Kayla

“Look, there's the heart beating. You see, when I move the probe this way you can see her spine, and look, she just kicked. So tell me, have you picked a name yet?”

“I think I'm going to call her Kayla.”

Now that I could finally navigate the ultrasound with confidence, it was exciting to show the young mother a glimpse of her first baby. While I waited for the resident to arrive, I examined the fetus and tried to determine whether there was leakage of amniotic fluid. The mother had presented to the obstetric triage earlier that night at 23 weeks gestation with complaints of mild cramping and some watery discharge. Because there was no obvious emergency at that moment, the resident allowed me to begin the exam alone. As I had rolled the ultrasound to the room, I had wondered, “Could this be a miscarriage? What would it be like to participate in a delivery at such an early gestation?”

“Once the nurse and resident get here, they'll use the speculum to examine you further. They will inspect your cervix for dilatation and test your discharge for the presence of amniotic fluid, okay?” She nodded in response, and I continued with the exam.

As I continued, I impressed myself by locating and measuring the amniotic fluid pockets in each of her abdominal quadrants. My confidence rose further as I discussed the discovery of each contour and limb as they emerged. As I moved closer to her pelvis, …