# What did Ralph Northam's comments really mean? (about "discussion between physicians and mother") **URL:** \ **Category:** Great Debates\ **Created:** [April 29, 2019, 3:08pm UTC](https://boards.straightdope.com/t/what-did-ralph-northams-comments-really-mean-about-discussion-between-physicians-and-mother/833219 "2019-04-29T15:08:53Z")\ **Posts on this page:** 11\ **Page:** 1
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [April 29, 2019, 3:08pm UTC](https://boards.straightdope.com/t/what-did-ralph-northams-comments-really-mean-about-discussion-between-physicians-and-mother/833219/1 "2019-04-29T15:08:53Z")
Last year, Ralph Northam made [some comments](https://www.wdbj7.com/content/news/Trump-addresses-Virginia-Gov-in-call-for-late-term-abortion-ban-505408721.html)about late-term abortion that sparked a great-deal of frenzy among abortion opponents: _"when we talk about third-trimester abortions, these are done with the consent of, obviously, the mother, with the consent of the physicians, more than one physician by the way. And it’s done in cases where there may be severe deformities, there may be a fetus that’s non-viable. So in this particular example,_\* if a mother is in labor, I can tell you exactly what would happen. The infant would be delivered, the infant would be kept comfortable, the infant would be resuscitated if that’s what the mother and the family desired, and then a discussion would ensue between the physicians and the mother."\*\* \* This led to Trump commenting recently that Northam had called for babies to be “executed” - which might be a massive exaggeration - but what exactly does this quote by Northam mean? Does “non-viable” mean “an infant that is going to die within a few hours after birth?” If so, then all Northam is saying is that the infant would be kept comfortable but the parents and doctor might just allow “nature to take its course,” which might not be that controversial. ---
**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\ **Post date:** [April 29, 2019, 3:18pm UTC](https://boards.straightdope.com/t/what-did-ralph-northams-comments-really-mean-about-discussion-between-physicians-and-mother/833219/2 "2019-04-29T15:18:45Z")
Not part of these comments, but… I recall some articles where interviews with maternity ward nurses and doctors, they said going back decades that in some places, severely malformed babies would be “allowed to die” if there was no hope they would survive long term. (I.e. missing a brain, or many vital organs, etc.) The presumption was they applied the same “no extraordinary measures” criteria used with geriatric patients in extreme dire straits. The idea a doctor would actively cause a normal baby or full-term fetus to die because the mother didn’t want a baby is ludicrous. (Besides, who changes their mind at the 8-month mark?) ---
**Author:** ![AK84](https://avatars.discourse-cdn.com/v4/letter/a/85e7bf/32.png) [@AK84](https://boards.straightdope.com/u/AK84)\ **Post date:** [April 29, 2019, 3:24pm UTC](https://boards.straightdope.com/t/what-did-ralph-northams-comments-really-mean-about-discussion-between-physicians-and-mother/833219/3 "2019-04-29T15:24:42Z")
Dude, a politician tried to be too clever and it backfired on him. Nothing more needs to be thought. It has been known to happen. ---
**Author:** ![Velocity](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/velocity/32/18006_2.png) [@Velocity](https://boards.straightdope.com/u/Velocity)\ **Post date:** [April 29, 2019, 3:38pm UTC](https://boards.straightdope.com/t/what-did-ralph-northams-comments-really-mean-about-discussion-between-physicians-and-mother/833219/4 "2019-04-29T15:38:09Z")
> [@md2000](#): > > Not part of these comments, but… I recall some articles where interviews with maternity ward nurses and doctors, they said going back decades that in some places, severely malformed babies would be “allowed to die” if there was no hope they would survive long term. (I.e. missing a brain, or many vital organs, etc.) The presumption was they applied the same “no extraordinary measures” criteria used with geriatric patients in extreme dire straits. > > The idea a doctor would actively cause a normal baby or full-term fetus to die because the mother didn’t want a baby is ludicrous. (Besides, who changes their mind at the 8-month mark?) I’m assuming the vast majority of the controversy was because the “non-viable” part of the paragraph wasn’t quoted and people took it to mean that Northam was talking about normal healthy babies. (Also, mods, please don’t GD/Election/IMHO this) 🙂 ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [April 29, 2019, 4:14pm UTC](https://boards.straightdope.com/t/what-did-ralph-northams-comments-really-mean-about-discussion-between-physicians-and-mother/833219/5 "2019-04-29T16:14:11Z")
[Moderating] I don’t see how “what did a politician really mean” can possibly be a factual question. Moving to GD. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [April 29, 2019, 4:17pm UTC](https://boards.straightdope.com/t/what-did-ralph-northams-comments-really-mean-about-discussion-between-physicians-and-mother/833219/6 "2019-04-29T16:17:19Z")
[Not moderating] I can’t see how what he said could possibly be twisted into “killing babies”. He didn’t even talk about a baby being allowed to die: He said that it would be resuscitated. That’s the opposite of killing. ---
**Author:** ![AK84](https://avatars.discourse-cdn.com/v4/letter/a/85e7bf/32.png) [@AK84](https://boards.straightdope.com/u/AK84)\ **Post date:** [April 29, 2019, 4:59pm UTC](https://boards.straightdope.com/t/what-did-ralph-northams-comments-really-mean-about-discussion-between-physicians-and-mother/833219/7 "2019-04-29T16:59:18Z")
> [@Chronos](#): > > [Not moderating] > > I can’t see how what he said could possibly be twisted into “killing babies”. He didn’t even talk about a baby being allowed to die: He said that it would be resuscitated. That’s the opposite of killing. :rolleyes: You are being disingenuous here. He said it would be resuscitated, _if thats what the mother and family wanted_. Pretty big difference. This is a topic which makes smart people lose their minds. Yeah, its stupid to claim he talked in favour of murdering babies. Its also stupid not to recognize that he spoke poorly. We had a thread on this topic eons ago, and IIRC the answer was that while its a very miniscule percentage of abortion which result in a born alive situation, the sheer numbers of abortions means you have several dozen cases a year. And further IIRC, thr info in that thread was that the mothers wishes are expressly not considered, when deciding on a course of action in these circumstances. ---
**Author:** ![brossa](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/brossa/32/3040_2.png) [@brossa](https://boards.straightdope.com/u/brossa)\ **Post date:** [April 29, 2019, 7:28pm UTC](https://boards.straightdope.com/t/what-did-ralph-northams-comments-really-mean-about-discussion-between-physicians-and-mother/833219/8 "2019-04-29T19:28:25Z")
> [@AK84](#): > > :rolleyes: > you have several dozen cases a year. Is there a citation for this? ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [April 29, 2019, 10:29pm UTC](https://boards.straightdope.com/t/what-did-ralph-northams-comments-really-mean-about-discussion-between-physicians-and-mother/833219/9 "2019-04-29T22:29:36Z")
> [@AK84](#): > > …info in that thread was that the mothers wishes are expressly not considered, when deciding on a course of action in these circumstances. Offering “info in that thread” as your citation? As fond as I am of the smartass symphony that 'R Us, the SDMB…well, a bit much, don’t you think? Also, just a mite unspecific. ---
**Author:** ![Iggy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iggy/32/3364_2.png) [@Iggy](https://boards.straightdope.com/u/Iggy)\ **Post date:** [April 30, 2019, 4:49am UTC](https://boards.straightdope.com/t/what-did-ralph-northams-comments-really-mean-about-discussion-between-physicians-and-mother/833219/10 "2019-04-30T04:49:09Z")
From [FactCheck.org](https://www.factcheck.org/2019/03/the-facts-on-the-born-alive-debate/) which has cites to The New England Journal of Medicine and the CDC.: > [@](#): > > **What statistics are available on cases of failed abortions in which a baby is born alive? How often does this happen?** > > …What about abortions that result in a live birth? One CDC report on death certificates for infants for 2003 to 2014, showed “143 deaths involving induced terminations” of pregnancies during that 12-year period, 97 of which “involved a maternal complication or, one or more congenital anomalies.” The data “only include deaths occurring to those infants born alive; fetal deaths (stillbirths) are not included.” > > The CDC notes that the 143 number could be an underestimate of induced terminations of pregnancies. In looking at the data, the CDC found some cases where it was unclear whether a pregnancy termination was induced or spontaneous. In such cases, if congenital anomalies and maternal complications also were involved, the CDC assumed those were spontaneous terminations, due to the “strong association between severe congenital anomalies or maternal complications and premature labor and birth.” In other words, the CDC assumed such cases were premature labor as opposed to a decision to induce labor or end the pregnancy. So 143 over a period of 12 years, but the CDC notes that may be low. Not all states report data. And this data referenced deliveries earlier in pregnancy that are often at or near the limits of pre-term viability. More from [FactCheck.org](http://FactCheck.org): > [@](#): > > Six states require some reporting on abortions that result in a baby born alive: Arizona, Florida, Michigan, Minnesota, Oklahoma and Texas. > > In Minnesota, there were 10,177 abortions in the state in 2017 and three resulted in an infant born alive. None survived, according to the report from the state Department of Health. One infant was given “comfort care”; another was given no specific care; and the third had a low APGAR score, a measure of a newborn’s well-being. > > Arizona enacted a law in August 2017 requiring physicians to report born-alive cases and to “document that all available means and medical skills were used to promote, preserve, and maintain the life of such fetus and embryo.” A state Department of Health Services report says: “From August 2017 to December 2017, 10 abortion reports involving fetus or embryo delivered alive were submitted to ADHS along with the physician’s statement documenting the measures taken to preserve the life of the fetus or embryo.” There were a total of 12,533 abortions performed for the full year. > > And in Florida in 2018 there were six reported born-alive cases out of 70,083 abortions, according to state reports. As for late-term abortions, two occurred in the third trimester, one due to life endangerment and the other due to serious fetal defect. > > In Oklahoma, there were no reports of infants born alive due to an abortion from 2012 through 2014 and again in 2016. For 2015 and 2017, the state reports don’t contain figures for that reporting requirement. Also, Texas reported zero live births as a result of an abortion for the three years for which that information is available, 2013 to 2015. That’s 3 in Minnesota in a year compared to 10,177 abortions statewide; 4 in four months in Arizona compared to 12,533 statewide for the full year so extrapolating that could be 12 live births from abortions over the course of a year; 0 in Oklahoma in four years with no data available for two more years (from an [Oklahoma Department of Health report](https://www.ok.gov/health2/documents/HCI_2002-2012ITOPtrends.pdf) (pdf at link) there were 5,967 abortions per year on average in Oklahoma, so 0 live births in about 23,868 abortions over a four year period); 6 in Florida in a year compared to 70,083 abortions statewide; and 0 in Texas in a three year period with the Guttmacher Institute estimating 55,230 abortions in Texas per year, so 0 live births in about 165,690 over a three year period. It is clear that it is small numbers of cases so one more or fewer cases may skew the percentages quite a bit. Very, very rough estimating from the above numbers include approximately 21 live births in 282,351 abortions, for a rate of 0.74 live births per 10,000 abortions. The Guttmacher Institute [cites](https://www.guttmacher.org/fact-sheet/state-facts-about-abortion-oklahoma) approximately 926,200 abortions in the United States in 2014. Using that 0.74 live births per 10,000 abortions rate there would be approximately 69 live births from abortions per year in the United States. I’d call it a few dozen cases per year. Whether between five and six dozen cases are year counts as “several dozen cases a year” as AK84 described is up to the reader to decide. However, what is called and abortion as opposed to a pre-term delivery is another issue of concern that may cloud the statistics. Though severe fetal defect is an oft cited factor in many late term abortions another factor is maternal pre-eclampsia. With pre-eclampsia cases the baby may be born without developmental defects and with good prospects for a full \*IF \*if he/she can survive the hazards of prematurity. Some reporting includes such cases as later term abortions while other reporting calls them premature labor and excludes them from late term abortions. But that’s a big _IF_. ---
**Author:** ![Max\_S](https://avatars.discourse-cdn.com/v4/letter/m/46a35a/32.png) [@Max\_S](https://boards.straightdope.com/u/Max_S)\ **Post date:** [April 30, 2019, 6:13pm UTC](https://boards.straightdope.com/t/what-did-ralph-northams-comments-really-mean-about-discussion-between-physicians-and-mother/833219/11 "2019-04-30T18:13:26Z")
> [@AK84](#): > > :rolleyes: > You are being disingenuous here. He said it would be resuscitated, _if thats what the mother and family wanted_. Pretty big difference. > > This is a topic which makes smart people lose their minds. Yeah, its stupid to claim he talked in favour of murdering babies. Its also stupid not to recognize that he spoke poorly. > > We had a thread on this topic eons ago, and IIRC the answer was that while its a very miniscule percentage of abortion which result in a born alive situation, the sheer numbers of abortions means you have several dozen cases a year. And further IIRC, thr info in that thread was that the mothers wishes are expressly not considered, when deciding on a course of action in these circumstances. I lean conservative and find no issue with Dr. Northam’s statement. Unless the patient shows up in labor, chances are that doctors have plenty of time to explain that your baby’s heart isn’t working properly. A serious congenital heart defect could be detected as early as 18 weeks. Some newborns still have unexpected defects at birth though (eg: unexpected cyanosis or blue skin). If the parent (or their legal guardian) wants to resuscitate the infant this can be done, preferably by writing resuscitate in big letters on the clipboard/whiteboard during check-in. For extended life support at the hospital things get much less clear depending on state law, hospital policies, and the doctor’s determination of futility. Perhaps it was a stupid thing for a politician to say on the record, but the dope is the straight dope. ~Max