Wednesday, July 16, 2008

The Danger of Childbirth

Currently, in the United States, women are allowed to make medical decisions for themselves, even about their reproductive systems. Certainly these rights are under attack, by people who would make it a crime to not report a miscarriage to the police, or people running for office who want to take away abortion rights, but really, for now at least, American women have a good situation for medical care. Compare them to the situation of women in Malawi:

On the night in question, Sam ran up against a health-care problem just as typical here as chronic under-funding and dearth of supplies, but perhaps less obvious to Westerners when they think of conditions in Africa: Women are definitely second-class in Malawi.

Around 8 p.m., a nurse midwife called Sam to the maternity ward where he saw a woman covered in blood mixed with soil, unconscious and deathly pale. Her extremities were cold, her pulse faint and her blood pressure an abysmally low 76 over 28. This woman, a mother of three, perhaps in her late 20s, had been three months pregnant with a fourth child. That morning, she had begun bleeding vaginally. Instead of coming to the hospital, her husband had decided to take her to a traditional birth attendant. She stayed with the attendant for nearly six hours, bleeding all the while. After she lost consciousness and the midwife grew frightened, the pregnant woman’s relatives loaded her onto a bush-bicycle ambulance and walked with her for about two hours to get to the hospital. She continued to bleed on the journey to the hospital.

As Sam rightly points out, women in Malawi, regardless of age, are not empowered to make decisions about their own health. When they are sick or giving birth, they must wait for their husband or other male relatives to decide when they should be taken to the hospital. This leads to delays – particularly when the decision-making man has gone far away from the village – and many women who come to the hospital at all come late, when complications have already set in.

In this case, Sam had to act quickly to save the woman’s life. (Calling for me to come from home would have wasted precious time.) He and the nurse midwife started IVs in both arms and drew blood for type and crossmatching. They looked for her relatives in the hope that someone among them would donate blood, but they had run off after dumping her at the hospital, perhaps thinking that she was already dead. Luckily, the lab technician, called from home, found a unit of compatible blood in the blood bank, and a transfusion was started for the woman. The ultrasound by Sam showed that the woman had a partial miscarriage and needed to have all of the products of conception removed from the uterus to stop the bleeding. Due to the woman’s poor condition, going to the operating theater and doing the evacuation of the uterus under full anesthesia was out of the question. So Sam did it right there in the maternity ward under Pethidine, an analgesic like Demerol, and followed up with Pitocin, for her uterus to contract and the bleeding to stop. The next morning, only some nine hours later, the woman was walking around and even asking to go home.

It's amazing to imagine that a woman can be in serious need of medical attention, but unable to make the decision to go to a hospital. Even an American woman without health insurance can go to an emergency room (but that's no excuse for our government refusing to create a universal health care plan) and be seen.

But those who would like to see American women no better off than those in Malawi are everywhere. Even in the comments section, anti-choice readers spew their rhetoric:

The author writes: “she needed to have all of the products of conception removed from the uterus to stop the bleeding.”

I know this is a technicality in regards to this particular story; however, have we really moved the terminology from “human child,” to “fetus,” to “product of conception?”

Product of Conception?

I.e. - “my product of conception was developed for 6 months before my doctor terminated it.”

This makes the procedure sound much more clinical and “humane.”

Also, the loss of a human life in this story = a “happy ending?”

— Posted by BradJ

Notice that Brad puts the emphasis on the badly damaged fetus, instead of the life of the mother that has just been saved. In this case, a hemorrhaging miscarriage took place, and the fetus was not viable, but only draining the life of the mother. It wasn't a life, at three months, it was a blob of cells that had one had the potential to become a life. A non-viable fetus and the partially developed placenta and any shed uterine lining are not a "baby," they are the "product of conception." Brad's sarcasm indicates that he doesn't see the treatment of this woman as humane. It doesn't matter to him that this woman is needed to take care of her three children, all that matters to him is that she miscarried and "killed" her fetus.

Beware, woman of America, the Brads and McCains who have publicly declared war on your reproductive rights. Or someday you too, could be no better off than the second-class women of Malawi.

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