When those in the pro-life movement think of babies losing their lives, they immediately think of abortion. The focus is almost exclusively on the deliberate choices that lead to the death of an unborn child. Rarely talked about is another type of death that is occurring and devastating families — deaths we may be able to prevent.
In some cases, mothers experiencing pregnancy complications are kept out of labor and delivery departments and instead treated in emergency rooms, with caregivers and settings far less tailored to pregnant women in distress. In other cases, mothers in labor show up to the hospital and are sent home to miscarry or deliver a stillborn or preterm baby on their own, without medical professionals’ support for them and their babies.
The common link between these two scenarios is a lack of information — parents having no knowledge of the little-known differences between available care at hospitals. Parents don’t know, and don’t even realize they need to know, that something as simple as which hospital they go to in labor or preterm labor will drastically affect whether their preterm infant is offered only “comfort care” or moved to a neonatal intensive care unit and offered every chance at survival.
ERs Are Ill-Equipped for Pregnancy Complications
There’s a big difference in the setup and care models of labor and delivery (L&D) and emergency departments (ED). L&D has one real purpose and setup: to care for women in their childbearing years, helping them safely birth their babies. L&D is full of clinicians who have devoted their careers to mothers and their babies, to the careful monitoring of all the things that can go both right and wrong during pregnancy.
The emergency department is another world, filled with every kind of patient. Doctors and nurses want to do their best by all patients, of course, but must treat all ailments rather than specialize in childbirth.
And sometimes, the ED triage fails these women, like it failed Jamie Larson, a mother from California. Larson gave birth to her son at 24 weeks, 5 days of gestation after nurses failed to recognize she was in labor, telling her she simply had a urinary tract infection. She went home, bleeding and in pain, with a prescription for antibiotics. Her mother-in-law drove her to another hospital where she gave birth in the parking lot to a tiny baby boy. He needed 138 days in a NICU to stabilize him and save his life.
Larson’s birth story is harrowing to read, but it perfectly illustrates how mothers can be mismanaged in EDs. Larson and her baby needed better care than the first hospital gave them, and it is miraculous that her baby is okay today: “They pulled him out and he wasn’t moving. I thought he was dead. He was just so, so tiny,” Larson said.
According to the account, “The nurse scooped the baby up and ran with him back into the hospital. … They wheeled Larson back into the hospital. She was sobbing hysterically and covered in blood. After what felt like an eternity, a nurse brought the baby in just briefly to say hello. It was the first time Larson had gotten a look at him. It was a short visit. They whisked the baby away to a different hospital for specialized neonatal care.”
Some Hospitals Discriminate Based on Gestational Age
Not all hospitals are capable of or willing to treat babies born at all gestations, which is problematic considering babies are surviving — and thriving — at earlier and earlier gestations. For example, Amillia Taylor was born at less than 22 weeks of gestation in 2007, and is happy and thriving today. Baby “Saybie,” who was born at just 8.6 ounces — about the weight of an adult hamster — is also home from the hospital and growing. Lyla was born at only 21 weeks and is now a preschooler with no disabilities.
Some hospitals will treat babies such as these, born very early, but some hospitals will only treat babies much later, such as 26 weeks or beyond. This information can be difficult to find, and parents often don’t even realize they need to look for this information. People assume hospitals are equipped to provide lifesaving care, without knowing many hospitals will offer only comfort care to the tiniest of babies.
Posted on Twitter is a list of hospitals that will treat babies born before 24 weeks: “Everyone expects to have a normal, healthy pregnancy. Many people are not aware that all hospitals WILL NOT necessarily provide life-saving measures for babies born before 24 weeks, and sometimes parents do not find out this information until it’s too late. If you are pregnant, PLEASE take the time to research your hospital’s policies on gestational age and interventions. If you are facing an emergency delivery before 24 weeks, all hope is not lost! The list below shows hospitals that will help your baby. To put this as honestly as possible, there are hospitals that will simply let your baby die before 24 weeks with zero help.”
Finding Ways to Heal and Help
After Karen and her husband tragically lost two babies and received horrible hospital treatment, she has used her experience to help other mothers going through pregnancy complications and loss. Karen was forced to stay in the ED instead of L&D because she was a mere five hours short of her hospital’s cut-off, leaving her with an emergency room physician who left her and her husband, Dan, alone to deliver their baby without help. “It was frustrating that they weren’t doing things. My wife — you know — that they weren’t at least making sure she was okay. I mean, it seemed like there was no care for her,” Dan said.
Now Karen and Dan help others communicate about stillbirth and pregnancy loss. “I think that’s been helpful that I could help people [to talk about loss]. … Let them know they’re not alone.”
Laura Wiese has shared similar devastating experiences, both miscarriage and infant loss over the course of her 21 years of marriage. “There are a lot of changes that have been made over the years in medical care for families suffering through losses,” she said.
“Many years ago there was a different process that often included parents not being allowed to see, hold, or even bury their babies. Unfortunately there is still some of that today, particularly with early miscarriages. But with later losses, the medical community has made a lot of progress,” Wiese said. “They often have take-home gifts and mementos of the baby for the parents. Still there can be some improvements. Thoughtfulness goes a long way. There is a difficulty working in the medical field when you see a lot of heartache. Sometimes medical staff can become somewhat numb to it.”
Emily Carrington, the president and co-founder of the Early Pregnancy Loss Association, started a nonprofit after her second miscarriage to help families after pregnancy loss. She thinks medical professionals can play an important role in helping families heal: “One of the biggest gifts an OBGYN could give a family is to waive miscarriage and stillbirth-related expenses. I know this is a lot to ask, but these bills can be an untimely stab in the heart to a family. The Early Pregnancy Loss Association is currently saving money with the intention to find a way to help cover these expenses for families.”
Carrington notes, however, other resources may be available to help families cope with loss. “Many medical systems have bereavement specialists as well as support groups. These are great ways for doctors and hospitals to provide support in the aftermath of loss. Medical bills, menstrual cycles, potential milk production, hormone shifts, due dates, holidays, and future pregnancies all seem to be hidden landmines after loss.”
These mothers and babies matter, and the loss of an infant’s life at any gestational age brings sincere grief to families. “I think it is a huge pro-life issue and I think that we as a society are in a lot of denial about what it means to a woman to lose your baby regardless of the gestational age,” said Dr. Donna Harrison, the executive director of the American Association of Pro-life Obstetricians and Gynecologists. “And I think we don’t handle sibling grief or father’s grief well either. I think there’s a great room for improvement for us to recognize that, that losing a baby at any gestational age is involved with grief. And it takes a while to heal. I think that we need to treat miscarriage better than what we do as a society. Having miscarried three times, I can tell you our society does not do well with miscarriage.”
Demanding Hospital Transparency
Not taking steps to save the lives of these babies is wrong, and if hospitals are ill-equipped or unwilling to provide care during pregnancy complications, they must transparently disclose that information to women before these situations occur.
“If hospitals have made that decision — between 22 and 24 weeks [not to treat], that they should inform patients before the patient gets to the emergency room,” said Harrison. “In other words, that if Hospital X says ‘We’re not going to resuscitate below 24 weeks and we’re not going to transfer, ‘ then all the moms who are pregnant in that region need to know. I think that needs to be part of the prenatal care packages for the OBs who do rounding in that area so that patients know, ‘If I’m 23 weeks, I’m not going to them, I’m going someplace else.’”
If parents know hospitals will or won’t treat their child, they can make informed decisions for their pregnancies and babies. Without this information, they will continue going to hospitals expecting care they will not receive and finding out they’re out of options far too late. This is a disservice to families, to babies, and to our communities.
“Let’s make a big push for transparency — hospital transparency,” said Harrison. We need transparency for mothers to know whether or not a specific hospital can handle their pregnancy complications. We need it for babies who could live given NICU care but are instead being born at hospitals that do not even attempt to save their lives. And we need transparency for families who are experiencing miscarriage, stillbirth, and other infant loss, so they can be sure they are accessing the most compassionate and complete care available.”