Abortion

There are those who say abortion is illegal no matter what. There are those that say abortion is LEGAL no matter what. There are those that say abortion is illegal unless the mother’s life is at risk.


Please define that. Do I want a non-medical somebody defining that?


Do I want the government defining what is safe for a mother’s life and what is not?


The medical field does have some black and white lines. In fact, it has many. But it also has lots of grey ones.


What is abortion? It’s terminating a pregnancy.


I live and practice in a country where abortion is illegal. I also live in a country where NOTHING is illegal. Corruption is rampant. Are rules really rules?


Trust me. I have my religious convictions. But I also think that God created us to USE OUR BRAINS! The Devil has created sicknesses, diseases, and terrible parts of pregnancies that cause death to a mother. This is even more rampant in the developing world here.


I have seen my share of death. Believe me. Where over 15 moms die a year at my hospital, I have seen my share of death! Multitudes of developing fetuses die. Multitudes of newborns die (prematurity, vertical transmission of malaria, neonatal tetanus, sepsis from home deliveries, prolonged labor causing hypoxemia, etc). I’m not exaggerating. Multitudes.


I am NOT in favor of killing. The fetus or the mother. But whose life is more important? Can a dead mother support her developing fetus anyways?


I used to think… Wow! That’s a hard decision to make. I would let the family decide.


Well, guess what? Families don’t decide here. Women are used to having no rights. Really, NO rights! And the men never come to the hospital because they have no backbones and are afraid they will have to pay something if they show up. Or maybe they might have to give blood to save their hemorrhaging wife. Meanwhile they have 2 other wives at home.


So I decide.


I decide to let mom live. I FIGHT for mom to live. I SCREAM for mom to live. I GET ANGRY for mom to live. I PRAY for mom to live.


One of my moms on maternity right now came in a few days ago with generalized edema. She was probably only 16 or 17 years old and on her first pregnancy. She measured 33+5 weeks on the ultrasound. The baby measured just over 2 kg’s. She had severe preeclampsia with very elevated BP’s. Severe preeclampsia is very dangerous here. The treatment and road to recovery is delivery of the baby. (The only helpful lab work here for this are blood type, hemoglobin, and a urine dip stick…….No platelets, liver, or renal labs).


I explained to her 2 sisters and her that her pregnancy was making her very sick and could kill her if we didn’t deliver her baby sooner rather than later. I also explained that at over 2 kg, the baby had a high chance of living but was still premature. On the ultrasound the baby looked quite active, so didn’t appear unhealthy.


I gave her steroids for fetal lung maturity and induced her. It was her first baby, but still she delivered quite quickly with cytotec. She delivered in the night with one of my best nurses.


The baby died soon after the delivery. The nurse said she had a hard time pushing the head out, so maybe not enough oxygen during labor along with prematurity could be the cause of death.


Mom’s diastolics are still in the 130’s the day of her delivery. She’s still quite sick and at risk for death here in the bush of Africa. Preeclamptics die of pulmonary edema here. I’ve seen it many times when they come in late in the game and seizing. There’s no back up when mom’s lungs go south. There’s no ICU to send her off to. It’s best to prevent pulmonary edema by knowing the risks for developing it. If you get pulmonary edema with severe preeclampsia here, there’s lasix, but…then you either live or die. It’s not easy here.


So did I take one life to gain another?


Yes.


I don’t believe God is EVER happy with losing life. He CREATED life. He made us to love and hope for the best in things.


It’s easy to look at things in the rearview mirror and judge. Lets say if I would have waited another week to induce mom. Would baby have had a higher chance of living?


Maybe.


Would mom have had a higher chance of dying?


Definitely.


It’s never black and white in these difficult cases.


Next patient comes in and breaks her water at 12 weeks. The fetus is still living. She’s hemorrhaging. But her cervix is closed. Can I help the mother live? Or should I just sit by and watch her die? Can I do a life-saving surgery on her? It’s an abortion.


Or maybe she’s not hemorrhaging. Maybe she’ll just develop sepsis in a couple of weeks and die from that overwhelming infection. I’ve seen it all here because people come with extremely delayed care here. Should I wait and see? I make my choices to help mom live.


I know why people are against abortion religiously. The Bible says do not kill. If you allow a government to carry out killing, then you are guilty of killing too. If you have the chance to vote against killing, and don’t, then God will hold you accountable.


But please use your brains. If the government can say that abortion is illegal no matter what, it then favors the killing of a mother when her own life is at risk.


I for one would prefer to make my OWN choices as an OB/GYN. I don’t want some non-medical professional telling me how to treat my patients.


My patient is my number one priority. And I deserve to have a choice. I just try to have God guide me to make the right decisions. It’s all in His hands.


Just something to think about the next time you want to judge abortions.