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November 11, 1983

Five Perfect Fingers

Author Affiliations

Federal Way, Wash

JAMA. 1983;250(18):2440. doi:10.1001/jama.1983.03340180018006

I was a third-year medical student on the obstetrics service. I had already delivered more than three dozen babies, all warm, wiggling, light, and joyous little things that brought smiles to everyone's lips. Three dozen times I saw the tension and pain of childbirth turn instantly to pleasure with the newborn's first cry. How different it had been tonight!

I had just delivered the stillborn fetus of a diabetic primigravida. The mother was very obese and her diabetes had been out of control during her pregnancy. I had waited in agonizing silence for this baby. The collapsed skull entered the birth canal before complete cervical dilation had occurred. I spent an eternity whispering reassurances to the mother while waiting for passage of the baby's shoulders. Finally with a rush of fluid, the baby dropped, limp and heavy, into my hands like a bag of sand. I will never forget the