For me, preparation for the operating room is a meditative act. It is a brief time before surgery when I change into scrubs specific to the theater, replace my zebra shoes with high boots, put on my favorite zebra hat to cover my locs, and wash my hands in a highly methodical way. It is a brief time that I feel truly present and focused on one individual task. There is no temptation to answer my phone. There is no expectation to provide care to additional patients beyond the woman who is currently on the operating table. And I can exhale, briefly forgetting the entropy of Labor and Delivery.

We are fortunate to have our own Labor and Delivery theater. There is only one room, but with very few scheduled cesarean sections, the space is adequate. That being said, getting to the theater is sometimes an obstacle. Staff shortage remains a problem especially in the evenings. During the day, we have a dedicated team just for Obstetrics. Besides myself, I will always need an anesthetist (I have not gone so far as to place my own spinals although it is very tempting) and an assistant (although I can certainly manage without one). My ritual hand washing or surgical scrub is not as calming and rote here – sometimes there is no running water and I must use the back-up water in the large container. I wear an apron over my scrubs that does not allow anything to penetrate (especially air) and a cloth surgical gown that is sometimes still wet from the wash or the rain. And I never quite realized the importance of surgical gloves with powder until I tried to struggle into a pair that was damp from humidity. I don’t always have the instruments I desire or need, but I’ve learned to improvise my surgical techniques. A physician here told me, “we can’t always do what’s indicated, but we do what we can.” And slowly I have left behind medical-legal formulaic medicine and have adopted the fluidity of the art of medicine.

Welcome to Obstetrics Theater:

Myself and a surgical tech assistant

Panoramic view of the Operating Theater

Incision time

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Delivery!

The hand off (the one step in surgery that makes me nervous EVERY time!)

Neonate examination by Nurse Midwife

Our NICU

Our Labor Ward (1 of 4).