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Doctors weigh in

On Michael Nugent’s post about Savita, a midwife named Clare insisted that an abortion wouldn’t have saved Savita’s life.

This case is very clearly nothing to do with abortion. Pro “choicers” have simply seized upon it and dishonestly pretended that abortion would have saved her life. This scenario is not unusual in obstetrics and whether she aborted or not, what she needed was close monitoring and  timely, effective prophylactic antibiotics. There are a number of similar cases of women who have also died of septicaemia following legal abortion.  Had this unfortunate woman aborted, precisely the same risks of infection would have remained.

And

The miscarriage didn’t kill Savita, septicaemia did. Septicaemia is also a major risk following abortion. Abortion does not stop people dying of septicaemia.

As to your descibing Savita as being ” in the middle of a long miscarriage” the likelihood is that she was in the middle of a *threatened” miscarriage. Obstetric terminology does not refer to a pregnancy as a miscarriage until fetal demise. Until that point miscarriage is *threatened*. Under ordinary circumstances a woman with a threatened miscarriage is given appropriate care and monitoring in order to prevent such needless death. Here in the UK where abortion is perfectly legal, women with ruptured membranes and threatened misc are not offered abortion in case they might develop septicaemia and die. That would be absurd.

She got her head handed to her, along with an even clearer picture of what happened to Savita.

From EL -

As a medical person, you should know the difference between premature rupture of membranes in a viable fetus, and in a 17 wk pregnancy. Finally,  you know, or should know if you are a midwife as you claim, that an open cervix and leaking amniotic fluid is a risk for amnionitis, and the longer the duration, the more increased risk. Remember the old saying “never let the sun set twice on a laboring woman”? Since there was no chance of viability, antibiotics along with evacuation of the uterus was the correct treatment. Especially for someone in severe pain.

From Dr Kitty -

Clare, she had PPROM at 17 weeks with cervical dilation. BY DEFINITION this pregnancy was not viable. Even if the cervix was not dilated, second trimester ROM leads to fatal lung hypoplasia. Even if there was no ROM an open cervix will not close. It was an incomplete miscarriage.

Whether FH was present or not is IRRELEVANT, the treatment of a second trimester incomplete miscarriage is to evacuate the uterus ASAP to reduce the risk of bleeding and infection. The longer the cervix is dilated with ROM the higher the risk of chorioamnionitis developing and the greater the chance of sepsis. She was septic well before ERPOC was even performed, so it was too little, too late by then.

The treatment of chorioamnionitis requires prompt removal of the infected tissue, i.e. the membranes and placenta. IV antibiotics alone do not cut it.

She requested the pregnancy be ended. Her life was at greater risk the longer she remained pregnant.

If she had had a D&E or medically induced miscarriage the day the pregnancy was found to be non viable there is EVERY chance she would still be alive.

And a followup -

Clare you’re a MW, so your field is normal, uncomplicated, birth. I assume you’re quite good at that.

Your knowledge of pregnancy complications is not as good, so I’ll help a little.

A threatened miscarriage is when there is bleeding in the fist trimester without cervical dilation. Bleeding in the second or third trimester without cervical dilation is a placental abruption. When the cervix is dilated it is an inevitable miscarriage. When there is a significant ROM before 24 weeks there usually isn’t sufficient amniotic fluid to allow foetal lung development, leading to lung hypoplasia and death.

Women with second trimester ROM in the UK are absolutely offered TOP, because the pregnancy is considered non viable and the risk of developing chorioamnionitis is high.

Women with second trimester cervical dilation and prolonged very preterm labour ARE offered TOP, because the cervix is not designed to stay open for days on end, the uterus is not designed to contract for days on end, they are in pain, and the pregnancy is going to end before viability regardless.

Do feel free to double check everything I’ve typed against your gynaecology textbook and the RCOG green tops.

Decisive, I think.

 

 

Comments

  1. Tony–Queer Duck Overlord of The Bronze– says

    How much do you want to bet she doubles down and continues thinking she’s right?

  2. laconicsax says

    As unreliable as my gut is, it tells me that “Clare” is neither a licensed midwife nor a woman called “Clare.” The tone of her comments is exactly what I’m used to seeing privileged Christian men say on the subject of pregnancy and abortion–the ignorance, the attempts to insist that intervention would have done nothing, etc.

    Her comments read as mansplaining and I’m willing to bet that it is.

  3. sgailebeairt says

    nah she sounds like Jill Stanek, i bet she’s a prolife woman and possibly one of the quiverful midwives of the sort that nearly killed Vicki Garrison at No longer Quivering….

  4. says

    Shit like this is what has me convinced that pro-life is the epitome of self-centered moralizing bullshit. Things like this happen, and yet they constantly get blanketed over by the so-called “good intentions” of magical individual pro-lifers who don’t support this crap in the least.

    Except for every pro-lifer I’ve encountered who gladly holds up their propaganda as fact and tries to dismiss the facts as propaganda.

    It’s sickening. And it gives cover to every single other denialist, that such a prominent and powerful movement is allowed to cover for deadly lies.

  5. Slappy says

    Kindly tell Dr. Kitty that a mother would disagree:

    I just recently lost a twin to chorio.. my water broke at 17 weeks.. they couldn’t determine why.. we held on until 25.6 weeks ( 9 weeks!!) I drank a ton of cranberry juice and was on strict bed rest.. the whole goal was to give the other baby a fighting chance.. but we still had hope.. i ended up delivering baby a( the one with the infection) at home and baby b in the hospital..shortly after baby a delivered i spiked a temp of 104.7 and they induced me to deliver the other baby. baby b is currently in the NICU at 3 months old and is doing great – his original due date is August 11 and he should be coming home next week. sadly we lost baby a 3 hours after his birth.. they said the infection was so bad and his lungs were so underdeveloped that he had no chance of survival. i have so many mixed emotions – we are so happy that one of them survived but so sad for the loss of the other..

  6. chrislawson says

    Slappy,

    I can cut you some slack because you are right in the middle of an emotional time that has some similarity to the case at hand, BUT… it is disappointing to see you repeat an error that was already addressed by Dr. Kitty and reposted by Ophelia above.

    Here are the differences between your situations:

    1. You had PROM at 17 weeks. Savita had PROM at 17 weeks with an open cervix and a developing septicaemia.

    2. You developed a high fever after the delivery. Savita developed septicaemia long before the delivery.

    3. One of your foetuses had a small but not negligible chance of survival. Under the circumstances described, Savita’s foetus had zero chance of survival.

    4. You were never at serious risk of dying. The only serious risk, the post-partum infection, occurred when the pregnancy was already over, thus making it easier to treat and past the point where the foetus’s welfare was in possible conflict with your welfare. Savita had a huge risk of dying as soon as the doctors decided that keeping her pregnancy going as long as possible was the highest priority.

    5. Regardless of the actual probabilities…and this is the single most important difference here…you CHOSE to take your risks with the support of your medical team, while Savita was FORCED to take her risk against her will, and that of her husband.

  7. billyeager says

    Why does religion encourage such dishonesty?

    +1

    We atheists are persistently painted as being void of morals and that we are nothing more than psychopathic-murderers-in-waiting (after all, if you don’t believe in God, what stops you from slaughtering everybody you meet, amirite?), yet theist argument has, as its very foundation, intellectual dishonesty.

    It is this dishonesty which insidiously pervades *every* facet of theism, from personal perspectives to groupthink policies.

    Perhaps this very question about the prevalence of dishonesty in theism needs more of a focus than it currently gets. “Oh but we’re always telling theists they are being intellectually dishonest”, you might say, however, we rarely challenge them in public debate to provide for an explanation as to *why* they are dishonest.

    It would be incredibly easy to present a litany of examples where theist dishonesty is apparent (the apologists in this tragic case being merely raindrops in a monsoon of lies) and would make for interesting listening as to how an intellectual theologian (oxymoron much?) might attempt to weasel their way around the issue.

    I propose that the question be posed exactly as written, “Why does religion encourage such dishonesty?”

    In fact, I suggest this question be asked repeatedly, in debate and elsewhere, from classrooms to auditoriums, it demands an answer. An honest answer.

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