Physician at Work: Delivering babies in the early morning

The work can be stressful—but often it’s wonderful

Christian Pettker, MD

Christian Pettker, MD, remembers being a medical student and watching an older obstetrician stroll off to a delivery at 3 a.m. “He was really excited about it, and I had a vision that I could still wake up in the middle of the night and get excited about delivering a baby at his age,” Dr. Pettker said.

A little over 15 years later, Dr. Pettker is medical director of the labor and birth unit at Yale-New Haven Hospital. He supervises normal labor and deliveries, and practices as a maternal-fetal specialist, caring for women with such complications as fetal abnormalities and preeclampsia, and such medical conditions as diabetes, hypertension or lupus.

Delivering babies can be stressful, especially when a delivery doesn’t go well. Early in his career, Dr. Pettker decided he wanted to be able to provide each of his patients with the safest delivery possible. In 2004 he joined colleagues at Yale to launch a patient safety program aimed at teaching staff to work better in teams and developing new protocols for common procedures. The program reduced adverse outcomes by 30 percent and reduced malpractice suits significantly.

The job can also be wonderful. He recalled an experience from early in his career where a deaf woman visiting Connecticut from another country arrived at the hospital, bleeding and with a fetus in distress. “We quickly pulled a team together. We had to communicate with a woman who could only read lips that she needed an emergency C-section and we’d have to put her to sleep for anesthesia, and we had to get consent from her for the procedure, all in 10 minutes or less.” Then all of the team members put on surgical masks, and Dr. Pettker had to write notes to communicate with her.

“It was a very traumatic for everyone involved,” he said. “But two things were really striking about it. One was her gratitude that we saved her baby’s life. The other was that we were able to very quickly pull together a team and deliver the baby. It was probably 15 minutes from the time she was rolled in to the delivery of the baby.”

Another thing that drew him to obstetrics was the opportunity to help not one, but two patients, the mother and the baby. “A lot of the time they will have opposing interests. Something I do for a fetus may put the mother at risk, or something I do for the mother may put the fetus at risk. It’s intellectually challenging to balance the two, and it’s emotionally satisfying to help the family through a difficult time,” he said.

While there are never guarantees, the experience often ends happily. “Getting woken up at 3 a.m. to go to a delivery is still fun,” Dr. Pettker said.

Name: Christian Pettker, MD

Title: Assistant professor, Obstetrics, Gynecology & Reproductive Sciences

Area of expertise: Maternal-fetal medicine

Place of birth: Santa Monica, CA

Age: 39

College: Princeton University

Medical school: Columbia University College of Physicians and Surgeons

Training: Residency in ob/gyn at New York Presbyterian (Columbia) and fellowship in maternal-fetal medicine at Yale School of Medicine.

Family: Wife, Hope Metcalf (a lecturer at the Yale Law School), two cats and a dog.

What is the most important thing you’ve learned from your patients? When I became an obstetrician, I believed that the successes and saves in my patients’ pregnancies would be the most important way I would make a difference. While those are certainly satisfying experiences, it seems the majority of patients that reach out and thank me for my work are those whose pregnancies we could not save. This stresses the importance of trying to get it right when things have gone wrong.

What was the biggest challenge you ever faced as a physician? I am humbled when I think about how medicine has evolved to have so much power to heal, while at the same time this power has so much capacity to do harm. In my focus on patient safety, my recurring challenge is to take events where errors or mishaps have been noted, and sometimes caused harm, and construct something positive out of them.

How have your experiences with patients changed your approach to care? I have learned over the years how much of medicine is a team sport, and including the patient in our concept of the team is as important as anything.

Personal interests or pastimes? My wife would say that my hobby is finding new hobbies. The latest ones are ice cream-making, gardening and trying to build a small boat.

Last book read:  IQ84, by Haruki Murakami.