Thursday, April 02, 2009

Which is safer for the mother?

Imagine the scenario. Your loved one, six months or more into pregnancy, is suffering from a medical condition that might impair her for life, or even kill her, unless the pregnancy is terminated as soon as possible. Which scenario seems safer?

Option AOption B
Patient is treated in the nearest appropriately-equipped facilityPatient must travel, perhaps a considerable distance, using the ordinary transportation method of her choice, such as car or plane, accompanied by the companion of her choice
Patient in a fully-equipped hospitalPatient in a motel room
Patient attended 24/7 by trained medical professionalsPatient attended by the companion of her choice
No invasive procedures other than those necessary to facilitate ending the pregnancyInvasive procedure to kill fetus prior to induction of labor, plus any other procedures as necessary to facilitate ending the pregnancy
Fetus is aliveFetus is dead and in the process of decomposition
Equipment on site to contend with any emergencyPatient must be transported by ambulance to care facility in case of emergency
Pregnancy terminated within hoursPregnancy terminated over a period of three days

If you chose Option B, you might be a member of the Tiller jury.


Lilliput said...

Christina, I've just read the comments on the link from the other Tiller post you did where you and Kathy are arguing with the Tlaloc on some hypothetical case of medical emergency requiring a very late term abortion. I have no doubt in my mind that almost all of these late term abortions have nothing to do with health whatsoever. If you look at those statistics you can see that 71% of women have late abortions because they didn't know they were pregnant? - I don't even know how that happens? or 48% said that they had trouble getting earlier abortions - again we need to look at that - as these women had enough time to change their mind about having an abortion - so maybe we need to help them do it earlier?

Basically I believe Tiller got off free because the jurors believe in choice - no matter how many weeks prenant.

We have to look at why women are wanting abortions so late in pregnancy when they have had so much time to bond with their babies - or why some don't even know their bodies well enough to know when someone is sharing it with them.

Thats the issue here - not a man providing a service that people obviously want.

Christina Dunigan said...

I'd not even say people obviously "want" the "service". A lot of people, in a time of stress and demoralization, will pursue an unwise course of action that they'll later regret in spades. If a patient, stressed out over work comes to a doctor wanting heroin, should the doctor help him get the heroin? Or should the doctor refer the person to what will really help him in the long run -- mental health treatment to deal with the stress?

Part of what we're supposedly paying doctors for is their clinical judgment based on not only their own experience but the experiences of other doctors with their patients.

I "knew" I wanted oral surgery to correct my undersized lower jaw. I "knew" it for ten years. And I was annoyed as hell when the oral surgeon wouldn't just do the job. He insisted on a prolonged informed consent process -- giving me information that I hadn't known or hadn't given sufficient thought to, along with time to think about it and discuss it with friends and family. In the end, I not only rejected the oral surgery, but was very pleased with the doctor that he was wise and conscientious enough to make sure we were not proceeding unless I REALLY knew what I'd be getting into.

Tiller's not doing that. The patient calls, they set up the appointment, he gets a form letter from another doctor who has agreed to sign them, and they go ahead. If it's irresponsible to simply allow a patient to self refer for other surgery because they think it will help them, isn't it equally irresponsible to simply go ahead with something as irreversible ad traumatic as a late abortion without equal effort going into making sure that this is really, really the best option for this patient?

Lilliput said...

Christina, these women obviously don't have the luxury of a long drawn out process of informed consent - and you can see that there is a significant amount of women who do end up having late term abortions because they were taking their time to decide - so I'm not so sure if it will help.

Also, if the woman has noone else she can turn and talk to at such a late stage of pregnancy that she is showing - I'm wondering how much support she will have a round when she does have the baby.

Do you think Tiller should send them to a therapist or adoption agency first - can you force someone to have therapy or listen to a spiel on adoption?

I'm trying to understand what you want to do to stop these women aborting.

Kathy said...


In regards to women "not knowing they were pregnant" -- I'd have to agree with a lot of what you've said; but I know one woman personally and have read and heard the stories of several others who likewise did not know they were pregnant until late in pregnancy. In the majority of the cases, the women had some sort of female trouble which led them to believe that they were infertile, or had been previously told they could not have children, or had very irregular periods, so going for months without a period was not unusual for them. That's not terribly common, of course, but it's not completely unusual, either. (The woman I know personally said that she didn't know she was pregnant until she felt the baby move; the doctor thought she was literally crazy, and just wanted a baby so badly that she was having fake pregnancy symptoms; she was 5 months along when she first found out she was pregnant.)

Also, some women have light spotting or bleeding early in their pregnancies, which they may mistake for a short or light period, so not realize that they are actually pregnant, or think that they are not as far along as they actually are.

Using hormonal birth control can mess up some women's cycles, so they may think they're just adjusting to the new pills or IUD when the real reason they're not having periods or having only light spotting is that they're pregnant.

These are all different reasons why a woman might not realize she's pregnant during early pregnancy. But I would still suspect that a lot of women are just plain ignorant, or perhaps too busy and/or stressed out to realize they've gone so long without a period. I think you gave the link on another comment to an article which talked about why smart and savvy young women who should know birth control backwards and forwards still mess it up. It began with a story of a young woman who had discontinued her birth control when she ended a relationship, but then had a one-night stand with an old friend and got pregnant. She missed three periods before she realized it! While I can't quite understand that, in other ways I do. Perhaps willful ignorance plays a role, too.

army_wife said...

Let us not forget that with Option A there is a good possibility that the baby will... LIVE! Although the baby may have to be delivered early, thus "terminating the pregnancy" as far as the mother's body is concerned, the baby could still receive livesaving care in the NICU and survive. There is no excuse whatsoever for late term abortion (although I would go farther and say there is no excuse for any abortion, period).

Christina Dunigan said...

Lilliput, the fact that their lives are a total train wreck should entitle them to MORE care and attention, not a quick dirty abortion and home to cope alone.

There were NO aftercare plans made for ANY of the Tiller patients whose files Dr. McHugh reviewed. So they're not getting attention and help beforehand, and they're not getting attention and help afterward. Tiller just snatches them at a moment wen they're vulnerable and makes a quick buck.

Wouldn't it be a better strategy to make MORE services available, rather than to simply turn our backs and leave them to an abortionist to whom they're just one more uterus?

Katie said...

The excuses they try to come up with to justify late term abortion are pathetic, and should be outright offensive to anyone capable of rational thought.

Lilliput said...

"Wouldn't it be a better strategy to make MORE services available, rather than to simply turn our backs and leave them to an abortionist to whom they're just one more uterus?"

Exactly - but I wonder who is responsible for paying for this. I am presuming that most of these late term abortion customers are women who have no medical insurance - but I could be wrong. Here in the UK you would go to a GP which is free, he would chat with you and refer you to where you could get help.

I guess these women don't have access to doctors so just scrape together the money for an abortion.

Christina Dunigan said...

It's $6,000 minimum for one of Tiller's third-tri abortions. Then there's the cost of the travel for herself and her companion, the hotel, meals, and the $300 to whoever he has rubber-stamping the abortions that week. All told, probably close to $7,000 cash. Women aren't going to Tiller because they're broke.

Kathy said...

Wow, the cost of each of my births, including all the prenatal visits with a midwife, a visit with the back-up doctor, etc., was between $3000-$4000. And I could pay in installments. And I know that lots of midwives in the US will work out deals and accept less and barter if a woman has trouble meeting her fee.

And I could be mistaken, but I think it's pretty much standard practice for an adopting couple to pay for all costs related to pregnancy and birth for the birth mother, so a woman who does not want the child and cannot afford to give birth can choose adoption and have her expenses covered.

Or she could just choose what a lot of women have chosen for philosophical or other reasons, and given birth without any paid professional around -- an unassisted birth, which can cost almost nothing (one woman said that her only cost in her unassisted childbirth was about $40 for just a few supplies like chux pads and something to tie off the umbilical cord). If she's so unconcerned about the life of her child (after all, she's contemplating an abortion to kill it!), then she shouldn't worry about fetal demise for any pregnancy, labor, or birth complication.

Lilliput said...

Then if thats the case - that these women have equal access to medical help in having, adopting or aborting their kids - and they still choose to abort - then we have to respect their choice don't we? What else can we do- force them to give birth? Would you then trust them with that baby - how many times have we heard mothers have children in toilets and leave them in the dustbin?

I have come across this lady called Sarah B Hrdy -

I'm going to try and get a copy of one of her books to read. She's an anthropologist who has researched a lot about infanticide.

Christina Dunigan said...

Lilliput, these third-tri abortions are done on babies that COULD be delivered live -- with less physical risk to the mother, I might add.

Is the right to abort about ending the pregnancy, or about ending the baby's life?