The adage that medicine is an art as well as a science holds true, except for those among us who are quite adept at making a creative mess. 

A patient presented to the labor room with complaints of vaginal bleeding and pelvic pain twelve weeks before her due date and subsequently delivered a baby in a toilet bowl.  This type of calamity might be expected to occur in a restaurant or a public facility among unsuspecting lay people but never in a hospital staffed with trained nurses and physicians.   This type of abashment makes me want to dust off my scrubs and return to the delivery room in high gear.

If a pregnant woman is experiencing pain and bleeding, the last place she needs to be is in a bathroom unattended.  The  poor woman rang the emergency bell in the bathroom three times trying to get help from nurses who had deaf ears and misplaced priorities.  It was only after she emerged from the bathroom with baby in tow and attached to the umbilical cord, did she finally obtain the attention that she so rightly deserved.  Some rushed to cut the cord and get her admitted, while others scurried to get a warm blanket and find a pediatrician.  Her placenta also had to be delivered.  Although the baby only weighed two pounds and remained in the hospital for approximately a month, both mom and baby are now home and thriving.

A pregnant woman should never be directed to the bathroom without first having a pelvic exam if she complains about vaginal bleeding or pelvic pain.  Obtaining a urine sample should be a low priority until someone can document that a delivery is not imminent.  Sometimes the best clinical treatment we can offer a patient is the art of common sense.