Fortunately the baby was doing well. He was a 25 weeker but was breathing fairly well on his own. We brought him to the NICU and put him on nasal CPAP -think of it as blowing air and oxygen into the baby with a little bit of pressure - and he looked fine and dandy.
Before I left the delivery room I briefly showed the baby to mom and dad and told them I would talk to them in more detail once we got the baby settled in the NICU. I again saw them briefly when they went through the NICU on the way to mom's room, and I told them I would be out in a few minutes, once mom got settled in her room, to go over everything with them. When I got to mom's room, she was there with a friend, but no dad. "Is the dad here?" I asked. No, he had gone to the store.
I sighed a little; I guess dad didn't think it too important to hear about the baby. So I went over everything with mom: the approximately 75% chance of survival; the possibility of needing a mechanical ventilator; the need for an IV for likely 4 to 5 weeks (maybe less if he does really well;) the possibility of bleeding into the brain; the increased chance, versus if he had been born full term, of a neurological problem; and several other things, including a pitch to have her pump her breasts to feed the baby.
All in all, it was the kind of talk I wish the father had been there for, because he should hear this stuff and because I really didn't want to go over it all again. Sometimes the father comes later and wants to hear it; I try to tell them, but having done it once, I know I condense it the second time. It can get a little frustrating, especially when you make an effort to get parents there at the same time.
Sometimes I've talked to mothers at the bedside or in their room, and after I go through a long spiel they say, "Can you tell that to my husband , too? He's just outside in the waiting room." Now you tell me?
Before I left the mother of the 25 weeker I asked her if she had a name picked out yet. She said yes, he would be a junior. I waited, thinking she would tell me the name, since I didn't know dad's name, but nothing more was forthcoming. Finally I asked and she told me.
I sighed again. Some days communication is just tougher than other days.
P. S. Grand Rounds is up at Healthline.com and Pediatric Grand Rounds is up at Pediatrics Info.