So here I am, still green, about to perform my first delivery ever, and this is what I’m handed:
A woman in labor with a non-viable pregnancy, where the baby had likely died in utero two weeks prior.

Her water hadn’t broken, so I got her up in stirrups, positioned myself between her legs, with my preceptor standing behind me. I ruptured the membranes, and out came black amniotic fluid. That was the moment it all became very real. The fluid was thick, tar-like, necrotic. There was no odor—thankfully, we were in a sterile environment—but the appearance alone was horrifying.

Worse still, she wasn’t lubricating, and the labor wasn’t progressing well. It was dry. She wasn’t pushing effectively. And my preceptor kept telling me, “Pull. Pull.”

But this baby had been dead for two weeks. I was terrified I’d pull it apart.
I refused to yank. I pulled gently. And somehow—miraculously, maybe—I was able to deliver the baby intact.

It was an anencephalic infant, the top of the skull completely absent, just as expected.

I don’t remember much about what happened after that. I imagine it wasn’t good.
I do remember going downstairs the next day to assist with the autopsy.
That part stuck with me.

To this day, I believe this may have been one of the worst first obstetrical experiences anyone could have.
And yet, I got through it.