While I realize Joe Walsh lost his election bid, it is still worth emphasizing that his infamous statements about abortion are false, especially considering efforts like those in Ohio to pass a “heartbeat bill”. Abortion is sometimes necessary to save the life of the mother. Via the Irish Times we hear the sad story of a woman being allowed to get sicker and sicker, while a non-viable but “living” fetus kills her.
“The doctor told us the cervix was fully dilated, amniotic fluid was leaking and unfortunately the baby wouldn’t survive.” The doctor, he says, said it should be over in a few hours. There followed three days, he says, of the foetal heartbeat being checked several times a day.
“Savita was really in agony. She was very upset, but she accepted she was losing the baby. When the consultant came on the ward rounds on Monday morning Savita asked if they could not save the baby could they induce to end the pregnancy. The consultant said, ‘As long as there is a foetal heartbeat we can’t do anything’.
“Again on Tuesday morning, the ward rounds and the same discussion. The consultant said it was the law, that this is a Catholic country. Savita [a Hindu] said: ‘I am neither Irish nor Catholic’ but they said there was nothing they could do.
At this point the story is mostly upsetting because of the pain and distress the patient was undergoing for a nonviable fetus. But in the next sentence the story goes from describing mere horrific, dangerous medical care and patient abuse to total medical incompetence and wrongful death:
“That evening she developed shakes and shivering and she was vomiting. She went to use the toilet and she collapsed. There were big alarms and a doctor took bloods and started her on antibiotics.
If this timeline is correct, this sounds like “rigors”, a classic sign of impending sepsis. Her collapse is concerning for impending septic shock. One of the most important factors in preventing worsening sepsis after infection, per the Surviving Sepsis guidelines, is source control. That is, if there is a source for the sepsis – a foreign body, and infected wound, etc., it needs to be removed/drained so that the condition doesn’t worsen. This, in addition to being common sense, is medically imperative to prevent the worsening of symptoms.
However, for the sake of a non-viable fetus in the midst of a miscarriage, source control was ignored, and the patient proceeded to worsen and die.
At lunchtime the foetal heart had stopped and Ms Halappanavar was brought to theatre to have the womb contents removed. “When she came out she was talking okay but she was very sick. That’s the last time I spoke to her.”
At 11 pm he got a call from the hospital. “They said they were shifting her to intensive care. Her heart and pulse were low, her temperature was high. She was sedated and critical but stable. She stayed stable on Friday but by 7pm on Saturday they said her heart, kidneys and liver weren’t functioning. She was critically ill. That night, we lost her.”
This appears to be death from a critical delay in source control, in the face of septic shock. Removal of the fetus should have occurred emergently when she presented with signs and symptoms of sepsis in order to save her life. This was not done, and she almost certainly died as a result of this delay.
Maternal mortality in pregnancy is very rare thanks to modern medicine. However, when ideology trumps medically-appropriate care we turn back the clock to when women died routinely in childbirth.