Voices
Illustration by Krieg Barrie

A grief conserved

Perinatal hospice offers an alternative to the trauma of aborting a disabled child

Issue: "New faces of New Orleans," Aug. 15, 2009

"Something's wrong with this baby," my ultrasound technician told me. She had just scanned Mrs. Jones (a fictitious name) at 20 weeks and went on to describe her findings, findings that surely meant little chance of survival for that baby. As I later spoke with Mrs. Jones to relay the findings, she wept. I arranged an appointment with a maternal-fetal medicine (MFM) specialist.

The next day I received an urgent call from my patient. Through more tears, she described her visit in which the MFM doctor confirmed the grim prognosis. The baby would die, probably within a week or two. The MFM insisted on scheduling her for an abortion in three days. "Do I have to have an abortion?" she asked. I promised to call the MFM and assured her she did not have to abort.

When I called the MFM specialist, she immediately rattled off the severe abnormalities found, the fetus' incompatibility with life, and the scheduling of an abortion. I interrupted: "If the baby is going to die anyway, why do you want to kill it before it dies a natural death?" There was silence on the other end. I went on to explain that the parents would not have to deal with the guilt of killing their child if it died naturally. There was a pause, then, "I hadn't thought of that," she said.

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So much for nondirective counseling, as it is called. Sadly, I've had several similar experiences in my 27 years of practice.

My patient's baby did die in utero about two weeks later. She labored and delivered a stillborn baby with all the grief and pain associated with it. She was thankful, however, for the love and support of family and friends during the process and the knowledge that she had not contributed to her baby's death.

When a pregnant woman clearly understands the primary purpose of genetic testing-abortion of a handicapped baby-a majority decline testing in my experience and almost all pro-life women decline testing. Nearly every problem now identified by prenatal diagnosis has no treatment. David Grimes, a well-known OB/GYN, professor at the University of North Carolina School of Medicine, and a strong abortion advocate, spoke truth in a rare moment of public clarity when he said prenatal diagnosis would disappear if abortion were not available.

But what happens when a routine 20-week ultrasound shows a baby with a profound abnormality, possibly an abnormality that will certainly result in the death of the baby prior to or shortly after birth? Or when a genetic test is done and shows similar results and the patient then decides against abortion? What then?

Enter perinatal hospice, the brain child of Byron Calhoun, a pro-life maternal-fetal medicine specialist.

Perinatal hospice honors life. The woman carrying the disabled child receives extensive counseling and birth preparation involving the combined efforts of MFM specialists, OB/GYN doctors, neonatologists, anesthesia services, chaplains, pastors, social workers, labor and delivery nurses, and neonatal nurses. She carries the pregnancy to its natural conclusion. She and her husband are allowed to grieve and prepare for the short time God may grant them with their child while their baby lives inside or outside the womb. Such a process obviates the grief caused by elective abortion, killing the child before it could be born.

Doctors and nurses often withdraw from hopeless patients, and surely a baby with a lethal anomaly is a hopeless patient. Add to that, as my example above illustrates, the concept of natural death for babies with lethal anomalies perplexes those who advocate abortion and prenatal eugenics. For them, not terminating a hopeless pregnancy is stupid.

Perinatal hospice, on the other hand, allows natural grief and separation with the support of the medical community. Calhoun says parental responses have been overwhelmingly positive. "These parents are allowed the bittersweetness of their child's birth and too-soon departure. Grief lessens as time passes and the parents rest secure in the knowledge that they shared in their baby's life and treated the child with the same dignity as a terminally-ill adult."

Even those mystified by a patient choosing life have recognized the value of Calhoun's idea, as perinatal hospice programs now dot the nation. But this mystery is no mystery to us. As Job 1:21 states, "Naked I came from my mother's womb, and naked shall I return. The Lord gave, and the Lord has taken away; blessed be the name of the Lord."

-Matt Anderson is a practicing OB/GYN in Minnesota and blogs regularly at mdviews.wordpress.com.

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