Delivering babies (#1308)

Topics/tags: Michelle

Michelle trained as a family physician in a different generation. Part of being a different generation meant that residencies felt that it was their responsibility to prepare family physicians to be able to make good decisions after being awake for twenty-four hours straight since physicians often found themselves in such situations. And the best way to prepare people is to give them practice, right? So she had lots of call and lots of back-to-back shifts. Or at least that’s how I recall it.

But there’s also another important difference, the focus of this musing. She trained at a time when family physicians, or at least rural family physicians, regularly delivered babies. She rounded with an obstetrician, delivered babies, and prepared to perform similars service for her patients as she moved into practice.

When we arrived in Grinnell, all (or most of) the family docs still delivered babies. It’s one of the reasons we chose to come here. And I remain convinced we made the right decision.

It confused some people when she told them she had delivered a baby. I didn’t know you were an obstetrician, they’d say. But no, you don’t have to be an obstetrician to deliver most babies. Delivering children is a natural part of family practice; family docs take care of the whole family, at whatever stage. I know she appreciated being able to take care of babies, their siblings, their parents, their grandparents, and also assorted other relatives. It was clear to me that she could give better care because she knew the broader psychosocial environment of her patients.

In any case, Michelle delivered babies. Helping bring new life into the world was one of her favorite parts of her job. I recall her having onesies made up that said something like Delivered with love by Dr. Rebelsky. She also used to make up a poster each year of all the babies she’d delivered; at some point, HIPAA changed enough that she wasn’t able to do so. But we still have a few of those posters of babies sitting in our basement.

Being a family doc who delivered wasn’t necessarily easy. She felt a strong compulsion to deliver her patients, even if she wasn’t officially on call. So when a patient was due, she was implicitly on call, if not explicitly. And it feels statistically improbable to see how many expectant mothers come in during off hours. The family generally knew not to make plans when she was on official or unofficial call.

She was also frustrated by local practices, particularly in the early years. She was the first female family physician. Although her male colleagues were wonderful, women think about delivery and what is and what is not necessary or appropriate very differently. I think she made things better. Having Dr. Laura Ferguson come to town allowed the two of them to work together to make more positive changes.

In spite of the time involved and the political battles, delivering babies and making change was rewarding. It’s clearly a privilege to help someone bring new life to the world. And, while it can be terrifying, she was also very good at predicting potential problems and adjusting for them. She’d come home and vent about how difficult it was, but I know she was proud that she usually achieved a good outcome.

I remain amazed at the power of the connections she made in this role. Each day, as nurses and staff visit, either because it’s their responsibility or just because she’s in GRMC, I hear stories of how happy they are that she delivered their babies, whether it’s twenty-plus years ago or just a few years ago. Even those she cared for but couldn’t deliver because they were high risk clearly appreciate the love she brought to pre-natal and post-delivery care.

When she left her practice in Grinnell to take on a senior leadership role in Audubon, giving up delivering babies was probably the hardest thing for her. (Moving away from me may also have been close, but we could see each other on weekends.) Her professional life felt very different without the joy and connections that delivering babies brings.

I’m not sure how many babies she delivered. I don’t think she knows, either, although I suppose she could have figured it out with some effort. Somewhere between 1000 and 2000. So many wonderful lives.

Michelle made many positive contributions to the world, whether to our family, our friends, medicine in Iowa, or to her patients. But new life and the love that accompanies it is, perhaps, the most positive of all.

Version 1.0 of 2024-09-30.