In obstetrics, we often emphasize surgical protocols, blood transfusion strategies, and technical expertise. These are vital, but they are not the whole picture.

What we rarely highlight is the psychological factor of the surgeon — the ability to remain calm, focused, and decisive under extreme pressure.

🧠 Why the Psychological Factor Matters

1️⃣ Time Pressure – Seconds can decide life or death.

2️⃣ Dual Responsibility – The surgeon carries the weight of both mother and baby.

3️⃣ Leadership Under Stress – The team relies on the surgeon’s direction.

4️⃣ Emotional Impact – Stillbirth, hemorrhage, or maternal collapse test emotional endurance.

5️⃣ Burnout & Resilience – Fatigue and stress can cloud judgment if not controlled.

Obstetric surgery doesn’t just test hands — it tests the mind and spirit.

🌸 A Real Example

A young woman came in active stage of labor, with severe abdominal pain and a distended abdomen. Ultrasound confirmed intrauterine fetal demise with a large retroplacental hematoma (~11cm).

Her platelets dropped rapidly — she was already slipping into HELLP syndrome. The dilemma was clear:

➡️ Wait for natural labor?

➡️ Or act immediately to save her life?

There was no time for hesitation. We rushed her to the operating theater.

Inside, we found:

• Massive concealed hemorrhage (~1500 ml)
• A bruised, blue uterus — Couvelaire uterus

The baby was already lost. The fight was now to save the mother. We controlled the bleeding, preserved her uterus, and admitted her to ICU.

She later developed eclampsia, but with magnesium sulfate and intensive care, she improved.

✨ Days later, she walked out alive, on her feet, with her uterus intact.

🌱 Reflection

This case reminded me that complex obstetric surgery is not only a technical battle — it is a psychological one.

Strong hands may stop bleeding.

But only a strong, resilient mind can carry a surgeon through chaos, lead a team with clarity, and give a mother the chance to walk out alive.

📖 As the Royal College of Obstetricians and Gynaecologists reminds us: “The wellbeing of doctors is patient safety. Fatigue, stress, and burnout impair clinical judgment and increase the risk of adverse outcomes.”