179. Please, Mommy?

When I came on call Friday I looked at my schedule and saw a D&C (dilation and curettage) added to my schedule for 1:30, a miscarriage.  I looked up the chart and saw that Emilia also underwent D&Cs for miscarriages in 2013 and 2011.  

All told she has experienced 6 miscarriages and one life birth. The most recent miscarriages may be related to her age, 42, but there may be some other factors to explain so many.

She tells me that she didn't really want to try another pregnancy, but her daughter keeps pleading for a brother or sister. But this is it, she tells me, not again. I want to believe her.

178. Dead Poets Society

28 year old Samantha is about two thirds the way through her first pregnancy.  I always ask about work issues that may impact antepartum care; she told me she loves her job as a high school language arts/creative writing teacher, a career she attributes to an inspirational high school teacher.  

We also talk about two other issues noted on her problem list. She has had problems with "substance abuse" in the past, but is not shy to tell me that she will be two years sober in October.

And there is a history of depression, a subject which when raised brings tears and a choked admission that, "I'm having a real hard time with Robin William's death."  She's not alone.