In reading about the abortion debate I typically come across an exception for late term abortion that is required to save the mother’s life. In fact, many of the state bans on late term abortion, past viability or 24 weeks gestation, include this exception.
I am curious what type of medical condition would require an abortion, rather than the preterm birth, post viability.
With neonatal medicine at the stage it is today, there ARE infants who have survived birth from 20 weeks on–normal pregnancy is considered to be 40 weeks.
If it is absolutely necessary that the pregnancy be halted, for whatever reason, and the fetus is at least 20 weeks, then I would imagine there would be a delivery rather than an abortion.
It’s obvious that if the mother is in a potentially fatal situation, the fetus will not survive without intervention. The question would be, “Is there any way to allow the pregnancy to progress any longer?” Even a single day allows the fetus to develop just a bit more, increasing survivability.
Seizures and rising blood pressure of full-blown eclampsia is handled by delivery. A premature separation of the placenta is also cause for immediate delivery.
~VOW
That’s a clinical judgment in which (I suspect) the courts would be slow to intervene, and different clinicians might suggest different lists of conditions which would, or would sometimes, endanger the mother’s life if pregnancy continued.
I don’t have the medical knowledge to attempt a list; I’m just making the point that there probably isn’t an uncontroverted or undisputed list available.
And, to complicate matters further, it’s possible that the clinical judgment required varies between jurisdictions. One state may permit an abortion, say, “where necessary to save the life” of the mother, and another “where continuation of the pregnancy would endanger the life of the mother”, which is not quite the same thing.
I have heard of cases where the mother’s psychological condition is such that having a living child would put her life at risk, thus justifying the abortion rather than simply delivering the baby.
I DO understand how very extreme this can sound. Please let me point out that a friend of mine died of Postpartum depression. Some called her death a suicide, and I can’t really say they’re wrong. But the suicide was most definitely brought on by the postpartum depression.
I’m not saying that in her case an abortion would have prevented the depression and saved her life. I’m only saying that – in the imagination of this non-physician – there might be some other cases where it is possible.
There’s also a big difference between “the fetus might be viable” and “the baby will live”. How many babies delivered at 20 weeks actually suvive, how many grow up reasonably healthy and normal?
I suspect (IANAD) that even just going back compared to 10 years go, we have made significant strides in care of premature infants; let alone compared to 20 years ago when a lot of this debate became prominent.
I guess the question also is, in certain circumstances (i.e. strong possibility of severe mental / physical problems) to what extent do the wishes of the parent figure into the effort to produce a live birth vs. abortion?
(BTW, my step-mother had 2 abortions many many years ago; in both cases her kidneys flared up and started to fail, and the doctors told he fairly early on it was either the baby or both of them… The fact that she tried a second time says something about how much she wanted children. Another acquaintance had an abortion when ultrasound showed her twins had about half a brain between the two fetuses.)
A friend of mine was carrying conjoined twins. One was grossly misshapened and missing several organs, and was feeding off the other. The doctors told her that she could have a Ceasarian and they could separate the twins,but the deformed one would die. She decided to go for it.
At five months the healthy twin died. The doctors told her if she carried to term, the defective twin would be born alive, but would die minutes later. They advised an abortion, which she had.
In his book “Pro-Life Answers to Pro-Choice Questions,” Randy Alcorn states that all abortions are bad, that it’s better to give birth to a dying children and have the natural grieving that accompanies it, rahter than the unnatural grieving after an abortion. Of course, HE has never been pregnant.
The only cure for preeclampsia is delivery, no matter the gestation.
In the case of PROM, there are a couple of reasons to terminate the pregnancy. One is fetal/maternal infection. Another is hypoplastic fetal lungs. Amniotic fluid is vital to fetal lung maturity and without fluid these babies cant be ventilated because their lungs are stiff and rupture like a defective ballon instead of inflating.
A friend was pregnant with a child that was diagnosed with a form of anencephaly sometime past the point of when an abortion would be normal. The baby had a brain stem and a partial cortex, but was not considered viable. After the abortion, the doctors told the parents that the baby had a few other abnormalities along with the anencephaly.
My specialty hospital has had a very small handful of survivors at the late 22 week range in the 14 years I have worked there but most people don’t deliver at a facility equipped to handle approximate 24 week gestation infants. Infants born at a non-specialty hospital in the micro-preemie range don’t tend to live long and if they do live, they generally suffer serious consequences such as interventricular hemorrhage (brain bleeds), necrotising enterocolitis (bowel death), and life and brain threatening respiratory distress of different types and infection since infants have poor immune systems. These are common problems of preemies.
While other, ‘smaller’ problems such as blindness (Stevie Wonder), deafness, mental retardation and cerebral palsy are survivable, some families don’t care for the odds of all of these risks.
It seems to me that the last five posts are all talking about cases where the question concerns the fetus’s ability to survive. That’s NOT what the OP is about.
The question of the OP is not “In what cases is the baby better off dead”, but rather, “In what cases will the mother’s health be different depending on whether the fetus is aborted or delivered, if it is a given that one or the other would happen at a specific time?”
Just because there’s a low chance of survival and a high risk of complications doesn’t mean they’re not viable. Families might not care for those things, but that’s a different issue.
I’m sorry to hear about your friend your friend. I don’t normally think of mental stability as a reason for abortion, I guess because I’m not sure how well such a severe postpartum depression could be anticipated.
Do you know if there was something in particular that triggered it? Would her doctors have been able to anticipate such a severe postpartum depression?
For that matter, do we even know precisely what causes postpartum depression? Is it triggered by the presence of the baby, or by the lack of the pregnancy? If the latter, then presumably abortion would be no different from birth in that regard.
But how could that ever be proven in court in an unlawful abortion case? If the doctor went ahead and did the abortion, how could you ever prove that the mother would necessarily have died without it? There are enough unexplained medical phenomena and so much that is not understood about the body that it would seem dangerous to let a court decide whether or not the mother would have died, just like it would be unreasonable to let a court decide whether or not I would have died of a sinus infection if I had not taken antibiotics, or whether I would have gotten an infection had I not put rubbing alcohol on a paper cut three years ago, or whether a friend would necessarily have committed suicide had they not seen a therapist. Who could possibly know? We can’t do a test run with a clone.
Same way a court determines anything that’s outside the expertise of lawyers: You call the doctor in as a witness and he takes the stand and says “In my expert medical opinion, the patient would have died without this procedure”.
There are forms of cancer treatment which would either be potentially fatal to the fetus or cause severe fetal damage.
I took care of a woman in her early twenties with newly diagnosed cancer who had a second trimester abortion so she could get a chance at survival. In her case it was not successfully treated but the chances that she would have lived to give birth to a healthy infant without it were almost nil also. It’s possible she could have held on as long as possible and the baby might have lived although very premature.