Wednesday, June 17, 2009

A maternal-fetal specialist comments on Tiller's practice

Kathy fetched this statement as a response to a troll who has been defending Tiller's practice of keeping his supposedly deathly ill third-trimester patients in a motel room for three days with their recently-killed babies rotting inside them. Thanks, Kathy!

1) Dr. George Tiller was a family practice doctor. He had NO training in high risk pregnancies, fetal or maternal problems.

2) There is no need after 23-24 weeks to ever perform an abortion in the way that Dr. Tiller did, to save or protect maternal life or health in any way. If life or health is threatened all trained obstetricians and maternal-fetal medicine physicians can and would simply deliver the baby and place the baby in a neonatal intensive care unit. It happens every day, many times, all over the United States .

3) Sometimes before 23-24 weeks (rarely) a pregnancy has to be delivered because the mother’s life is clearly in danger. In this case, the labor can be induced, the baby delivered and the baby will not survive because of the early gestational age, but this can be done without intent of killing the baby.

4) The only reason abortions were done by Dr. Tiller was because the mother did not want a LIVING baby born. He induced their labor and delivered the baby, almost always killing the baby first, before inducing the labor, to achieve the real purpose for which woman came to him: they did not want to deliver a living baby.

5) If a mother’s life or health was really at risk from her pregnancy it would at least border on malpractice, if not be frank malpractice, for a family practice doctor without any special training in high risk obstetrics to induce the labor in such a woman in the outpatient setting. This alone should make it clear to anyone familiar with medical practice that none of the abortions he did were MEDICALLY necessary, at least not with the need to kill the baby before delivery.

You won’t find any “authoritative” voice that will say exactly what you are looking for. It would be like looking for an authoritative source that says if you jump out of an airplane and want to survive you need a parachute. In other words, it is so obvious, and there is no other way it is normally done, that you don’t need an authoritative source to state this in so many words. Any one in medicine who works in obstetrics would have to admit this.

On the other hand, every single text book on obstetrics or maternal-fetal medicine can be scoured and you will not find any description stating that killing a fetus before delivery is necessary to save the life or health of the mother, in any circumstance. This should be evidence enough. . ...

Nathan Hoeldtke, MD for the Pro-Life Maternal-Fetal Medicine Group.


Dr. Hoeldke's credentials:

Dr. Hoeldtke is a physician with Mid-South Perinatal Associates who specializes in caring for women with a high-risk pregnancy.

He received his fellowship training in Maternal-Fetal Medicine and completed residency training in obstetrics and gynecology at Madigan Army Medical Center in Washington.

He received his medical degree from the University of Washington School of Medicine and a bachelor’s degree from Seattle Pacific University.

Most recently, he held the position of Medical Director, Maternal-Fetal Medicine, Department of Obstetrics and Gynecology at Tripler Army Medical Center, Honolulu, Hawaii.

He is a fellow of the American College of Obstetricians and Gynecologists and a member of the Society for Maternal-Fetal Medicine.

Dr. Hoeldtke has published numerous articles and abstracts relating to the field of Maternal-Fetal Medicine.


You can search Dr. Hoeldke's mentions in the American Journal of Obstetrics and Gynecology compared with Dr. Tiller's.

Dr. Hoeldtke's Tennessee physician profile. Hawaii doesn't give as much information.

ADDENDUM: Kathy also graciously provided this link to the Kansas health department's abortion report. If you scroll down on the 2008 report, for example, you'll find 192 of these abortions after 22 weeks were done on fetuses the doctor (presumably Tiller, since he was the guy who did them) determined were viable, compared to 131 in which he said they weren't viable. If you look at how it was determined that the fetus was not viable, Tiller always just checked ""It is the professional judgment of the attending physician that there is a reasonable probability that this pregnancy is not viable." A reasonable probability. In not a single case did he check "Ultrasound - Extreme immaturity of heart and lungs". In not a single case did he check "Hypoplastic Left Heart, Chromosome abnormality". In not a single case did he check "0 Apgar score; mother had severe oligohydramnios; fetus had poly/multicystic kidney disease". In not a single case did he check "Diagnosis by genetic specialist with no amniotic fluid and other abnormalities". In not a single case did he check "Extreme Immaturity of Organs". In not a single case did he check "Anencephaly". In not a single case did he check "Hypoplastic L Heart determined by Level 2 ULS and perinatology consultation". In not a single case did he check "Trisomy 22 Hydrocephaly". NOT ONE TIME IN 2008 did Tiller even determine that there was anything specific wrong with one of the third-trimester babies he aborted that gave him any reason to believe the baby had no chance of survival. He just generically checked off that in his "professional judgment" there was "a reasonable probability that the pregnancy is not viable".

That needs to be said again: The vast majority of third-trimester fetuses are viable. Tiller did not check at ANY time in 2008 that there was a SPECIFIC DIAGNOSIS that led him to believe that ANY fetus he was aborting wasn't viable. And in 192 of 323 third trimester abortions (59% - over half) he flat out admitted flat out that he knew the fetus was perfectly viable.

It's as if he flipped a coin to decide if he'd check the box for "fetus viable" versus "fetus not viable". When he checked "not viable", he never, never once, gave a specific reason that a baby of viable gestational age was, in his "professional judgment", not actually viable.

What about 2007? He thought 6 fetuses were too young to be viable. For the remaining 119, he gave no reason for thinking they weren't viable. And not a single "life of the mother" abortion.

In 2006, six too young, the remaining 141, he gave no specific reason to think they weren't viable. Not a single "life of the mother" abortion.

I need to leave for work now. I will definitely revisit this later.

19 comments:

Kathy said...

GG -- if you want to check all of them, go ahead; but I already checked the data summaries, and NOT ONE SINGLE ABORTION after 22 weeks from 1998-2008 was done "to save the mother's life." Not one.

Osumashi Kinyobe said...

Who the hell gave this man power of life and death over people? It seems to me he never used whatever ability he had to save others. This is beyond appalling.

GrannyGrump said...

But I'm also looking at the fact that NOT ONCE did he note any specific diagnosis when he was claiming a fetus was "not viable". Like I said, it looks like he just flipped a coin.

Tlaloc said...

So one admittedly prolife (i.e. biased) doctor claims there's no medical reason and the board disagrees with him.

Why now do you expect the former to outweigh the latter?

Oh, because you want it to. Right.

GrannyGrump said...

Tlaloc, Tiller is ONE DOCTOR who claimed that the best treatment for a woman suffering a life threatening complication in the third trimester of pregnancy is to kill the fetus and keep the mother in a motel room for three days.

EVERY OTHER DOCTOR ON EARTH would say, "Fucking nutcase. But sadly, it's legal to do that so we can't really stop him."

But you, who worship at the altar of the Great and Infallible Tiller, keep insisting that because he did it, there MUST have been a compelling medical reason.

GrannyGrump said...

Let me correct that -- EVERY DOCTOR WHO COULD GET REAL WORK.

LeRoy Carhart was working out of a disused muffler shop. He'd have had no work at all if Tiller hadn't given him a job. Kristen Neuhaus got her mill shut down because she was even worse than Tiller. Who the hell knows what was wrong with Shelley Sella. THREE WASHOUTS agreed with Tiller that yeah, it makes perfect sense to add sepsis risk to whatever other health problems the woman is having, then keep her in a motel room with her mom.

You defending Tiller is on a par with defending a mechanic who uses Wesson instead of motor oil. It's not ILLEGAL. And nowhere will you find a book that says, "Do NOT putt Wesson in the car instead of motor oil". So it MUST be perfectly okay to use Wesson instead of motor oil, right? It MUST be the best thing to do for cars, right?

Tlaloc said...

"Tlaloc, Tiller is ONE DOCTOR who claimed that the best treatment for a woman suffering a life threatening complication in the third trimester of pregnancy is to kill the fetus and keep the mother in a motel room for three days."

Tiller was one doctor but and I can't believe you are making me post this again and again- the Kansas board of healing arts (i.e. a bunch of doctors) found no wrong doing. So that's a bunch of doctors who agreed with the practice or at a minimum found the practice not to violate the ethical rules of the profession.



"But you, who worship at the altar of the Great and Infallible Tiller, keep insisting that because he did it, there MUST have been a compelling medical reason."

You;re being irrational and insulting. I've said no such thing. I don't have the medical expertise to know. Neither do you. But I'll listen to the conclusion of the review board, and you won't. You have to go out and find one doctor who agrees with you and then trumpet his biased opinion as if it outweighed everyone else's.



"You defending Tiller is on a par with defending a mechanic who uses Wesson instead of motor oil. It's not ILLEGAL. And nowhere will you find a book that says, "Do NOT putt Wesson in the car instead of motor oil". So it MUST be perfectly okay to use Wesson instead of motor oil, right? It MUST be the best thing to do for cars, right?"

If they were taken to court and the jury found that it was fine, and he was also taken before some state board of mechanics and they gave him the thumbs up- yeah I probably would consider whether they had a point. There's some benefit in listening to people who actually know the matter, Christina.

Really, there is.

Kathy said...

Y'know, Tlaloc, the funny thing is, you say that being "admittedly prolife" means "obvious bias"... but you seem to believe that someone being "admittedly pro-abortion/choice" is NOT biased. Hmm. So, then, it comes down to a philosophical or political reason, not a medical one.

Tlaloc said...

"Y'know, Tlaloc, the funny thing is, you say that being "admittedly prolife" means "obvious bias"... but you seem to believe that someone being "admittedly pro-abortion/choice" is NOT biased."

And where did I ever say that? Take your time, it'll be pretty hard to find.

Look, if I was quoting the head of Planned Parenthood then that's analogous to the source Christina uses here- an obvious partisan. Notice i do no such thing. I'm happy to rely on the jury, grand jury, and review board that all exonerated Tiller.

Now is it guaranteed that any or all of those groups is impartial? No, but what are the odds that all three are biased and biased the same way? More to the point can you demonstrate bias on the part of any or all of them? Christina admits her source's bias, and its obvious. if you have evidence the courts and review board were baised by all means present it.

But you don't have any such evidence. You just assume it must be so because you're so sure of your own judgment in the matter.

It's a witchtrial. You know the "truth" despite the evidence and nothing can dissuade you from issuing a guilty verdict precisely because you have no respect for the process of determining truth. You just want this to be true so it must be true. That you steamroller all common sense in the process is, well, "collatoral damage."

SegaMon said...

Christina doesn't go down the normal path to find truth? *ahem* "Kathy also graciously provided this link to the Kansas health department's abortion report." The Kansas Health Department!!!

...anyways...

Tlaloc said...

"Christina doesn't go down the normal path to find truth? *ahem* "Kathy also graciously provided this link to the Kansas health department's abortion report." The Kansas Health Department!!!"

The links are good. The problem is they don't say what Kathy/Christina think they say. This is why bias is a problem. You look at the evidence and see it through your ideological filter because that filter is so strong it colors *everything*. Kathy and Christina looked at Tiller's paperwork and Christina leaps to the assumption that it proves Tiller's guilt in aborting health fetuses. At the same time Kathy more correctly realizes that the best explanation is that the paperwork has been filled out generically with no regard to the actual case but she still somehow manages to convince herself that THAT shows Tiller was guilty of aborting healthy fetuses from healthy mothers.

Two opposite interpretations leading to the same conclusion? Obviously at least one of them is faulty (as it turns out both are probably faulty and there's nothing that can be gleaned from the paperwork except that the murdered man didn't bother to fill it out with any specificity at all).

SegaMon said...

I do have a question regarding the report. In a section titled "reasons for determination of fetus viability" why would it mention fetal abnormalities? To me, actually, it's pretty vague.

One thing that I can gleam from this is that the documentation shows that late-term abortions were done on normally developing fetuses.

I would also like to know how a "patient would suffer substantial and irreversible impairment of a major bodily function" so that abortion was the only alternative.

Note how there were 0 abortions to save a patient's life.

Interesting stuff, for sure.

SegaMon said...

I'm tired. lol. I think I answered my own question. Fetal abnormalities effect fetal ability to live outside of the womb. Dur! Time for sleep! Much needed, too. :)

GrannyGrump said...

Yeah, Sega, the way he flat out failed to answer open ended questions -- MOST OF THE TIME.

I'm wondering if other doctors did the 15 abortions where there was a reported reason for thinking the fetus wasn't viable, or if of all the abortions Tiller did, he had only 15 actual diagnoses of lethal anomalies.

I'm suspecting that the remainder were Down syndrome, cystic fibrosis, club foot, cleft palate, nonlethal dwarfism, etc. - conditions where Tiller thought the baby's life wasn't worth living, where it wouldn't have what he considered "a real life" so in his "professional judgment" they were "not viable".

Kathy said...

Being a "birth junkie" I see things about rare conditions with some regularity. As Christina has pointed out repeatedly (with links to Be Not Afraid and other similar websites in the sidebar), many women diagnosed prenatally with a baby with lethal defects are urged and encouraged to get an abortion. Even when they decline, they are offered an abortion every doctor's visit with an attempt at coercion into it. There may be diagnoses that are 1 in a million so are not widely known; others may be more common.

If you want a look at some of the conditions click here to see the CDC's query of linked infant birth-death records, which don't account abortions, miscarriages or stillbirths -- only live births with subsequent deaths. Many rare disorders have a near-100% neonatal mortality rate [first 7 or 28 days, depending on the definition], including genetic disorders like Trisomy 13 & 18, and developmental disorders like anencephaly. Of course, as Baby Faith proved, they are not always 100% fatal in the first few days, but some doctors will consider such cases as non-viable. Using the query, you would make it as broad as possible, with "group results by" the field "cause of death".

Tlaloc,

Let me quote what I said which you also quoted:

"Y'know, Tlaloc, the funny thing is, you say that being "admittedly prolife" means "obvious bias"... but you seem to believe that someone being "admittedly pro-abortion/choice" is NOT biased."

And you responded, "And where did I ever say that? Take your time, it'll be pretty hard to find."

Read, please; read. I said you seem to believe; because I've pointed out the possible or actual pro-abortion bias of several of the sources you cite, but you seem to believe that they are not and cannot be biased.

I seem to have lost another message in cyberspace, and will try to resurrect it, but will say in the meantime that the jury, the grand jury and the board did not exonerate Tiller in the way you imply. They did not look at the medical necessity of any abortion he performed. What they did was say, "He complied with the letter of the law, in that he got a signature from a second doctor." We have a serious problem with the rubber-stamping second doctor -- and even the grand jury said that Tiller's abortions went against the clear reading of the law, but they thought their hands were tied based on the Kansas Supreme Court's requirement for "maternal health" (which was stretched around the galaxy and back to include finances and "I don't wanna baby right now"). You can click here to read an alternative viewpoint on that point.

As far as the paperwork -- if Tiller were aborting healthy fetuses from healthy mothers, he would not admit to it. It's obvious that that would be criminally stupid to convict oneself in that way. So, we can't rely on Tiller for self-incriminating evidence. Yet, the only evidence about the abortions was what he did himself -- the fetuses themselves were incinerated, and no records were kept of things like sonograms that might have proven things one way or another. If Tiller had an actual case that was less on the line and actually went into some more credible medical reason for an abortion, it seems like he would have corrected the paperwork to show the truth -- unless the truth incriminated him. If Tiller actually thought he was saving a woman's life, it seems likely that he would have indicated that, because it would have been far more medically justifiable to kill a baby to save a woman's life than to kill a baby to preserve her "mental health" from not wanting a baby at 30 weeks gestation. Maybe not -- he could have been sloppy as well as stupid; but it seems the smart thing to do to make any legal cases as compelling as possible.

Tlaloc said...

"Read, please; read. I said you seem to believe; because I've pointed out the possible or actual pro-abortion bias of several of the sources you cite, but you seem to believe that they are not and cannot be biased."

I just find it odd you are able to discern these beliefs of mine when I have said nothing of the kind and have explicitly said the opposite. You're telepathy is strong.


"I seem to have lost another message in cyberspace, and will try to resurrect it, but will say in the meantime that the jury, the grand jury and the board did not exonerate Tiller in the way you imply. They did not look at the medical necessity of any abortion he performed. What they did was say, "He complied with the letter of the law, in that he got a signature from a second doctor." We have a serious problem with the rubber-stamping second doctor -- and even the grand jury said that Tiller's abortions went against the clear reading of the law, but they thought their hands were tied based on the Kansas Supreme Court's requirement for "maternal health" (which was stretched around the galaxy and back to include finances and "I don't wanna baby right now")."

I have trouble accepting that interpretation given how easy it is to get an indictment. The inability to get one is generally taken to mean that the case was laughably bad.



"As far as the paperwork -- if Tiller were aborting healthy fetuses from healthy mothers, he would not admit to it. It's obvious that that would be criminally stupid to convict oneself in that way. So, we can't rely on Tiller for self-incriminating evidence."

I agree, and yet that was the entire argument from Christina.

SegaMon said...

Tlaloc: "The inability to get one is generally taken to mean that the case was laughably bad."

How so?

Tlaloc said...

"How so?"

It's pretty easy to get an indictment. MUCH much easier than a conviction.

In a grand jury hearing the defendant doesn't have a lawyer. They often cannot introduce any evidence in their own defense. The whole point of a grand jury is to see if the prosecutor *unopposed* can establish that there's enough of a case to warrant a trial. Lastly a grand jury usually does not operate under a "beyond a resonable doubt" standard that you have in a real trial.

"Sol Wachtler, the former Chief Judge of New York State, jokingly observed that a prosecutor could persuade a grand jury to "indict a ham sandwich.""

In other words in a grand jury the prosecutor has EVERY advantage. If they still fail to get an indictment then the case was really bad.

SegaMon said...

Thanks for your interpretation, Tlaloc. :)