Renaissance Trophy Wife

I couldn’t post this right after the debates because I needed to cool down first.  While McCain has many positions with which I disagree, and I will not go into those here, I do need to address the topic of maternal health in pregnancy to set the record straight.  No matter how you vote, you should be aware of the facts, sans snarky air quotes.

Why should you listen to me?  I am a woman and an MD– but don’t listen to *just* me, listen to all the accredited medical institutions out there, the history of healthcare in our country, and the CDC.  These are people who have stats to back them up and collective experience with pregnancy and maternal health complications to far outweigh the Republican party’s knowledge.

Despite what McCain might have you believe, there are two, fairly common, serious ways in which pregnancy can cause the death of a woman.  Yes, DEATH.  Anyone with an understanding of the concept would consider that death is a grave concern in managing one’s health– note that health is not in air quotes.

The two main conditions are the following:  Ectopic implantation (or more commonly, ectopic pregnancy), and preeclampsia.

In ectopic implantation, the egg implants outside the uterus, where it is non-viable.  End of story.

Let’s see what a midwestern medical center has to say. According to the Mayo Clinic, “An ectopic pregnancy can’t proceed normally. The fertilized egg can’t survive, and the growing tissue may destroy various maternal structures. Left untreated, life-threatening blood loss is possible.”

The Centers for Disease Control and Prevention (CDC) states that ectopic pregnancies “are the leading cause of pregnancy-related deaths in the first trimester and account for 9% of all pregnancy-related deaths in this country.”

No matter how long the pregnancy goes, the cells will never develop into a fetus.  However, the tissue does needs to be removed, as it is not benign.  This can be done by methotrexate injection, and/or laparoscopic surgery.  These are not comfortable methods, and carry their own risks to the mother, but at a mortality rate far less than an untreated ectopic implantation.

The McCain camp would have you believe that this constitutes abortion, even when there is NO possibility of an actual baby resulting from the implanted tissue.  Further, they would eliminate a woman’s right to be treated for a life-threatening medical condition.  People (including McCain) have tumors removed every day in an attempt to save their lives, but women can’t have an ectopic implantation removed to save theirs?

Think about yourself, your daughter, your sister, your mother… what would you want for them in this situation?

Now on to preeclampsia.  When I was on my OB rotation, this is one of the serious conditions that we would always be on the lookout for.  While the signs (high blood pressure, protein in the urine) don’t sound that serious, preeclampsia can get really ugly, really fast.  If a doctor diagnosed preeclampsia and didn’t treat it, they would be sued for medical malpractice.

Potential complications include:

Loss of blood flow to the placenta, which may affect the viability of the fetus.

Placental abruption, or separation of the placenta from the inner wall of the uterus may occur.  Severe abruption can cause heavy bleeding, which can threaten the lives of both mother and baby.

HELLP syndrome (Hemolysis, or destruction of red blood cells, Elevated Liver enzymes and Low Platelets)  may cause rapid organ failure in the mother, and become life-threatening for both mother and baby.

Eclampsia– essentially preeclampsia plus seizures — may permanently damage a mother’s vital organs, including the brain, liver and kidneys. Left untreated, eclampsia can cause coma, brain damage and death for both mother and baby.

The only treatment is delivery of the baby.  Obviously if the baby is near term, delivery poses fewer risks to both mother and baby.  In the earlier stages of pregnancy, however, the fetus may not be viable– and if you don’t deliver, both mother and baby may die.  Treatment decisions are made on a case-by-case basis, involving the woman and her doctors, and unnecessarily limiting the scope of treatment options is not beneficial to anyone’s health.

The decision, no matter which way it goes, is heart-wrenching, stressful, and life-changing.  I’ve participated in these conversations, watched girls and women anguish over these questions, and cried with them.  There is no right answer.  In the end, only women can decide for ourselves, but we do have that right– supported by the Supreme Court ruling, no less.

Healthcare involves just that– caring for your health, not throwing it away cavalierly.  If McCain is pro-life, why does his respect for life not extend to pregnant women?   Next thing we know, it’ll be all women’s healthcare at risk.

Does anyone have an answer for that?