By Carol F. Roye
Wednesday, September 10, 2008
Sarah Palin's delivery details still cry out for fuller explanation, says Carol Roye, R.N. If her story checks out, it offers a public service announcement about what not to do if your water breaks when you're far from home on a business trip.
(WOMENSENEWS)--As a mother of six myself and a registered nurse, I just can't seem to control my incredulity.
Yes, I'm talking about the Republicans' nominee for vice president, Alaska Gov. Sarah Palin, and her fifth child, Trig, a baby with Down Syndrome born in a small Alaskan hospital after Palin's water broke almost 18 hours earlier in Texas, where she addressed a governors' conference.
When a woman's water breaks, the rule is "get to the hospital now." If contractions do not begin on their own, the doctor will induce them. The baby must be born within 24 hours, because of the high risk of infection.
The pro-Palin Weekly Standard reports indignantly in its current issue that a major U.S. newspaper has demanded the McCain campaign share medical records "relating to Palin's amniotic fluid."
I don't know which paper they're talking about, but I echo that impertinent demand. I don't want to know about her amniotic fluid, rather, how she handled this risky situation.
Some may think it's unfair to attack a woman for the choices she makes about her reproductive capacities. Some will also think that I'm hypercritical because she's anti-choice and I'm pro-choice.
However, I believe that a politician who wants to limit other women's reproductive freedoms holds herself up for special scrutiny.
A New York Times story on Monday, "Fusing Politics and Motherhood in a New Way," sheds some light on why Palin kept the early months of her pregnancy out of the public eye.
Apparently the governor wanted to conceal a surprise pregnancy as long as possible to restrain public doubts about her ability to carry on with her official duties.
This bothers me. No matter how high-powered her position, a woman should be allowed appropriate time off for a pregnancy. A male governor with a male-only circumstance, such as prostate cancer, would be let off the hook. Why not a pregnant woman?
When tests revealed the fetus had Down Syndrome, Palin then needed some peace and privacy to prepare herself, according to the Times' account.
Palin's doctor, Dr. Cathy Baldwin-Johnson--who is a family physician and not an obstetrician--declined to talk to the New York Times for the story.
Given doctor-patient confidentiality ethics and rules, as well as the unusual nature of this story, I can understand that to an extent.
But since this concerns a candidate for one of the country's highest political offices, I think Palin should release her doctor from confidentiality and clear the record. After all, the presidential candidates must release their medical records. Why not the vice presidential candidates, especially when there are so many questions?
For now, I'm left to speculate. And I'm not alone.
Rumors began swirling in blogs about the pregnancy almost immediately after Palin was chosen as the nominee, suggesting that Trig was really her grandchild. She responded by saying her daughter, Bristol, could not be the mother of 4-month-old Trig because Bristol was already five months pregnant.
The cover of Us Weekly, due out on Friday, headlines "Babies, Lies and Scandals."
In an April 22 article in the Anchorage Daily News, Dr. Baldwin-Johnson said "Palin did not ask for a medical OK to fly." That leaves me supposing the governor took an unacceptably high risk and showed poor judgment. But maybe I'm wrong. Only a thorough explanation can settle the matter.
Meanwhile why did Palin's doctor clear her to fly home from Texas when she was 36 weeks pregnant--four weeks before her due date--with a ruptured amniotic sac that was leaking fluid? The doctor said afterwards that she had not given the OK, though Palin said she did check with the doctor. She was in pre-term labor. Did her doctor really understand the situation at the time?
Dallas has top-notch medical centers where Palin could have received treatment.
I would think that the governor and her doctor would have wanted the best care available, especially since the baby had Down Syndrome and needed special care; at a minimum cardiac imaging. Instead she took risks to reach a small regional hospital that does not even list a department of pediatrics on its Web page.
At age 44 and seven months pregnant she had a high-risk pregnancy for two reasons: her age and the fact that it was her fifth pregnancy. Two major risk factors for maternal death are advanced maternal age and having already delivered more than two babies; the more babies, the greater the risk. Palin had delivered four.
After delivering baby No. 5, Palin reportedly went back to work three days later. Although she did not take any family leave to care for her baby, her husband did, according to the New York Times report.
All these facts are already known and published in various places.
But I think it's important to echo calls--however impolite and intrusive they may seem--for more medical information.
At the very least, this story is now entering the annals of public health awareness and should be classified as a case study in what not to do if something like breaking your water while on a business trip happens to you.
At worst, this is a story that still has the potential to be discredited. I have cared for many women post-partum and I'm amazed that a woman can be seven months pregnant with her fifth child and hide it from her whole family, including, according to the New York Times, her own parents and children. I have spoken to half a dozen doctors and nurses about this issue and they are similarly perplexed.
Palin and her supporters have used the story of Trig to give backbone to Palin's anti-choice posture. Fair enough. Nothing like walking the walk as well as talking the talk.
But before conferring credibility on her account, those of us with medical doubts are entitled to confirmations that we still currently lack. She chose to put herself in the public spotlight. She owes us that much.
In the Times' story a friend of Palin's, Curtis Menard, put an admirable interpretation on Palin's extreme efforts to get back home after her water broke in Texas. "She wanted to get back to Alaska to have that baby," he said. "Man, that is one tough lady."
Tough is not what I call it. Reckless is my response. This is not the kind of thing readers should try at home, so to speak.
Carol F. Roye, EdD, RN, CPNP, is a professor at Hunter - Bellevue School of Nursing at Hunter College and assistant dean (acting) for nursing research. She is also a pediatric nurse practitioner, with a practice in adolescent primary and reproductive health care. You can visit her Web site, Women's Health Is A Family Value, at http://www.carolroye.org.
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