Tuesday, 26 April 2011

A Doctor Finds Sarah Palin's Wild Ride Absurd

I heard from my doctor friend. She has no interest in Sarah Palin and had not seen any of these photos before. The conversation was on Facebook. I sent her a first message asking for her medical opinion (admitedly, my friend is not an obstetrician, she's an endocrinologist):


"In your medical opinion, how far along in her pregnancy would you estimate this woman is in each of the photos? She's 44 years old, in her 7th pregnancy (4 live births and 2 pregnancies that ended around 12 weeks)?"


"According to the photos, I have the impression she's not pregnant at all. I can't see any evidence of a pregnant belly and the little there is in the first photo would be perfectly normal for a woman who gave birth four times, even if not pregnant."

I then sent her this photo:


"This woman announced her pregnancy between photos (1) and (2), saying she was seven months pregnant. Eighteen days after photo (3), she was photographed again and had a big belly. What do you think?"

In the same message, I gave a brief description of the wild ride:

"35 weeks pregnant: The woman was 4,900 km from her home town, attending a conference. At 4am, she woke up with a strange sensation down in her belly, with contractions that felt different from the usual and was leaking some fluid. She rang her doctor back home and said she wasn't going to change her plans and would go ahead with a speech at 1pm the next afternoon. The doctor said ok.

After the speech, she boarded two planes for four-hour flights , with a two-hour layover in between, then drove another 45 minutes to a small hospital which was not equipped for complicated births.

The woman had tests at 12 weeks and knew the baby had Down syndrome. The doctor induced the birth and the baby was born some time later, five weeks premature.

Three days later, the woman went back to work, taking the baby with her and was filmed with the baby, showing him to the world and her colleagues."

At this stage in our exchange, Cecilia thought I was pulling her leg:

"This story is absurd. If the membranes had ruptured and she was leaking amniotic fluid without going into labour there could be serious consequences for this woman and the baby. If she was having real contractions, considering that it was her fifth baby, she would have delivered in the middle of her speech, if she made it to the conference room at all!"

There have been opinions by doctors and other medical professionals posted on various blogs. None of them bought the story as told by Sarah Palin. Cecilia gave up trying to be serious about it and couldn't be bothered to give answers to specific questions. She thought the whole thing was ridiculous and didn't merit a considered medical opinion.

Not only is Sarah Palin completely different from all other pregnant women, but her doctor seems to be quite unique as well.

People who try to defend Sarah Palin's actions say that each pregnancy is different. I agree, women's experiences vary enormously. Where Sarah Palin and her doctor deviated from the accepted norms (however unique each pregnancy may be) was by having an attitude which counted on certainties, leaving no room for any unexpected developments. They didn't consider any eventualities that didn't fit their plans.

The general consensus, based on statistics, is that labours get shorter with each pregnancy. There are exceptions, of course, but doctors only find out that a patient was an exception after the fact. The expectation is for a short labour in a fifth pregnancy, which was Sarah Palin's case. Neither Sarah nor her doctor could have known that she would fall outside the accepted statistics before the actual labour concluded. Any advice given by her doctor over the telephone would have been guided by her experience, that a fifth labour is faster, unless she had a crystal ball and knew beforehand that her patient was to become an exception.

Sarah Palin herself relied on her previous experiences to justify her actions: None of her four babies had been early. But Trig was 5 weeks early, which proves that not every pregnancy goes according to plan.

I know four women (personally) whose best laid plans went awry. One minute they were not in labour at all and in a very short time they had a baby in their arms.

A former neighbour called a maternity ambulance and gave birth outside her house, in the parked ambulance. I was pregnant with my second son at the time and the commotion in the middle of the night filled me with trepidation about my own fate (My first labour had lasted 20 hours. The second lasted 3, from my first contraction to my son's first cry - thankfully, in a hospital).

Another had her second baby in the car, on the way to the hospital, delivered by her husband. They called their little girl Carina, an anagram of "in a car."

A good friend gave birth to her third baby in the hospital car park. But the most dramatic story was that of another friend, who had no time to call anyone: She gave birth to her daughter on the kitchen floor, 3 weeks early, while her two-year-old little boy was taking a nap.

All these women had other plans, all of them thought they had time. None of them had a strange sensation down their bellies or leaked anything, giving birth 20 hours later. They had no warning signs at all. Sarah Palin had strong signs that labour was imminent - Todd called her doctor in the middle of the night, remember?

But at 4 a.m., a strange sensation low in my belly woke me and I sat up straight in my bed.

It can’t be, I thought. It’s way too early. Moments later, I shook Todd awake.

“Something’s going on.”

Desperation for this baby overwhelmed me.

Please don’t let anything happen to this baby. It occurred to me, once and for all. I’m so in love with this child, please God, protect him!

After all my doubts and fears, I had fallen in love with this precious child. The worst thing in the world would be that I would lose him.

What made her behave the way she did? She was desperate for her baby. So why didn't she get checked by a real life doctor in a hospital 10 minutes away from her hotel? How could she predict, with all certainty, that she wouldn't go into full labour before she reached Mat-Su Regional Medical Center? How could her doctor check whether her cervix had started to dilate over the phone? How could her doctor be so certain that Sarah had time to make her way back to the Valley, when that prediction went agaisnt all the statistics regarding the length of a fitfh labour? She had decades of experience delivering lots of babies...

Labour is not predictable. Doctors and midwives give advice to their pregnant patients not to stray too far from their chosen hospital in the last weeks of their pregnancies. Are they paranoid? Don't they know that labour can "let up" long enough for women to make their way to the hospital, that it's perfectly possible to make a relaxed journey involving two 4-hour flights, a 2-hour layover and a 45 minute journey by car before their patients can be induced at leisure? Don't they know that leaking amniotic fluid and having contractions that feel "different" don't constitute labour? Why are there so many alarmist, irresponsible websites giving women the wrong advice?

We didn't invent Sarah Palin's account of her labour with Trig. Her version of the events is documented in her own voice. She wrote about it in her book. We didn't write the press release saying that she had gone into labour in Texas. We only used logic and common sense and thought things didn't add up.

[I'm posting the Wild Ride again for easy reference. You don't need to listen to it again if it insults your intelligence!]

As my friend Cecilia said, this story is absurd.

Useful links:

Transcript of the Wild Ride
Other considerations about this story