Teddy and Owen walked into Carina's office for her 36 week appointment, it was decision time for whether or not Teddy would need a C-section.
"After reviewing your ultrasound from this morning," Carina started, "your daughter is still in a breech position."
"Okay," Teddy replied, "that means an automatic C-section."
"In your case it does," Carina replied, "looking at the notes from Dr Ndugu I'm hesitant to try an external version and natural delivery for a breech baby is risky."
"When can we schedule it," Owen asked, knowing Teddy would start to panic and he needed to take charge.
"I'd like to do it between 38 and 39 weeks," Carina said, "Teddy do you remember how many weeks you were when Allison was born."
"39 plus 3," Teddy replied.
"So we'll do it before 39 weeks," Carina replied.
"At 39 weeks," Teddy replied, "I want her in as long as possible and to try to support her lung development."
"She's not going to be early enough to require steroids for her lungs," Carina assured.
"She had such a rocky start I want to wait," Teddy replied.
"The latest we can safely book you for is 39 exactly," Carina replied.
"It's elective so we can be bumped," Teddy said.
"Same day only," Carina said, "you're too high risk. Baby is breech and your heart. Dr Altman your thinking like a mother I need you to think like the surgeon you also are. I know this isn't what you want. You can not withstand labor right now. If your cardiac event had been a year ago instead of six months we would have a different conversation but it's not safe. Your baby girl is safe either way but you are not. This is about a healthy living mom and baby. Teddy trying for a natural birth risks your life. Risks your children not having their mother, Owen losing his wife. We want you to be alive."
"Teddy you have to," Owen said taking her hand, "our family needs you to do this. I know it's major surgery and you'll be awake for it. It's not under general just a spinal. You've done emergency C-sections yourself."
"Only in trauma then I wasn't trying to keep both alive," Teddy said.
"Your baby girl is healthy," Carina assured, "this is an abundance of caution. I'm not going to let you try and have something go wrong. You will have Owen with you, you can ask for another support person if you want two."
"Just Owen and I," Teddy replied, "Evelyn and Megan to bring the older kids once were out of recovery and in a room."
"We can do that," Owen agreed.
"I don't want to scare the kids," Teddy replied.
"We tell them the truth that you are going to have a very routine surgery so the baby can come out of your tummy," Owen said, "that I will be with you and everything will be okay. They can see you that day after your surgery and meet their baby sister."
"Home 48-72 hours after," Carina said, "but your older kids can be here as much as you want them to be. Owen can stay with you over night."
They finished their appointment. While Teddy wasn't happy about another major surgery and needing so much help with her kids after she knew Owen would take the time off and that Megan and Evelyn would be happy to help.
Owen went to the skills lab to teach the residents while Teddy headed to her office to interview an incoming intern.
"Dr Altman," Sloan Riley greeted.
"Sloan," teddy smiled, "it's good to see you. Come have a seat and we'll talk."
"Thank you," Sloan smiled.
They sat at Teddys desk, "what made you choose medicine?"
"My dad and Dr Montgomery," Sloan said, "after Lucas I spiraled for a bit but then I realized I could go to school. There was a chunk of money when my dad died and I suddenly had choices. I went to community college and upgraded all my math and science courses then transferred to UCLA to do nursing but after my first year I realized I wanted to be a dr so transfered again to premed. Pre med took me 6 years but I did it. Then I know it's not a great med school but I got in at the university of Iowa."
"Nothing wrong with state school," Teddy smiled, "I went to Texas southwestern. An accredited school is an accredited school they all meet the same standards. Your residency has more bearing. Why surgery?"
"Lucas," Sloan said, "he would never have been able to walk with out what Addison did. I want to do that."
"Fetal surgery," Teddy confirmed.
"You have Addison Montgomery and Arizona Robbin's," Sloan said, "I want to learn from them."
"It's a hard road," Teddy said, "training in OB and general surgery, plus pediatrics. It's a crossover between 4 specialities. It's a full residency plus 6 years of fellowships."
"I know," Sloan said, "I want it and I want to do the work. I want to make my dad proud."
"You're here," Teddy said, "he would be. Sloan I've talked to your references and seen your transcripts. I want you here. I also know that right now we're a safety program and a second choice."
"You are my first choice," Sloan said, "I won't let you down and I won't let my dad down."
"You have not let Mark down," Teddy assured, "Sloan he would be so proud of you. I know he'd be pleased. You did it on your own, you accomplished this. It's not because of your dad or having advantages. Sloan you did it yourself. I knew a teenager in a rough patch but what I'm hearing about is a woman of integrity, compassion, courage and determination. We can teach you surgical skills we can't teach you those things."
They went through the formal interview.
"Sloan, I will be recommending you for our residency program," Teddy smiled at the end, "while you're here there's a few others that want to see you. Callie, Arizona, Addison, Owen and Meredith. They all know your here and are likely waiting outside my office. Be proud of yourself. Sloan you grew up, you learned. There's no gaurnetee but I would expect to come here in July."
"Thank you Dr Altman," Sloan smiled and shook Teddys hand.
Teddy walked her out of the office and smiled at her assembled attendings, "if the match goes the way we want."
"Welcome home," Arizona smiled at Sloan.
"Addison, Arizona she's yours," Teddy smiled, "fetal surgery is the goal."
"We'll get her there," Addison promised, "it's good to have you Sloan. Teddy do you have a minute?"
"I do," Teddy agreed ushering Addison into her office.
"Carina and I spoke," Addison said, "about your case. I feel more confident than she does about letting you try a vaginal delivery with some parameters."
"Okay," Teddy asked, "what are they."
"It has to be an induction and you are on the heart monitor the entire time," Addison said, "I'd like to schedule an induction right at 40 weeks. If you go into natural labour before that we will adapt but you come in as soon as you have a single contraction for monitoring. We have your daughter on the monitor the entire time. Iv access is established as soon as you are admitted and I highly recommend an epidural."
"Yes to all but the epidural," Teddy replied, "I don't react well to most anesthetics. I would be more open to a spinal for the C-section but if we're doing a vaginal delivery I want no meds. I didn't with Allison."
"This is all assuming baby turns and comes out of the breach position," Addison said, "if baby remains breach it is an automatic C-section."
"Can you do the version," Teddy asked.
"I can try once with you on all the monitors but I will only try once. Well book you in for Friday," Addison replied.
"We'll be there," Teddy agreed, "Owen will come with me. "
"Of course," Addison agreed, "your not operating right. "
"No," Teddy replied, "just paper work and admin work. "
"Two weeks," Addison advised.
"Three," Teddy negotiated.
"We'll see," Addison replied.
Teddy finished her day working with residents and getting things set up for her leave.