by Grattan Brown, STD, and Susan Bane, MD
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Fifty years of Roe v. Wade have turned induced abortion into a false standard of care for children with life-limiting conditions before birth. Already in this “Pro-Life Professional Insight” series, Dr. Elizabeth Nelson’s article explains how the emergence of prenatal testing revealed risks of disability in more and more children. Induced abortion eliminates that risk by unjustly eliminating the person who may or may not have a disability. It effectively replaces the care that more families historically offered to their disabled children.
The pregnant women and their doctors who bypass induced abortion are taking on that risk not only to respect their child’s human right to life, but also to achieve a much greater goal: to love the child who may be disabled to the fullest extent of their life.
The following story is a hard case that turned out harder than expected. Prenatal diagnosis clearly identified a life-limiting condition in one twin who would not survive long after birth. It did not show the life-threatening complication discovered during delivery. Thus, it is a classic case of a high-risk pregnancy, which today often leads physicians to recommend induced abortion.
Based on her personal and professional experience, Dr. Susan Bane handled it differently. From prenatal diagnosis through delivery, she treated Crystal’s dying twin with the same respect that she treated the surviving twin — as well as her own dying father.
Here is Susan Bane’s story in her own words.
Two Diagnoses at the End of Two Lives
It was March 2008, and I got a phone call I will never forget. My dad shared with me that “he had lung cancer and a few spots on his brain and adrenal gland.” Stage IV lung cancer. I knew my dad was going to die — I just didn’t know when. I also knew I wanted to spend as much time as possible with him. I began the grieving process that day.
That same year, my patient Crystal received news she would never forget. She was pregnant with twin boys, Joseph and Macon, and was told that one of her babies had major birth defects. We knew Joseph would die — we just didn’t know when. Crystal and her family knew they wanted to spend as much time as possible with him. They began the grieving process that day.
Two human beings, one born and one pre-born. Both with a grave diagnosis, but treated so differently in our society.
My dad’s plan of care focused on his diagnosis and treatment options: radiation and chemotherapy to treat the illness and palliative care to manage pain and enhance his quality of life. Although euthanasia is legal in some states, no one offered it to my dad.
Skewed Treatment Options at the Beginning of Life
Treatment options for Joseph were also shared with Crystal and her husband by a maternal-fetal medicine specialist at Duke University. Like my dad, the options included both curative and palliative procedures, but for Joseph, doctors automatically added the option of ending Joseph’s life.
This final option is even presented as the standard of care by one of the leading OB/GYN professional societies, the American College of Obstetrics and Gynecology (ACOG). ACOG recommends four options: a broad range of procedures and surgeries that can be performed on the fetus during pregnancy (fetal intervention) and after the baby is born (postnatal therapy), a range of options to alleviate suffering and maximize quality of life (perinatal palliative care), and an induced abortion or induction with the purpose of ending the life of the fetus (pregnancy termination).
These options are offered to parents in an extremely vulnerable situation. As an OB/GYN myself, I have worked closely over the years with several families who have been in Crystal’s situation. It is devastating for them. The child they wanted so badly is now so sick. The acknowledgement of losing “what was supposed to be” is painful, just as it is when a child that is a toddler or teenager is given a life-limiting diagnosis.
Helping Crystal Deliver Her Babies
Crystal went into labor at 34 weeks and needed a cesarean section. Twin births combined with Joseph’s disabilities required a large care team, and the delivery room seemed crowded. I made the incision, and after about five minutes, I was ready to deliver the babies. I tried to slow my breathing and stay calm. Even though we knew from the ultrasound the very serious nature of Joseph’s birth defects, I did not know what I would actually see when I got to him.
I reached into the uterus and delivered Joseph first. His brain was exposed, and at this point I was surprised to discover that it was actually attached to the placenta. We had not seen this on ultrasound, and I had definitely never seen it before in the operating room. I knew it could become life-threatening to Crystal because of the potential for blood loss. I told the anesthesiologist the situation, and then I prayed to God for wisdom.
I began working to detach the placenta from Joseph’s brain, and he started crying. I felt such compassion for him at that moment. I did not know if I was hurting him or he was simply crying like every newborn. I do know that my motherly instinct kicked in. I wanted to pick him up and hold him, but we were in a sterile environment, and I had work to do. Instead, I leaned over and whispered “It is okay, Joseph; you will be with Jesus soon.”
As it turned out, it was fairly easy to separate him from the placenta, and there was not much bleeding. Joseph was then placed in a bassinet, and I continued the surgery. I delivered Macon, and the neonatal intensive care (NICU) team cared for him in the operating room before taking him to the NICU.
Joseph continued crying while I was finishing surgery. I did not like seeing him lying all by himself in that bassinet. He did not go to the NICU like his brother. The plan was to make him comfortable, but he wasn’t, and neither was I. As I was operating, I looked toward him in his bassinet. I called a nurse over to the operating table and whispered, “Someone hold that baby. He is not going to die alone in that bassinet.” She told me she couldn’t. I could tell it was just too hard for her to do, so I told her to find someone who could. The child’s father and their pastor came over. His dad was able to comfort him as I finished surgery on his mom.
Later that night, I went into the room, and Crystal was talking to him and cuddling him like he was the most healthy, beautiful baby she had ever seen. He lived almost eight hours. Crystal saw beyond his birth defects to comfort her beautiful little boy through his last breaths. What an amazing privilege it was to witness Joseph’s parents’ unconditional love.
Un-Skewing the Treatment Options
Crystal did not need an induced abortion. She needed encouragement and support from people who are willing and able to help her care for each twin individually. I am a member of The American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), which provides a professional voice to challenge ACOG’s approach. AAPLOG formed when ACOG continually failed to represent our opinions regarding the acceptability of induced abortion, instead developing false standards of care like the one described above. Membership in AAPLOG, currently at approximately 7000 practitioners, is growing as more and more OB/GYNs recognize that ACOG ignores the diversity of opinions among its membership and allows no scholarly debate on induced abortion.
Professionally, AAPLOG recognizes that an obstetrician/gynecologist is called to care for two patients, mother and child. Ethically, AAPLOG holds that “it is never appropriate to shorten the life of one person for the mental, emotional, or social benefit of another. The physician can and should act in accord with her profession by promoting normal grieving and enabling the maternal patient (and her family if applicable) to savor and celebrate the extent of fetal and neonatal life lived, however limited.” Thus, AAPLOG rejects pregnancy termination and proposes perinatal palliative care “to allow parents to be parents for the natural length of their fetus/newborn’s lifespan and allow them to grieve.”
With fifty years of Roe v. Wade, many doctors would see the initial ultrasound and recommend a procedure to end Joseph’s life immediately. For Crystal, that would have been to avoid some potential, unspecified future risk of physical or psychological harm since “he was going to die anyway.” For Joseph, it would have been a kind of preemptive euthanasia, avoiding whatever suffering, if any, he felt during and after birth.
But we doctors have the medical training that helps kids like Joseph feel the love of their families and helps parents like Joseph’s comfort their dying children. Joseph lived eight hours after birth, and those eight hours were full of so much love as he died in the arms of his family. My dad lived four months after his diagnosis. My dad had moments of pain, but he also had unforgettable moments of love.
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