Wednesday 10 June 2015

Amnesty's sad miscarriage story is no reason to legalise abortion in Ireland

It shouldn't be a surprise that pro-abortion campaigners use information dishonestly, but for some reason I expected more rigour from Amnesty.

Among the heart-rending stories on Amnesty's UK website, presumably intended to illustrate why it is absolutely utterly necessary to allow Irish women to kill the living children in their wombs in order to for them to fulfil their destiny as human beings, is the story of Lupe "a woman who was forced to carry a dead foetus for two months". You can read Lupe's story here.

The problem with using Lupe as a poster girl for abortion in Ireland, is that as sad as her case may be, it is (as presented on the Amnesty website) utterly irrelevant to any argument about abortion. Lupe had what is commonly known as a missed miscarriage: her baby died in utero at an early stage, but her body - buoyed by the first trimester hormones secreted by the corpus luteum  - continued the pregnancy. This isn't uncommon. Many women are sad to discover at the end of their first trimester that their baby has died some weeks earlier. In a normal pregnancy the placenta takes over the regulation of hormones from the corpus luteum around 12 weeks into the pregnancy: this is why there is a statistical cluster of miscarriages at this point: most unviable pregnancies end this way. Like Lupe most woman in this situation will begin to bleed and miscarry normally as soon as the hormonal levels drop some time after the 12th week. Until early scans were common, it was not generally understood that the baby had often died weeks before the miscarriage. 

Lupe says that she felt that something was wrong with the pregnancy from an early stage. Again, this is not unusual: many mothers report feeling that something is wrong weeks before a miscarriage becomes evident. In Lupe's case she reports feeling that something was "wrong" around the time the scan indicated her baby had most likely died. I would argue that this is a good case demonstrating a bond between mother and baby; between a human mother and a human baby.

I have had two missed miscarriages, both running well into the second trimester. With one of them I remember lying in bed one night, hand on my tummy, talking to my then 9 or 10 week old foetus and suddenly breaking off to say "you're not in there, are you?" The words had just burst out, and they troubled me greatly. For the next couple of weeks I couldn't shake the feeling that there wasn't anyone in my womb. Thus I was shocked and saddened - but not really surprised - when a 12 week scan showed that my baby had died a fortnight earlier. 

Losing a baby to miscarriage is devastating on many levels: one thing that makes it much harder than it needs to be is that medical professionals are often clumsy in how they deal with miscarrying women. In British hospitals women having treatment for miscarriage are often put into a ward with women having abortions. In the UK much of the advice and guidance given about medical and surgical management of miscarriage is taken directly from abortion guidelines and is therefore not only not best practice, but is often not relevant to miscarriage. I intend to write more about this in another post, but for now will focus on Amnesty and "Lupe".

Lupe's distress appears to come from her perception that her miscarriage was mismanaged and that if she had been offered an abortion things would have been different. This deserves closer scrutiny. The doctors who insisted that Lupe have a second scan were, in fact, doing the right thing. It is a shame that it took two weeks for that scan to materialise, but best practise would suggest leaving at least a week. It is also important to note that the "vaginal scan" (TVS) that Amnesty makes much of is not necessary - an abdominal scan is perfectly capable of verifying foetal demise, although a TVS is clearer.  It is important to make sure that a baby has actually died rather than going in guns blazing and emptying "products of conception" from a mother's womb. This second scan and wait is something that - in abortion-happy Britain - I had to ask for. Which brings me to my second point: the safest method of managing a first trimester miscarriage is to allow it to happen naturally. Given the foetal measurement, likely date of demise and the stage of pregnancy, it was almost inevitable that the process would have resolved naturally. Surgical and medical management of miscarriage bring much greater risks to both a woman's health and her fertility. "Wait and see" might not be easy to hear, but it is actually the right thing to do for most women under the circumstances.  

It's entirely possible that there's something completely urgent that Amnesty left out of their version of Lupe's story, but assuming that there isn't, her treatment seems entirely reasonable under the circumstances. Abortion doesn't come into it because (ta-da!) the baby was already dead. Dead baby discovered by scan = miscarriage.  Nobody "forced" Lupe to "carry a dead foetus for two months": she had a missed miscarriage. Her baby had been dead for most of that time before it was discovered by her initial scan. Whilst the fact of the miscarriage is sad, the way it was managed does not seem either unusual or negligent despite the emotive language used on the Amnesty site. 

Lupe might make a good poster girl for better information to be given to miscarrying women in Ireland, or for better communication skills to be taught to medical professionals, but her story is at best irrelevant and at worst misleading with regard to abortion. For Amnesty to lead her to believe that her human rights have been violated because her miscarriage was not managed as she would have liked is reprehensible. The greatest risk that Lupe faced was her trip to Spain: nobody in their right mind would suggest that a miscarrying woman travel, let alone travel internationally. A miscarriage can be a messy and uncomfortable business, it can be painful and emotionally draining. It *is not* under normal circumstances a medical emergency, however there is always a risk of haemorrhage and for that reason it is inadvisable to travel far. "Stay close to home and wear dark clothes" was the advice I received from a veteran mother. Travelling from Ireland to Spain for what is a normal physiological bodily function seems both risky and ridiculous. If Amnesty encouraged this they should be held to account. They certainly should not be holding it up as an example of how to manage miscarriage, and under no circumstances should they be suggesting that it has any relevance to abortion.

Abortion has never been a treatment for missed miscarriage and never will be. Abortion involves the deliberate killing of a living human in the womb. Miscarriage is when a living human in the womb dies of natural causes. To conflate the two is dishonest and immoral. 

Thanks to Youth Defence for the graphic at the top of this post. Like them on Facebook!

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