The membranes rupture before viability and an infection sets up shop in the uterus.
Medically, the pregnancy has to end; whether the fetus is still alive or not does not matter.
At times the body offers a consolation and goes into labor.
Mayte Torres / Getty Images
It doesnt seem like it at the time but it is more than a small mercy.
It is like starring in a horror movie where you choose the weapon.
It hurts and can take days.
A premature uterus, especially an infected one, often does not cooperate.
Days of both grieving and waiting to grieve break even the strongest.
When women tell me they cant even get this right I want to cry.
At the end of the labor there is a baby.
Often bruised and macerated.
Many find that visual very hard as technically those injuries were sparked by their own body.
It requires more skill, medically speaking, than the labor.
Your instruments are like a hot knife.
You are using a hot knife to remove sharp fragments from a bed of soft butter.
Do it incorrectly and you damage the uterus, puncture the bowel, or cause catastrophic blood loss.
The fact that your patient is already ill with infection makes every potential sequelae worse.
The patient gets an anesthetic and afterward the physical part of the nightmare is over.
Sometimes, if the infection is advanced, the medical team may recommend a D&E up front.
The risks of a D&E performed by a well-trained individual are very low.
Some women chose labor but after a day or so it is clear their body has a different idea.
An infected uterus cant always be whipped into shape with oxytocin and prostaglandins.
As they wait for the uterus to labor correctly they get sicker and sicker.
Bacteria is showering the blood stream.
Their heart rate is unbelievably fast.
Their blood work is ominous.
Eventually, the patient agrees to the D&E and the relief is palpable.
Sepsis makes you feel as if you are dying, which you are.
Sometimes her partner glares.
He knows the answer, but he wants me to say it.
Im a gynecologist and I dont know.
(a) A physician or other person may not knowingly perform a partial-birth abortion.
A person who violates Section 171.102 commits an offense.
An offense under this section is a state jail felony.
No one knows how sick is sick enough.
Is it ruptured membranes?
Is it a fever of 101 F or 103 F?
This is how Savita Halappanavardiedin Ireland.
Banning D&Es unless Death himself is in your room unhooking your intravenous is also cruel.
Every single person I have ever counseled has known almost immediately what feels best.
Pregnant women can visualize the sequence of medical events with labor and with a D&E.
you’ve got the option to see it in their faces.
They know what is the least traumatic landing for them.
Now in Texas they have no say.
Related:
This story originally appeared ondrjengunter.wordpress.comand is reprinted here with permission.
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