"an abortion saved my life."

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I'm glad you keep the caveat in there. However, the accounting could be technically true and still grossly incomplete.

In a later post, the author states that she was in premature labor when she arrived at the hospital, and the ultrasound showed that her amniotic sac had lost its fluid. In this case, she may have been losing more fluid from amniotic leakage than from bleeding from the placental abruption, and putting her on an IV might have been a perfectly reasonable course of action. There's no reason to believe that her doctor was doing "nothing", for either her or the fetus.


She certainly suffered from a spontaneous abortion. It isn't stated what procedure was actually done. In sufficiently severe cases of placental abruption, a hysterectomy may be required; however, I suspect the severity of the situation may have been exaggerated in the article.

The way I view things, this woman would have died, leaving her other children without a mother if the abortion didn't happen. I'm pro-choice, especially if a mother has to choose between a pregnancy that will kill her and the fetus, or her children who were born before that pregnancy happened. As George Carlin once said, most pregnancies end before the woman realizes she's pregnant, and that " anti abortion people could say that any woman who has had more than one period is a serial killer."

There has been an anti-woman politician who wanted to make a state law that would require anyone who had a miscarriage to be criminally investigated to see if she did anything to cause it. That to me is sickening as most miscarriages happen because there was something physically wrong with the fetus, and it would have died anyway.

well, the responses of a couple of posters on this thread at least tell us how and why this could have occurred, assuming that those same attitudes show up in HCPs sometimes.
http://www.npr.org/templates/story/stor ... Id=7500743
http://www.marchofdimes.com/baby/premature_indepth.html
http://www.ncbi.nlm.nih.gov/pubmed/3838111

Ok... you make points. As I said, I don't work in L&D, but I'm fairly good on policy and procedure (I'm a very "by the book" sort of person). The fact that she was losing amnio fluid would make the fetus' situation that much more grave. She did state that she took, at least, 3 units of blood just to get through surgery. Hanging an IV bag would certainly help in this situation, but it's not going to fix it. And, she did state she can no longer have children, so perhaps they did have to do a hysterectomy.

7 years in the ER have taught me a few things. 1) For every beer a patient admits to, multiply by 3... and 2) Pt's exaggerate, if not out right lie. She could very well be exaggerating, or lying, but, 3) Doctors can be arrogant, self-righteous bastards.

The only thing we have to go on here is her accounting of the event. There are millions of maybes and what-if's that could possibly explain the situation, but we can't really evaluate those because the possibilities can be as endless or ridiculous as we want to make them. We have to assume that what the woman claims is true because we have no reason not to

If the doctor was hoping that hydration alone would help this woman, he should have told her so. Patients have a right to make informed decisions. They have a right to know what courses of treatment are available to them and what the realistic expectation is of each course. IF this is a true account, it doesn't seem that she was kept apprised of the physician's intentions or made aware of any real options (unless she was incoherent to comprehend or remember, which too would indicate she should have been transfused) . For godsake, they (apparently) didn't even give her pain meds.

I work in a clinical lab, and on a patient that's suspected of bleeding we're generally doing H&Hs every half hour, sometimes more frequently than that. The medical staff should have known exactly how badly she was bleeding, and if they didn't it was their own fault for not ordering the labs.

It is important, when talking about embryology and obstetrics, to make sure we are all talking about the same measurement. Embryonic age and gestational age are two different measures, which are generally about two weeks different.

OB/GYNs will almost always refer to an fetus' gestational age which is asumed to be the interval that has elaspsed since the first day of the mother's last menstrual period (LMP), making the assumption that conception occurred 14 days days later. This assumption will later be updated if more accurate information is available. Where the date of conception is known (in in vitro fertilization, for example) then gestational age is retrodated to 14 days prior to conception.

In a case like this, where subsequent hemorrhage has taken place, an estimate of the gestational age can be made, and then the date of the LMP established.

The cases that you refer to are likely citing the estimated embryonic age, which is misleading--because it is not consistent with standard obstetrical practice. The viability limit is expressed in gestational age, is is still below the cases that you cite, which both have gestational ages over 21 weeks.

The record for the most premature baby to survive is James Elgin Gill, who was born 128 days prematurely (21 weeks, 5 days gestational age).

The human body isn't a machine - you can't just push a button and have a baby pop out. It would still take hours.

And besides, in this particular case, the mother was bleeding out. You really think making her blood gushing uterus contract would have HELPED her and her by-then oxygen starved fetus?

Induction was not the answer here.



Nice to see you know what all of the medical community doesn't - how to make a 20 week fetus viable. Perhaps you should share your mystical medical knowledge so that more babies can survive - apparently state-of-the-art technology hasn't caught up with your advances.

As for the risk to the mother... My husband was a premie, and he and his mother almost died during delivery. Which was induced. And he weighed about 4.5 lbs. The odds of health complications are very much a dice roll, and depend on much more than the gestational age and size of the fetus.

Not that you'll listen to any of this. Because only people who don't think they know everything are willing to listen to others.

Oh, and as for the home birth "song and dance" - nice to see you take the types of complications that women and their babies can face during delivery so seriously. I expected nothing less of you.

ruveyn has never said any such thing that I can remember. He acknowledges that newborns are essentially fetuses outside of the womb, but that at that point, under the law, they are considered people and cannot be killed. Since both babies and handicapped people are out of the womb, and thus persons under the law, killing them would be illegal.

I forgot the part about not being able to have children; that does make a hysterectomy likely. That would also help explain why she had to be moved to a different department at the hospital, and why it took a while to get the right surgical specialist.

The fact that she required blood to get through surgery does not mean she needed it before they even had permission to do the surgery. For example, anemia that would not normally indicate a blood transfusion can be cause for a blood transfusion before surgery, including before a hysterectomy, and anemia is very common in pregnancy.

I certainly agree that doctors are often arrogant, and would agree that they often fail to keep the patient informed, except when they need the patient to agree to something, like a surgical procedure - and even then I've had forms shoved at me with a "sign this", and had to ask for time to read them first. And that may well apply to this specific case: for example, the author of the article described the blood as "gushing" out initially, but she drove herself to the hospital, which doesn't seem very likely with blood gushing out of her. More likely, the initial "gush" was her water breaking, and the fluid was mostly amniotic fluid, but red enough with some amount of blood for her to think it was mainly blood. The doctor may well have asked enough questions to realize what had happened, but not explained it to her, so she still though it was mainly blood loss when he realized it was not.

And while doctors are very often arrogant, they are not that often incompetent.


I think that's like assuming that the patient has had only one beer when that's what he tells you, when you know he's likely had three, in your example. There are lots of signs that indicate that this article is intended to inflame emotions to support a specific viewpoint. I think it's better in cases like this to reserve judgement as to whether it's true until one has heard the other side of the story if one can't tell for sure.

In this particular case, we actually know that the author is giving a false impression in at least one respect: she wants us to think it was a medical abortion, when we can tell it was actually a miscarriage. That to me is strong reason to be skeptical of the rest of the article as well.


I doubt he thought it would be enough to save her in the long run. I do suspect he thought it was enough to stabilize her until some form of surgery, and he was correct about that. I do agree that he should have explained and probably did not, but to be honest that's par for the course.


This brings up the issue of maternity ward versus emergency room. In the maternity ward, the default "pain meds" are epidurals. This might not be something the anesthesiologist would want in the body when preparing for, say, a hysterectormy. Of course, an epidural might not necessarily be what this patient had in mind, but in the communication daisy chain of patient to nurse to doctor and back, the details might well be lost.

Other differences: when a patient comes into the maternity ward under her own power, rather than into the ER in an ambulance after calling 911, the assumptions about implied consent are different. Anything beyond a routine delivery, and you're going to want explicit consent. People do not walk into the maternity ward expecting to walk out minus a baby, much less minus a uterus.

Good point on the pain meds. I do know, however, that painkillers other than epidurals are available (at least here in Canada). A friend of mine didn't want an epidural, and the labour was taking a really long time, so she had something else... I don't remember what it was, though.

Regarding the implied consent in the maternity ward - okay, but only up to a point. If anyone is losing more and more blood, then it is clearly a dire situation. This makes it anything but a routine delivery - and if life threatening, I can't see how a signed consent would be a requirement (but I don't work in the field).

Pregnant points topic

I did read every post, and some posts were really postal.

The point of the OP's article was that in this case an abortion saved the woman's life. She had two children who needed here. glad they still have a mom.

In my family tree there are at least three women (direct ancestors) who had died ( a century ago) due to the complications mentioned in the OP's article. Obviously I am descended from the surviving children (not the fetuses involved), who became motherless.

My point is that pregnancy is not without risk, and medical care has improved over the years, thankfully, and it is hoped silly beliefs that endanger the mother's or woman's life must be cast aside for the sake of life of these patients.

as an example of language use that "the mother's or woman's" is intriguing.

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question:

who and what and how determines that a belief is silly?

I think one of B.O.M.'s post best exemplified that where one or more doctors had apparently refused to abort even a dead fetus. But even then, "silly" is not really the issue ... and I suspect that is your point.

That makes no sense to me. In the absence of a fetal heartbeat, the tissue is dead, and should be excised. Waiting for spontaneous miscarriage is needlessly cruel, and places the life at the mother at risk. I am an advocate of the principle that medicine is both art and science, but waiting for a miraculous recovery of a deceased fetus has no place in obstetrical practice.

I think everyone here agrees.

QFT. getting the on-call surgeons up in the middle of night is some feat; they can be very inventive when it comes to making things 'medical'

I don't work in obsgynae, but I found this on pub med:


That sounds pretty much like what I've heard in the past.. It doesn't mean that the child will necessarily live once delivered ( at 20 weeks, it won't) so without further details, I wonder if that could be the 'abortion' that the author is referring to?

Or, as others have pointed out, since the author states the fetus died in utero before the surgery, it could have been a miscarriage and the medical procedure she underwent was simply to evacuate the contents and stop her bleeding.

(btw, the cousin at the end... wtf!?)