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Nov 27 2012

Exploding gifts from god

Dr Jen Gunter tells us about ectopic pregnancies and Catholic medical “ethics.”

A pregnancy has trophoblastic tissue, which is aggressive, like cancer, because the walls of the uterus are thick. The walls of the fallopian tube, on the other hand, are thin. Alert readers can tell where this is going.

These mini Ms. Pacman-like trophoblasts chew up the relatively flimsy fallopian tube tissue, damage blood vessels, and catastrophic bleeding ensues. The pregnancy can literally blow a hole in the side of the fallopian tube.

This is how women die from ectopic pregnancies, they bleed to death. Although thankfully this is very uncommon as we have ultrasounds that identifies these pregnancies very early on, surgery or medication to treat them, and blood transfusions just in case.

The recommended treatment for an ectopic pregnancy is surgical removal or systemic methotrexate (a cancer drug that kills the rapidly dividing trophoblasts, which are in many ways like cancer cells). According to the latest Cochrane review (Interventions for tubal ectopic pregnancy, 2009) there is insufficient data to support expectant management, i.e. watch and wait is not standard of care.

But the Catholic church doesn’t care what is standard of care. It cares about the sacred trophoblasts.

Yes, some Catholic ethicists argue that the catholic “Directives” preclude physicians at Catholic hospitals from managing ectopic pregnancies in a  way that involves direct action on the embryo. So a woman can have her whole tube removed (an unnecessary procedure that could reduce her future fertility), but she can not have the pregnancy plucked out (as is done with the standard therapy, a salpingostomy, where a small incision is made in the tube and the pregnancy removed) and she most certainly could not have the methotrexate.

How common is this practice? Well, it is pretty sad that someone had to study it. According to a study from 2011 by Foster e. al., (Womens Health Issues, 2011) some Catholic hospitals refuse to offer methotrexate (three in this study of 16 hospitals). The lack of methotrexate resulted in changes in therapy, transferring patients to other facilities, and even administering it surreptitiously. All of these expose women to unnecessary risks, expense and are, quite frankly, wrong.

I’m glad to hear it’s only 3 out of 16. I hope that number is representative. It ought, however to be zero. None.at.all.

It amazes me that with ectopic pregnancy, such a clear-cut case of life of the mother with therapies well supported in the literature, that any physician or hospital could have any other moral or ethical agenda than delivering the right medical care.

Putting religious beliefs ahead of urgent/emergent medical care in never right and I shudder to think how the management of ectopic pregnancies would change should a national personhood amendment pass.

It’s a stinking outrage, and I’m doing what I can to get it on the agenda of secular and atheist and humanist organizations.

 

 

 

 

3 comments

1 ping

  1. 1
    mouse

    I was not happy when I realized that my chosen hospital is part of a Catholic university. In fact, I tolerated the presence of an actual crucifix over my labor bed, because it was the closest option and my demanding job demanded it.

    But since I’ve been seeing all of these horrendous stories of women with unfortunate pregnancy mishaps – in the U.S., not some other place easily disregarded – I feel extreeeeeemely lucky.

    While I suspect that the Catholic hold on this particular hospital is tenuous, I don’t actually know. If I were planning to have another, I would go the extra distance on principle.

  2. 2
    F [i'm not here, i'm gone]

    I’m sure one could look up any women’s medical condition, and find Catholic hospitals committing ethical violations with respect to it, taking self-determination away from medically-captive women.

  3. 3
    iknklast

    Is it OK to say how much I hate the Catholic Church? I’ve hated them ever since their stupid anti-contraceptive ethics nearly killed my mother (not a Catholic) when I was ten. This is not to diss any of the perfectly nice Catholics I know, but to wonder how in the world they can close their eyes to their idiotic, dangerous church.

  1. 4
    nederland boot

    …Links…

    [...]Wow, awesome blog format! How long have you been blogging for?[...]…

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