controversy

There was whispering at the nursing station.

"17 weeks? We can't take her!"
"But 4A says they don't know what to do..."
"But it would be cruel!"
"Medical ward might be worse. They don't know what to do with pregnant women."
"But she's 17 weeks..."

The thing is, legally, if a fetus is less than 20 weeks, it can still be terminated (the medical term for induced abortion). Thus, a woman is not pregnant until she reaches 20 weeks. A woman with a 17 week-old is not pregnant. The labour ward only accepts women who are pregnant.

This is the first problem.

The second problem is that this baby was dead.

The woman and her husband had been sent in after an ultrasound showed that their baby had no heartbeat. (And yes, since this was a wanted pregnancy, I will call it a baby). The couple had been sitting in emergency for 2 hours while the wards bickered about who had to take them.

The medical ward refused, saying they didn't know what to do with a pregnant lady.
The labour ward refused, saying the woman was not pregnant, so should be treated medically.

Luckily, the Obstetrician overheard this (we were in the tearoom).

He arranged for the woman to be put in a quiet corner of the L&D ward, away from any newborns.
He arranged for medication to induce uterine contractions so the dead tissue could be expelled.
He arranged for the couple to have a space to grieve for their lost child. When that child was pushed into my hands, he helped me to clean and wrap it, so the parents didn't have to see why their baby couldn't have lived.

I was responsible for checking on the couple overnight. I slipped into their room around 2am and found that the husband had crawled into the narrow hospital bed beside his wife. They had fallen asleep together, his arm across her chest, her arm across her belly. I let them sleep.

I fully and truly believe in a woman's right to choose and easily access termination. Birth and babies are too harrowing and permanent to experience against one's will. But the legal definitions of fetus vs baby are arbitrary. 20 vs 17 weeks vs medical vs obstetrical...

Thank goodness my preceptor stepped over all this and took care of his patient.
"Above all, Samantha, we treat the patient, not the numbers."

It was my last night of obstetrics and I am now thoroughly traumatized. Luckily, I'm back on Family Med now. I talked to a patient about his rough sex practices for 30 minutes. Back where I belong.