on it, okay.
Hey y'all, welcome back.
Mama Doctor Jones, OB/GYN and mom to four.
I actually am a fan of the show
but I haven't made it up to season 10,
so there will be spoiler alerts in this for you and for me,
but I'm willing to fall on that sword
because I love you guys and you asked me to do this, so.
(sighs)
If you're not subscribed and you wanna be,
I would love to have you.
I am trying to hit 700k by my two-year anniversary
of uploading on this channel.
But also if you don't wanna be subscribed
and you just wanna watch this review of Shameless
with spoilers, you may not have seen this episode yet,
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(upbeat intro)
- I'll give it a shot.
- You know that mask's kinda freaky, right?
- Yeah, well it's better than junior being born
with flippers and a tail.
- Exposure to volatile chemicals in day-to-day life,
like hair dye, is probably not going to make
the baby be born with flippers, but it is probably
a good idea to wear a mask around volatile chemicals
if you are pregnant, and maybe even if you're not,
because these things can cause reactions
and difficulty breathing.
But most of the things that we use today
are not going to cause birth defects.
That mask she's wearing though,
(laughs) probably overkill.
- [Client] Jeff is definitely cheating on me.
But I'm not gonna confront him.
I think I'll just start sleeping around
until I pick up a nasty STD,
then give it to him so he can give it to her.
Serve the skank right.
- Okay, I know that this episode is supposed to be
about the pregnant character, Tami, and her birth,
however, let's maybe not do vindictive STD sharing.
Mostly treatable, some are not, wear a condom, prevent them,
and maybe don't cheat on your spouse.
- You think it's real this time?
- I'm not sure.
- Did you water break? - No, but..
- You got 'em pretty close together.
- (yelling) Just shut the **** up and find a parking spot!
- Can you walk? - Yeah.
- Yeah? - 'Course I can walk.
(Tami grunts) - Can you?
(Tami groans) - Hey, hey, whoa, whoa, whoa.
Should you be squatting?
- I feel like this is a very accurate representation
of myself in labor with my fourth baby.
And I've shared his birth story on this channel
way back when if you're interested in that.
But yeah, I mean everybody's labor looks different,
but mine looked like that.
- All right, I'm gonna find you a wheelchair
so you don't have the baby in the parking lot, all right?
(groaning)
I don't really know all the answers to these questions.
Don't you have it on file somewhere?
- Are you with Miss Tamietti?
- Yeah, yeah.
- In here.
- What, what's going on?
- She's carrying all of the gear for delivery,
so my guess is we're about to have a baby.
- Is there something wrong or um,
- Put those on.
- Surgical consent.
- [Surgeon] Fetal distress.
We're performing an emergency C-section.
- [Male Nurse] We have to get this baby out now.
- [Tami] No, no, no, no.
I'm not have a cesarean, I'm having my baby naturally.
- [Surgeon] That's not going to happen, Tami.
Sign it.
Asphyxia.
- [Nurse] Hold her hand.
(laughs)
- (laughing) I can't.
There are so many things wrong with this.
No wonder you guys wanted me to comment on it, okay.
First off, their communication is very poor,
meaning the medical team's communication with the patient
and with the patient's significant other.
Second, that is not an operating room.
They are in a regular hospital room,
and we don't do C-sections in regular hospital rooms.
I'm sure there's a situation where it was so emergent
that they have done that, but that definitely
wouldn't be the case in a situation like this.
They've let him walk in with his mask off
and nobody else looks like they're sterily
ready for a procedure anyway, but regardless,
that's not an operating room.
They also are not really explaining the situation to her,
and then they also mentioned the word asphyxia.
Asphyxia isn't a term that we use on the obstetric side.
We don't diagnose that prenatally.
We can say fetal distress like they did initially,
but we don't use that terminology on a baby
that is still on the inside.
This is probably one of the least accurate portrayals
of an emergency delivery that I've seen.
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Now, let's get back to the video.
(baby crying)
- It's a boy.
Did you know?
- [Lip] No, no.
(overlapping chatter)
- So they've handed the baby off from the OB/GYN
to someone in a sterile gown who is not scrubbed in
for the surgery.
Shoo, fly.
And the reason that she's done that is because she wants
to keep, the OB/GYN wants to keep from contaminating herself
but needs to hand the baby off to someone.
So she hands it off to probably a pediatric nurse
or nurse practitioner or maybe the pediatrician
who carries the baby over to the warmer and lays them down.
First thing I notice is that baby should be laying
with its head towards the other side of the warmer.
You want the baby's head facing where people
can move around the warmer so that if you need to intubate,
it's easily accessible.
When I send the med students to lay the baby down,
they often lay it the wrong way, 'cause that seems like
the natural way baby should go, but it's actually backwards.
Also surprise with the boy or girl at delivery
is like my favorite type of delivery.
It is so much fun.
We had a surprise with my twins and it was so exciting,
but when I get to be the doctor who is there
for the surprise deliveries, it's like some
of the most memorable deliveries that I have.
It's absolutely so much fun.
(baby crying)
- Apgar seven.
- Seven, that's good, right?
That's good.
Hey, hey, it's a boy.
It's a boy.
- Yeah? - Yeah.
Tami, you won't believe it, he's so beautiful.
(baby cries)
Apgars of seven are good.
What apgars are are a kind of scoring system
that we use for neonates and seven is an average
to slightly below average score, but still good.
Although I would argue that me looking at that baby,
it's not a seven.
It's screaming and crying, the color is fine,
it's moving all of its extremities.
These are things that go into calculating that score,
and I would have given that baby a nine, but.
A seven is probably fine too.
- Tami, you okay?
(monitor beeping rapidly)
- What's happening to her, what's going on?
- Her BP is dropping. - She's hemorrhaging.
- Tami.
- [Nurse] Call surgery, tell them we're coming back.
- Tami!
- Sir, please step back. - Hey!
(baby cries)
- [Male Nurse] Make sure they have O neg on hand.
- Who's open? - Hey, I go with her, or?
- No, no, you should stay here with your son.
- I thought they were pretending that was an OR,
but apparently they are not.
They are pretending they did the C-section
in the labor room, which doesn't make much sense
if they could perform the C-section in the labor room
then they should be able to perform the steps
to stop a postpartum hemorrhage in the labor room.
That's not, like, I'm so confused
why they're moving her to an OR now.
The other side of that is that they're asking
for O negative blood.
They should have her blood type on file.
That's one of the very first things that we do
when someone comes into the hospital for prenatal care
and for delivery is check their blood type.
O negative blood is a universal donor,
so presumably she should be able to safely receive
O negative blood no matter what her blood type is,
but it is always better to receive your own blood type,
and they should have that on file.
So they should be asking for her type blood, not O negative.
You wanna save O negative for people who come in
in an unexpected situation, like a car accident
or a gunshot wound and they're having massive bleeding
and they need emergency blood transfusions
to save their life, but there's no time
to determine their blood type.
Hers should've been known.
- It's a boy.
(all exclaim)
- And Tami?
- She needed and emergency C-section.
Um, there were some complications,
bleeding, she's still in the OR.
- But she's gonna okay, right?
- I mean, they wouldn't tell me anything else.
- Well go find the **** out.
- Okay, okay, she's in surgery, Cami.
They'll let us know how she is as soon
as they have something to tell us.
- That's a really good depiction of the tensions
in waiting rooms when a baby's being born,
and 99% of the time, the significant other comes out
and is able to say "Great news, the baby's great
"and everyone's doing fine,"
but sometimes that's not the case.
And the depiction of the family kinda lashing out
at Lip a little bit is accurate.
I mean, people don't know how to react
when the mom in this situation is really sick,
because we live in a society where moms and babies
are supposed to be fine, and usually they're fine.
And I don't think that our brains quite comprehend
the real dangers that live within childbirth
because we're so used to good outcomes.
Which, don't get me wrong, is a great thing,
and don't get me wrong, we still have a long way to go
with maternal mortality rates in this country,
but overwhelmingly the outcomes of pregnancy and delivery
are positive.
And so I like how they depicted this kind of
weird interaction and not knowing where to direct your anger
and confusion and frustration.
(upbeat music)
(hushing)
- (yells) How are they still not going to tell us
how she's doing?
I'm not gonna go into the third episode today,
but maybe we can do that at a later time.
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Be kind to yourself, to each other, to me,
in the comments be kind, and I will see you next time.
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