partial birth abortion - page 5

THE OUTCOME of what is almost certain to be a legal battle fought all the way to Supreme Court will hinge on whether the justices accept the findings of Congress that the procedure is never medically... Read More

  1. by   CEG
    [quote=KellNY;2367082]One of the most common reasons is hydrocephaly with or without anencephaly. I'm not talking about the hydrocephaly where the girl goes on to be a happy 12 year old--I'm talking about an extremely malformed fetus, sometimes with a head so large the primip mother is 28 weeks and looks closer to 38. The head can reasonably be over 250% or larger than a "normal" head. And as most of us OB nurses know, hydro or anencephaly are not usually detected until the 2nd trimester or later.
  2. by   CEG
    Quote from KellNY

    One of the most common reasons is hydrocephaly with or without anencephaly. I'm not talking about the hydrocephaly where the girl goes on to be a happy 12 year old--I'm talking about an extremely malformed fetus, sometimes with a head so large the primip mother is 28 weeks and looks closer to 38. The head can reasonably be over 250% or larger than a "normal" head. And as most of us OB nurses know, hydro or anencephaly are not usually detected until the 2nd trimester or later.
    .
    I think the main issue for me is the pain the fetus/baby would suffer with this procedure. I am thinking even a baby suffering from a lethal condition would have the ability to feel the procedure and I could not reconcile putting my child through that, even if it meant I had a c-section in the case of hydrocephaly.
  3. by   Spidey's mom
    Quote from CEG
    I think the main issue for me is the pain the fetus/baby would suffer with this procedure. I am thinking even a baby suffering from a lethal condition would have the ability to feel the procedure and I could not reconcile putting my child through that, even if it meant I had a c-section in the case of hydrocephaly.
    Me too . . .I would have a cesarean first. I've had one and for me personally, it was not a big deal.

    Just the physical act . . . . turns my stomach.

    steph
  4. by   fergus51
    Quote from CEG
    I think the main issue for me is the pain the fetus/baby would suffer with this procedure. I am thinking even a baby suffering from a lethal condition would have the ability to feel the procedure and I could not reconcile putting my child through that, even if it meant I had a c-section in the case of hydrocephaly.
    In most cases the fetus is dead before the skull is evacuated. They aren't feeling anything. Doctors can inject them with a lethal dose of medication before the procedure.

    When you have to drain over a litre of fluid out of a baby's skull, a normal c-section isn't really an option. You're looking at a BIG incision and surgery carries risks, not to mention the impact it will have on your future fertility (inability to give birth vaginally again, limiting the number of children you can have without putting you at risk for a lovely uterine rupture). Plus, if parents want to hold and mourn for their child, they will look better after a D&X than they would taken out with a skull 5times the normal size. It may not matter to you and it may not be your choice, but it isn't a callous choice either. Some women really don't want a surgery if they can avoid it and they want an intact body to mourn over.
  5. by   KellNY
    If it makes any difference to you CEG and Stevielynn, I mentioned that the amniotic fluid was injected with dig beforehand, so the fetus had already died in utero before the syringe was injected into the skull (no scissors were used to "tear a hole in the base of the skull" or anything like that). I'll be the 1st to "admit", it was an awful, horribly sad case, for all involved. 1250mL of fluid...unimaginable! The poor mother and father...god, it was a tear jerker for sure.

    Motorcycle Mama, no one who knows anything in the medical field would call the infant in your story a fetus. Once it is born it loses it's fetal status and become a neonate or infant. But I'm sure you knew that.

    I'm confused as to why the use of medical terms bothers you or makes you feel like I'm "sugar coating" something. This thread was asking for facts and I was trying to provide them. I thought it quite appropriate to use the proper, accepted medical terms on a board where the majority hold college degrees in the scientific/medical field that is nursing (refering to the OB board, where most of us are RNs).

    Also to clear something up: very rarely does the fetus have to be manipulated into a breech position. Again, being OB RNs here, we know most 2nd trimesters are not in a cephalic/vertex presentation.

    ETA: Since my cross post with fergus reminded me of something....many doctors are of the "Once a c/s, always a c/s" mentality. For a primip, having a hysterotomy (c/s on an IUFD), this means all future births will be a c/s. It also may mean a classical incision for a severely hydrocephalic fetus. If this is a mother who plans on having 4 or 5 children, she would now be subjected to the risks of 4 or 5 more major abdominal surgeries (putting her and her future children at risk).

    We're experiencing a rush of accretas on my floor--it's in the water I guess. We have 3 right now. One is also an increta into the cervix, the other is a percreta into the bladder. The two more "involved" women are expected to require a hystorectomy. All are expected to require a transfusion and must be delivered in the main OR. ALL 3 have a hx of 3 or more c/s. I've only had one accreta in my experience who had no prior hx of a c/s. This is on top of the usual risks of bleeding out, infection, rupture, adverse reactions to anesthesia, etc etc etc.
    Last edit by KellNY on Aug 25, '07
  6. by   fergus51
    Quote from motorcycle mama
    = I still can't justify in my mind why anyone could participate in PBA's and be okay with it.

    I'll tell you why if you really want to know. If not ignore the rest...

    I see no reason to force a woman to have surgery to deliver a dead baby if it can be delivered vaginally and with its body basically intact. I don't see why her choice should be for a cesarean (which places her health and future fertility at risk) or a D&E (where her babies body will be ripped apart in the womb and sucked out piece by piece). She and her partner should be able to mourn their child with his body intact. That baby and his family deserve to be treated with as much respect and compassion as possible. I know some nurses can't do it, so I will. It isn't fun for me but it is necessary.

    I see no difference between this particular procedure and any other procedure used to terminate pregnancies in the second and third trimester. I've worked with patients who induced labor at 8 months to deliver their dead babies. I've worked with patients who had c-sections to deliver their dead babies. I don't see why one couple's choice makes them noble and the other makes them bad people. I treat them all with compassion and without judgement.

    What makes the c-section better? I don't see why leaving an extra liter of fluid in a kid's head is better than not leaving it. We don't let our living babies exist like that. We give them shunts or we do taps to remove the extra fluid.
  7. by   CEG
    I don't doubt that it is an extremely difficult decision for anyone who chooses it. I (with the luxury of not having had to do it) think that I would chose to carry an "incompatible with life" fetus to term no matter what the circumstances because I feel that's the right choice for me.

    Although I would choose differently I think I could provide care to patients undergoing this procedure. They certainly deserve compassionate care at that time. I do think I might have a little difficulty at the actual moment of the procedure. It hasn't been an issue yet...

    Future health and pregnancies are definitely an important consideration. Especially the info about the classical incision and per/incretas- not something to be taken lightly. Thanks for all the good info Fergus and KellNY.
  8. by   SuesquatchRN
    Quote from CEG
    Thanks for all the good info Fergus and KellNY.
    :yeahthat:

    And thanks to you, CEG, for asking a question and actually pondering the answers.

  9. by   farmgirl_dee65
    alright, here's a little background: i'm a recently graduated, newly licensed LPN, and the topic of abortion did come up frequently during schooling. i have had three pregnancies, gave birth to three babies, and after having lost one of those children at age 7 1/2, i'm pretty much pro-life.
    anyway. i have always wondered just exactly which maternal conditions would be so life-threatening that abortion would be the only option to save the mother's life? could have, should have asked my instructors but never really found the right time to ask that question. my mistake, i know.
    here's another thought, and i'm sure i will be stepping on some people's toes, religious belief-wise (sorry in advance!): WHAT IF at the onset of menarche barrier (diaphragm) or hormonal (depo, pill, etc.) contraception were available AT NO COST to actually protect from unwanted pregnancy? after all unplanned pregnancies happen all the time. yes, i know. all those things are available, but by the time most girls/women get on some b/c method they have already been sexually active. we are all human, right? and yes, i do realize that no form of b/c (except abstinence) is 100% effective, and that "accidents" (contra failure, rape, incest, etc.) do happen. however, if b/c were universally available, wouldn't that cut down on the chances of unplanned pregnancies? granted, it would literally take an act of congress/senate to make that happen, and i'm sure the pharma companies would throw a screaming hissy fit. would funding for that be a "health tax" that everyone would pay? who knows, and i sure don't!
    as far as the PBA, i find it beyond barbaric, horrific--more like the stuff that nightmares are made of. what monster dreamed up that particular procedure, anyway?
    and by the way: i didn't mean to hijack this thread, just wanted some answers to the maternal health question and to put in my 2cents worth. thank you.
  10. by   SuesquatchRN
    Quote from farmgirl_dee65
    as far as the PBA, i find it beyond barbaric, horrific--more like the stuff that nightmares are made of. what monster dreamed up that particular procedure, anyway?
    So, clearly, you didn't read anything that the posters who have actually dealt with this procedure wrote.
  11. by   farmgirl_dee65
    yes, i read, and understood. it's just my opinion. like everyone else, i have my own and am entitled to state it, as have others on this thread, thank you very much. besides that, that wasn't the reason for me to enter this thread anyway. please don't jump in the middle of me. no offense, okay?
  12. by   SuesquatchRN
    Quote from farmgirl_dee65
    no offense, okay?
    Okay. But it's hard not to respond to such strong words, farm girl.
  13. by   farmgirl_dee65
    agreed. i'll step off my soap box now. have nice day, and i will try to choose my words a little wiser in the future.

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