Sarah Palin's wild ride - Liar or idiot?

It seems to be a good time to have another look at Sarah Palin's wild ride. This month two women went into labour during flights and had their babies in the comfort of an aeroplane.

These women had no idea they were going to deliver their babies on an aeroplane. They didn't have a strange sensation down in their bellies the night before, were not leaking amniotic fluid and didn't experience "Big laughs, more contractions."

September 21, 2011

A woman gave birth to a healthy baby boy aboard a Philippine Airlines flight from Manila to San Francisco on Monday, the airline said in a news release.

Aida Alamillo, 41, a passenger aboard Flight 104, told NBC-TV affiliate KNTV that she was due to give birth Sept. 28 but was cleared to fly by her doctor in the Philippines and Philippine Airlines medical personal.

Alamilllo said she never expected to go into labor on the plane. She was traveling with her 13-year-old son, whom she said alerted flight attendants that she was experiencing contractions. She was led to a private spot in a business class cabin on the plane's upper deck, where she gave birth at 3:25 p.m. PDT with the assistance of three nurses on board and several cabin crew members just a few hours before the plane landed.

Alamillo, now a mother of four, said that although this was her most unusual delivery, it was the easiest. “It’s like 15 minutes,” she said.


September 1, 2011

A woman has given birth aboard an Alitalia flight from Milan to Paris.

The mother, a French national, went into labor halfway through flight AZ 3508 from Milan Linate airport en route to Paris Charles de Gaulle Wednesday.

The plane landed just in time for a medical team to enter and help deliver the baby boy to the applause of the passengers on board.


Sarah Palin embarked on two long flights with a 2-hour layover in between. She started her journey from Dallas to Alaska ten hours after experiencing a strange sensation down in her belly and phoning her doctor to report that her amniotic was leaking. She experienced contractions during her all important speech and left the conference in a hurry. Rick Perry joked: "Don't tell me you're going off to have the baby right now!" Sarah Palin thought to herself: "If only you knew!"

An yet she chose not to seek medical attention in Texas, preferring to travel for at least 10 hours by air and another hour by road to give birth in a small hospital without the proper facilities to deal with any possible complications.

Leaking amniotic fluid prematurely is not without risks:

Eighty-five percent of neonatal morbidity and mortality is a result of prematurity. PPROM is associated with 30-40% of preterm deliveries and is the leading identifiable cause of preterm delivery. PPROM complicates 3% of all pregnancies and occurs in approximately 150,000 pregnancies yearly in the United States. When PPROM occurs remote from term, significant risks of morbidity and mortality are present for both the fetus and the mother. Thus, the physician caring for the pregnant woman whose pregnancy has been complicated with PPROM plays an important role in management and needs to be familiar with potential complications and possible interventions to minimize risks and maximize the probability of the desired outcome.

Premature preterm rupture of membranes (PPROM) occurring from 24-37 weeks' gestation is far more difficult to manage than premature rupture of membranes (PROM) at term. Several issues need to be considered in formulating a plan of management. Prematurity is the principal risk to the fetus, while infection morbidity and its complications are the primary maternal risks. All plans for management of PPROM remote from term should include the family and the medical team caring for the pregnancy, including the neonatal and maternal medical team. Remote from term, PPROM should only be cared for in facilities where a NICU is available and capable of caring for the neonate. Because most PPROM pregnancies deliver within a week of ROM, transfer of the pregnant mother to a qualified facility is urgent and should be facilitated immediately upon diagnoses.

The physician who wrote the article above was referring to PPROM in pregnancies in a regular setting, where the mother-to-be is not 4,000 miles away from her doctor...

Now, people who read Sarah Palin's own account of her labour and delivery should be excused for thinking she wasn't pregnant at all, because nobody in their right mind can believe that a governor of state could be so monumentally stupid.

Her stories about tight abs and the photo showing a perfectly flat abdomen at 7 months add to the doubts.

March 14, 2008 - 30 weeks pregnant

Whatever people choose to believe, there's no escape for Sarah Palin: If she wasn't pregnant, she didn't risk her own and Trig's life, but perpetrated a hoax. If she was indeed pregnant, she's an unthinking, callous idiot.

[Please read the full transcript of the wild ride interview plus excerpts from Going Rogue HERE.]

What if Katie Couric Asked Sarah Palin Some Gotcha Questions About the Wild Ride?

Let's imagine for a moment that Katie Couric actually managed to have a final interview with Sarah Palin:

Couric: What steps did you take to ensure the safety of your unborn child with special needs? What resources helped shape your decisions about it?

Palin: Any of them, all of them that were put in front of me. It's not like we don't have hospitals in Alaska. Alaska is microcosm of the United States and we have resources and know all the steps, like the rest of the country.

Couric: You cut short your stay at the conference to embark on the wild ride. What do you have to say about that?


Palin: Like every American I speaking with, we're ill about this. What this wild ride does is help those who are concerned about the health of the mother and the precious unborn child. It's got to be about job creation too, all the nurses and doctors... Also to shore up the stories my dad put out there, so reining in loose talk and creating health and jobs, all under the umbrella of lame excuses, this wild ride is a part of that.



Couric: Your dad said you were leaking amniotic fluid. Can you give me an example of when it's appropriate not to seek immediate medical attention?

Palin: Everybody knows he's a maverick and trying to get people to understand what he's talking about. I can give you examples of what my dad has done, that shows his foresight and pragmatism.

Couric: Can you give me some concrete examples of what I asked you? Not to belabour the point, do you have any examples of when it's appropriate not to seek medical attention in those circumstances?

Palin: I'll try to find you some and I'll bring them to ya.

The Wild Ride

Recent bits and pieces about Sarah Palin

Sarah Palin is still doing her job of bashing president Obama on Fox News. Now her broadcasts have moved to the great outdoors and the chosen location has a landscaped garden, complete with a pretty artificial lake in the background. She's always animated when she mentions the president and in the new setting her hair is animated as well.



In her latest appearance there was a lot of blinking and lip licking.



Jason Easley commented on this recent round of Obama bashing on politicususa:

What Palin was insinuating with her little free and fair elections remark was that 2008 was not a fair election. Sarah Palin believes that the election was stolen from her by Barack Obama and his foreign money.


Inevitably, the other topic of interest is Babygate. David Wegel claimed that he contacted Mat-Su Regional Medical Center and obtained confirmation that Sarah Palin gave birth there, proving that all Trig Truthers are deranged and obsessed with with their theories about the pregnancy hoax. Does Weigel actually believe that all the bloggers who have been writing about this didn't think of phoning the hospital in the course of their investigations? After nearly three years he was the first person to get an answer out of them? How odd...

Of course Andrew Sullivan didn't fall for it and Phil Munger offered some local information that makes Weigel's claims look ridiculous.

Some bloggers are still intent in proving that Sarah Palin didn't give birth to Trig. It appears to be quite a difficult task and gives Sarah Palin an advantage: Until they actually prove something by producing cast iron evidence, she can chose to ignore their challenges urging her to prove otherwise.

Others have chosen to focus on the Wild Ride and use Sarah Palin's own statements about her labour and delivery of Trig to question her judgement.

Laura Novak interviewed a neonatal specialist and his answers were very interesting.

Delivering in small hospital without NICU:
For a full term baby with no known problems, this is fine because most babies and mothers do well. The equipment and personnel to resuscitate a baby would be there and the baby could be stabilized and transported to hospital with a higher level of care. However, when there are known problems with the baby, it makes no sense to take unnecessary risks that the baby will need immediate intervention that cannot be provided in community hospital.

Sally and Chuck Heath pose with Trig in one of the rooms
of a delivery suite at the local community hospital
a few hours after his premature arrival

Despite the happy outcome, the wild ride puts Sarah Palin on more dangerous ground than challenging the whole pregnancy. She has mentioned "Trig Truthers" in some of her speeches, but has never addressed the "Wild Ride Skeptics."

Sarah Palin is going to make a speech on May 3, addressing a crowd connected to special needs. I doubt that she will refer to her brave and selfless journey from Dallas to the Valley, when she took all necessary steps to ensure Trig's safe arrival...

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):


Regina:

"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)?"

Cecilia:

"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:


Regina:

"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

Waiting for the Answers...

While we wait for the full reply from my doctor friend, I would like to present my new, illustrated version of the "Wild Ride" interview.



I also added it to the sidebar.

This video goes well with the post "Sarah Palin's Pregnancy: "No More Conspiracy Theories - Just the Facts"

Sarah Palin's Pregnancy: No More Conspiracy Theories - Just the Facts

The information below is not new to the people who have been following Babygate for over two years, but I thought it would be interesting to have it all in one post, just in case an adventurous, independent journalist learns to google.

Salon, Politico and the Huffington Post have declared the story debunked, but as far as I know, the "biggies" haven't said anything yet. The NY Times and the Washington Post havent touched it, have they?

I wonder if there are any Woodwards and Bernsteins left out there. My fear is that journalism in the US may have moved into the corporate world and we will never see anything like Watergate again.

It must be very frustrating and frightening for Americans to feel that what used to be taken for granted - a media that had an important role in keeping politicians accountable for their actions - may now be a thing of the past.

The media focused on the conspiracy theory element of the story. Perhaps we should stop trying to prove that Sarah Palin didn't give birth to Trig. Let's accept that things happened exactly as she described in the "Wild Ride" audio and in Going Rogue. Geoffrey Dunn's article, rejected by the Huffington Post, was not based on conspiracy theories. His approach was to question Sarah Palin's decision to embark on a long journey by air after the onset of labour.

Perhaps we should abandon the conspiracy theory and act as people concerned about the poor example Sarah Palin set for pregnant women through her actions.

FLYING


Sarah Palin, "Wild Ride" interview:

Reporter: Just a clarification – you flew commercial Alaska Airlines?

Palin: Yeah, yeah.

Reporter: And did -- This was something else I think I heard your father say I just wanted to clarify. Did you have to hide your pregnancy because you were so far along?

Palin: Well, you know I never felt nor do some people say I ever looked like I was that far along, um, so no purposeful way or need to hide that I was pregnant. Um, some, I know that some airlines would have uh, some hesitancy on letting maybe a nine month pregnant person get on board but it wasn’t nine months so, um, it was…

Reporter: And you didn’t tell them you were feeling something when you came back on the plane?

Palin: No need to because I wasn’t feeling at all like I was in labor in fact, you know I wasn’t one or maybe two contractions an hour that felt just like Braxton Hicks which I’d been having for months. That doesn’t constitute labor, so…

Fox News:

While the vast majority of women heed airline rules against flying during the last four or five weeks of pregnancy or comply with requirements about providing a medical certificate from a doctor, some manage to conceal their condition or lie about how far along they are so they can get where they want to go.

Since 2007, babies have also been born aboard planes flying from Chicago to Salt Lake City; on a domestic flight in Malaysia; and on long-haul flights from the Netherlands to Boston, from Hong Kong to Australia, and from Germany to Atlanta.

But even when gate attendants question how pregnant a passenger is, they usually have no choice but to let the woman fly if she says she has not reached the airline's cutoff date and is showing no sign of physical distress, said Dr. Fanancy Anzalone, president-elect of the Aerospace Medical Association in Alexandria, Virginia.

"The rules now are based on honesty and (the idea) that a pregnant mom is going to protect her unborn," Anzalone said.

Wall Street Journal:

Gov. Palin's opted to board a jet from Dallas in April while about to deliver a child. Gov. Palin, who was eight months pregnant, says she felt a few contractions shortly before she was to give a keynote speech to an energy summit of governors in Dallas. But she says she went ahead with it after her doctor in Alaska advised her to put her feet up to rest. "I was not going to miss that speech," she says.

She rushed so quickly from the podium afterwards that Texas Gov. Rick Perry nervously asked if she was about to deliver the baby then. She made it to the airport, and gave birth hours after landing in Anchorage to Trig, who is diagnosed with Down Syndrome. "Maybe they shouldn't have let me fly, but I wasn't showing much so they didn't know," she says.

Information on various websites:

You can fly on commercial airlines without restriction during your first and second trimesters, but during your third trimester you may run into some restrictions.

Airlines rely on an "honor policy" when it comes to enforcement, so it's the passenger's decision to notify agents that she's expecting and how far along she is. Ticket agents won't mention travel restrictions unless asked, so inquire about them when you book your seat.

All airlines recommend you consult your physician before travel at any time during pregnancy. Play it safe by getting a "permission-to-travel" letter from your doctor. You won't — and shouldn't — get one if your pregnancy is considered high-risk. Be sure to take your due date into consideration on the return trip, too. And before you plan a cross-country or international flight, remember how you'll feel squeezed into a seat for hours.

Alaska Airlines — 800/426-0333
Domestic:
No restrictions
International:
No restrictions

Generally speaking there is no cause for concern when it comes to flying during your third trimester. However, it is important to discuss your trip plans with your general practitioner before you book your flight. If you booked your flight early on and you find out you will be in your third trimester during this time it is recommended you try to reschedule your flight times as soon as possible. This is especially important if your flight time corresponds with 35 weeks and beyond in your pregnancy because many airlines will refuse boarding at this time. Plane travel can be stressful and worrying and labor mid-flight would not be ideal. Make sure you check with your chosen airline for pregnancy admittance regulations, some of them may even refuse boarding for pregnant women under 35 weeks.

It is generally advised that even though you may be enjoying a healthy and normal pregnancy you do not fly within your third trimester just to be safe especially in your final month.

Your doctor will refer you to an appropriate medical professional for the duration of your holiday so make sure you get their contact details and keep them with you at all times should anything happen. You will also need to take your prenatal chart with you which will have all your pertinent medical data on it.

Finally, make sure you reserve a plane seat that is on the aisle and as close to the middle of the plane as possible. This will make sure your ride is as smooth and comfortable as possible and will also make it easier for you to get up mid flight to walk around and visit the bathroom.

Even if you're enjoying an uncomplicated pregnancy, it's best to avoid flying (or any travel far from home) during your final month because you can go into labor at any time.

The chance of premature labor is the main concern of pregnant women traveling by air during their third trimester, Douglas says. "It's essential to have a medical contact at your destination," she says. Douglas also states that a mom-to-be should make sure her health insurance is valid and will cover her newborn before she leaves home. "You don't want to be unsure, especially if you're in a strange or new location."

Decreased air pressure during flight may slightly reduce the amount of oxygen in your blood, but this isn't likely to cause problems if you're otherwise healthy. Likewise, the radiation exposure associated with air travel at high altitudes isn't thought to be problematic for most business or leisure travelers. There's a caveat for frequent fliers, however. Pilots, flight attendants and others who fly often may be exposed to more radiation than is considered safe during pregnancy. If you must fly frequently during your pregnancy, discuss it with your health care provider. He or she may limit your total flight time during pregnancy.

Sarah Palin was a frequent flyer throughout her third trimester:

Circa March 4: Los Angeles to Anchorage
Circa March 7: Anchorage to Fairbanks
Circa March 9: Fairbanks to Anchorage
Circa March 11: Anchorage to Juneau
Circa March 14: Juneau to Anchorage
Circa March 27: Anchorage to Juneau
Circa April 15: from Juneau to Dallas
April 17: from Dallas to Anchorage


PREMATURITY


Sarah Palin, "Wild Ride" interview:

And, uh, he wasn’t due for 4 or 5 weeks later and um, while I was at energy conference I felt perfectly fine but uh, had thought maybe a few things were starting to progress a little bit that perhaps there was an idea there that he might come early.

Well not contractions so much because I had Braxton Hicks contractions for months as every pregnant woman does, and nothing real painful but just knowing that, um, it was feeling like, I may not um, be able to be pregnant a whole another four or five weeks knowing that it would be not a bother to call our doctor and let her know.

Going Rogue:

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.”

Later that afternoon we entered a packed house at the energy conference, where I’d speak on the urgent need to tap conventional supplies and innovate on stabilizing renewable sources.

Big laughs. More contractions.

Then I introduced everybody to Todd, Alaska's "First Dude," who, instead of sitting at the head of the table, was standing at the back of the hall, giving me the "get on with it, let's keep it short this time" look and practically holding the door open for our quick exit to the airport.

The audience graciously gave me a standing ovation. Then I handed the mic back to Rick and walked off the stage. "Hey," Rick drawled over the sound system with a chuckle, "we're not finished with the program!" I turned around, smiled, waved, and kept moving. "I know you're pregnant," Rick said, joking into the mic. "But don't tell me you're going off to have the baby right now!"

The audience laughed. I smiled and waved good-bye. I thought, if you only knew!

Taking care of a premature baby:

Infections. Like other organ systems, the immune system of a premature infant does not function as well as that of older kids or adults. This places preemies at risk for contracting infections (especially viral ones) after discharge.

Expect to live quietly with your preemie at first. Because their immune systems are still developing, preemies are susceptible to infections. Therefore, you need to take some precautions. Visits outside the home should be limited to the doctor's office for the first several weeks, especially if your baby is discharged during the winter months.

Because doctors' offices commonly have several kids with viral infections, try scheduling your appointment as the first of the day or request to wait in an examining room instead of the main waiting area. Ask the doctor how limited your baby's contact with other kids and adults should be during these first weeks.

Most doctors recommend not visiting public places with preemies. And limit visitors to your home: anyone who is ill should not visit, nobody should smoke in your home, and all visitors should wash their hands before touching the baby. Talk to your doctor about specific recommendations — some family visits may need to be postponed to allow your little one's immune system to grow stronger.

DOWN SYNDROME

Our little friend Max

Wild Ride interview:

Reporter: Are you going to take a maternity leave?

Palin: No, mm,mm. I’ll, I’ll…

Reporter: You’re gonna be…you’re obviously back today..

Palin: I’ll be able to bring Trig with me, um, to many of the, um, meetings and, and events and um, parts of the job here that I’m engaged in and just working it around Trig either being here with me in the early days as I did… the last one, with Piper, when I was mayor of Wasilla, she was with me so often.

Sarah Palin wanted to be prepared.

Going Rogue:

I had always flippantly declined the amnios before, thinking they didn't matter, since I confidently asserted I would never abort anyway. But this time I said yes. This time I wanted information. If there was something wrong, I wanted to be prepared.

She was desperate for this baby:

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.


Precious Trig at 11pm, 41F

If a birth defect is discovered prenatally, your doctor may discuss what will happen in the time right after you deliver the baby. You and your doctor should discuss which hospital is best prepared to deal care for your baby so that you can plan to deliver there.

You might want to ask if you can tour the intensive or special care unit at the hospital to become familiar with it and meet the team of health care professionals who may care your baby. This team may include neonatologists, pediatric anesthesiologists, pediatric surgeons, neonatal nurses, nurse practitioners, and doctors in training (like fellows and residents).

Kids with Down syndrome are also at an increased risk of developing pulmonary hypertension, a serious condition that can lead to irreversible damage to the lungs. All infants with Down syndrome should be evaluated by a pediatric cardiologist.

Expectant parents preparing for the birth of a baby with Down syndrome will read information in our book and other on-line resources discussing the possibility of a NICU stay. Mom Adina over at Baby Center conducted an informal poll of moms which found the following:

32.4 percent of babies went home with mom

24.3 percent spent less than 2 weeks in NICU

19.8 percent spent 2 to 4 weeks in NICU

9 percent spent 4 to 6 weeks in NICU

14.4 percent spent over 6 weeks in NICU

Adina’s poll shows over half of the babies with Down syndrome had no NICU stay or only a short NICU stay. But a large percentage do have a stay over 2 weeks. So while many babies will not have a NICU stay, practically speaking it is a very good idea to prepare for the possibility.

Sarah Palin knew she was carrying a baby with Down Syndrome. She wanted to inform herself about the condition, so she must have known that babies with Down syndrome may need extra assistance at birth. The websites I visited talk about the steps taken in the delivery of full term babies. Sarah Palin indicated that she wasn't going to be able to be pregnant for another five weeks, so she knew Trig would be premature. Prematurity alone alters the routine of the mother during and after the birth. There are issues about the immature immune systems of preemies. There are health issues affecting babies with Down Syndrome. The combination of Trig's special needs and his premature arrival would make his concerned, well informed mother wish to avail herself of the best possible facilities and resources in case anything went wrong.

Sarah Palin didn't alter her routine during this pregnancy at all. She knew she was carrying a baby with potentially serious health issues and yet she clocked several thousand air miles in her third trimester. When the possibility of Trig arriving five weeks early became part of her reality, she didn't alter her plans. All the consultations and examinations of her impending labour were conducted by telephone. She was determined to give her speech and very determined to give birth at a poorly equipped hospital.

Women who are not pregnant with a baby with special needs think twice before booking a flight in their third trimester. Women who suspect they're leaking amniotic fluid or who experience strange sensations down in their bellies in their eigth month would make sure they see a doctor in the flesh and wouldn't dream of boarding two flights with a 2-hour layover in between, followed by a car journey to an ill-equipped hospital. What makes Sarah Palin so very different from all the rest of pregnant women? It should also be noted that Sarah Palin didn't alter her routine after the birth of her premature baby with special needs.

The happy outcome doesn't alter the fact that her nonchalant behaviour had the potential for tragic consequences for herself and her baby. It also doesn't justify her award-winning doctor giving irresponsible advice over the telephone.

How would Sarah Palin react if one of her followers copied her actions and died with her baby in mid-air? Another blood libel?

Questions the Media Could (Respectfully) Ask Sarah Palin

I've been focusing on certain aspects of Babygate recently. I have two reasons for doing this: To restore some of the information that was lost due to a photosharing account being deactivated and to add my two pennies worth to the story. I have never written many posts on this topic. Most issues had already been covered by other blogs and I'm not the investigative type who makes contacts with Alaska locals, hoping to obtain first-hand information about this particular pregnancy or unearth some tidbits about Sarah Palin's earlier pregnancies.

What I think I do well is look at the easily available information and ask questions about inconsistencies in Sarah Palin's tall tales. I like to connect the dots. It works for her political record and it works for the mysterious pregnancy and labour with Trig.

Babygate made a come back and is being discussed again.

I particularly liked the series of conversations between Brad Scharlott and Laura Novak. Both are puzzled about the media's lack of curiosity about the hoax and Laura brings the perspective of a mother who went through a complicated pregnancy to the table, offering a more realistic account of her experiences than Sarah Palin's badly concocted tales of fishpickers, erratic labour and abs of steel.

Geoffrey Dunn focused on the dangers of the wild ride and what it says about a "pro-life" mother who put her unborn baby with special needs at risk.

Most of the media simply dismissed the story, repeating the argument Sarah Palin and the campaign put out there to rebut the rumours: Bristol couldn't have given birth to a baby in April and to another baby in December of the same year. Case closed. Others added the tired statistics about older women having greater chances of conceiving a baby with Down Syndrome. They didn't bother to do any research into childbirth, comprehensive statistics about Down syndrome or anything else. They're still stuck in early September 2008 and won't budge.

Sarah Palin's camp didn't miss the opportunity to start another smokescreen in the "documentary" about Sarah Palin on E! True Hollywood Stories. Apparently, Sarah already had tight abs when she was pregnant with Piper. She's a truly remarkable and unusual woman: She can control labour at will and her body works in a backward fashion.

Sarah Palin's tight abs about one month after Piper's birth

That's when I like to come in and ask a few questions. A quick google search produces many results about second and subsequent pregnancies. I found an article about a second pregnancy. I wonder what the scenario would be for a fifth!

- You tend to show about a month sooner. After having a baby, your uterus doesn't shrink all the way down to its previous size, which gives it a head start in growing during the next pregnancy.

- You carry your baby lower. Your abdominal muscles get stretched so much by the first pregnancy that they're weaker. As a result, they can't support a baby as well as they did before, so the fetus drops lower in your abdomen. The upside to carrying lower is that you'll probably breathe more easily and eat more comfortably than in your first pregnancy. The downside? You may find that the urge to urinate frequently starts earlier and you may have increased pelvic discomfort from the additional pressure on your bladder and pelvic area. You can relieve some of the discomfort with Kegel exercises, which strengthen the pelvic muscles.

Sarah Palin's body is a marvel. Instead of having weaker abdominal muscles after giving birth to three babies, hers get stronger and tighter: Piper and Trig pregnancies were contained until the last minute! Her body also has a secret compartment to store the growing baby, placenta and amniotic fluid conveniently tucked away, completely out of sight, and the cumbersome bump doesn't interfere with her centre of gravity.

This fitness enthusiast tells a different story, which is about her first pregnancy:

Once I crossed over, into my second trimester, my energy levels skyrocketed, and I started to feel like myself again. My workouts became even more enjoyable. I also found myself truly enjoying my growing belly and highly active baby. My workout intensity increased slightly. During the first half of my second trimester, I wasn't really "showing", and it was very easy to maneuver my way through my workouts. But, by the end of my second trimester, my belly began to "pop", and my center of gravity shifted. Although It is still fairly easy for me, to maneuver my way through my workouts, I am even more cautious, than before, when performing exercises, that require me to stand.


At 28 weeks pregnant, I have continued to maintain the muscle tone, in my arms, legs, back, chest, and, shoulders. I have yet to experience any odd pains, exercise exhaustion, or any other complications for that matter. My workouts have not changed, very much, from my pre-pregnancy routine, but I have made some minimal changes. I am still feeling really good, and I have been able to maintain most of my pre-pregnancy physique (excluding my abdominal muscles - of course!).


Poor woman! She wouldn't have been able to take a brisk walk around Juneau in very high heels...



The bloggers who have been writing about Sarah Palin's amazing fifth pregnancy don't have the same resources as the media. We tend to rely on Google to obtain information. Some have more information than others because they work in the medical field. We're not really interested in establishing who gave birth to Trig, we're simply convinced that Sarah Palin didn't.

The clues we picked up in order to come to this conclusion came not from a conspiracy theory, but from the improbability of the story Sarah Palin herself put forward. The media could forget about the Bristol part of the story and focus on Sarah Palin's pregnancy and labour alone. It would take the conspiracy element away and leave only the medical improbabilities to be explored.

Wouldn't it be wonderful if the media tied Sarah Palin to a chair and fired a few probing questions? It could be done in a very respectful way.

"Dear governor (she likes that), you have mentioned your tight abs as the reason you didn't show during your pregnancy with Trig. Considering that you have matured normally in your adult life, without any serious weight fluctuations or health issues, how do you explain your body working differently from other women's bodies? A photograph of your healthy, young, beautiful self in an earlier pregnancy shows a very large baby bump. Normally, women show earlier and get bigger with each subsequent pregnancy. You have a small frame, so where in your body was your fifth baby growing? Where did you stash the placenta and the amniotic fluid?"


"Best governor ever, I did some searching and found several accounts of pregnancies from very fit, athletic women, many years younger than your fantastic self. They continued to exercize almost normally, but reported changes in their centers of gravity and their growing bellies. Their photos show very fit bodies and yet their bumps showed. On the other hand, very large, obese women don't show at all, you couldn't tell whether they were pregnant or simply fatter. That's definitely not your case, you're hawt! How do you explain your tight abdominal muscles working as a steel girdle, capable of keeping your profile perfectly flat at 7 months when even professional athletes failed to disguise their bumps much earlier in their pregnancies?"

"Your Highness, moving on from this boring subject of tight abs - after all, you said they're tight and I accept it - I have a question about that amniotic leaky. You said you were in regular touch with your doctor by telephone. Please tell me, how did your award winning doctor perform the necessary tests to confirm the nature of the leaky fluids over the phone?"



"Ah, Your Majesty, my colleague's question reminds me of another little question: You said you sat up straight in bed, with a strange sensation low in your belly. You were worried it was too early and feared for the life of your precious child. Your irondogging husband rang the doctor over your protests. I assume both your gracious self and your intrepid husband considered the possibility of you being in the early stages of labour. I'm curious, how did your doctor perform a pelvic examination to see if your cervix was dilating? Perhaps you and your doctor would be so kind as to share these telephone techniques in obstetric examinations with the rest of the professionals in the field."


"Wait, wait! Your Saintness, now that your precious child and your desperation for this baby have been mentioned, I think it would be interesting for you to expand on this topic. Early tests showed that your baby had Down syndrome. You had studied all that was available about the condition because you wanted to be prepared. As you no doubt learned from the material you read, babies with Down syndrome are prone to heart problems and may have complications at birth. Considering that your fishpicking gift from God could make an appearance a month early - as you said, the leaky, the strange sensations and the contractions during your speech were signs that you wouldn't be able to be pregnant for, uh, um, another month - wouldn't it have been safer for your miraculous baby if you had gone to the nearest hospital with a NICU? How did your doctor monitor the condition of the baby over the telephone?"

And so on and so forth. All that's necessary for the media to come up with a few questions is a healthy dose of curiosity, a bit of googling, an entertaining read of Going Rogue and a careful listen to Sarah Palin's account of the wild ride.

It couldn't be simpler! No conspiracy theories, just good, honest to God (He knows what He's doing) questions.

Sarah Palin's very interesting "Wild Ride"

Discussions about Sarah Palin's "Wild Ride" were revived in a recent thread, so let's review some of the events, using my favourite source of information: Sarah Palin herself!


Palin: And, uh, he wasn’t due for 4 or 5 weeks later and um, while I was at energy conference I felt perfectly fine but uh, had thought maybe a few things were starting to progress a little bit that perhaps there was an idea there that he might come early. So I called my doctor at about uh four in the morning in Texas and um I said ya know I’m gonna stay for the day here at the energy conference - have a speech that I was determined to give at one o’clock that afternoon and, um, had Todd check on a couple of flights that were earlier than we had scheduled. I decided it would be ok to, um, skip the reception that night that we’d already by that time have taken care of our meetings and my speech. So Todd checked on flights. A flight allowed us to get out a little earlier than we had planned. Skipped the reception and, um, called my doctor before I got on the plane to say, ‘Yea, we think that we will come home a few hours early,’ and, uh, she said ‘OK call when you land and I’ll check you out.’ But none of my babies had been early and being my fifth child I know what labor feels like (laughing) and if I had felt at all that I was really engaged in uh, labor activities I would not have desired to fly and, um, get back uh, to deliver in Alaska. But anyway, so no real huge labor signs. Landed in, uh, in Anchorage at about 10:30. Got out to the valley at 11:30 and she met us at the hospital, checked me out and said, ‘Um, Yea you look, you may have it um tonight or in the morning.’ And it was smooth, it was relatively easy, in fact it was very easy, the easiest of all of them because he was so tiny. And, um, it’s just been absolutely wonderful. It was all, it just all seemed meant to be… the logistics and everything else just worked out so perfectly and to us he’s absolutely perfect, too.

Reporter: Of course you’re back to work already today and actually signed a bill that day, right?

Palin: That day, yeah, staff came out to the hospital and I signed a bill there so I could uh make sure we transmitted that in time and then uh here today also yeah, we have some energy updates I didn’t want to miss so that was good look and at him he’s just doing so well and it’s been easy and relaxing and again all it seems just meant to be this way.

Reporter: You said you felt some signs of labor, what were those signs?

Palin: Well not contractions so much because I had Braxton Hicks contractions for months as every pregnant woman does, and nothing real painful but just knowing that, um, it was feeling like, I may not um, be able to be pregnant a whole other four or five weeks knowing that it would be not a bother to call our doctor and let her know. And um she’s delivered how many babies over the year did she say?

Todd: Lots.

Palin: A lot. It’s been a couple of decades of her delivering babies. We knew to call her and just get her advice and, um, from there we again decided to skip the energy conference reception and come on home and get checked out.

Reporter: So did your water break?

Palin: Well, if you must know more of those type of details, but, um…

Reporter: Well, your dad said that and I saw him say it so that’s why I asked.

Palin: Well that was again if, if I must get personal, technical about this at the same time, um, it was one, it was a sign that I knew, um, could lead to uh, labor being uh kind of kicked in there was any kind of, um, amniotic leaking, amniotic fluid leaking, so when, when that happened we decided OK let’s call her.



Going Rogue

The next month, Todd and I checked into a hotel in Dallas. The following day I was scheduled to keynote another oil and gas conference. My pregnancy was going fine, and with five weeks to go, I felt great. 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.” He sat up in bed, instantly alert.

“I’m calling CBJ.” “No, don’t do that. It’s one a.m. in Alaska.” I didn’t want to call anyone yet.

I just wanted to take stock and see whether this baby was really coming. I also wanted time and pray and asked God silently but fervently to let everything be okay.

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. God knew what He was doing.

Over my protests, Todd called CBJ. I told her that I felt fine and absolutely did not want to cancel my speech and disappoint the folks at the conference, including my cohost, Texas Governor Rick Perry.

We agreed that I would stay in contact with CBJ through the day, I’d take it easy, give my speech, then catch an earlier flight back to Alaska. I still had plenty of time.

Later that afternoon we entered a packed house at the energy conference, where I’d speak on the urgent need to tap conventional supplies and innovate on stabilizing renewable sources.

Sarah Palin goes on to describe her speech, saying that she had contractions when she told a joke:

Big laughs. More contractions.

Then I introduced everybody to Todd, Alaska's "First Dude," who, instead of sitting at the head of the table, was standing at the back of the hall, giving me the "get on with it, let's keep it short this time" look and practically holding the door open for our quick exit to the airport.

(...)

The audience graciously gave me a standing ovation. Then I handed the mic back to Rick and walked off the stage.

"Hey," Rick drawled over the sound system with a chuckle, "we're not finished with the program!"

I turned around, smiled, waved, and kept moving. "I know you're pregnant," Rick said, joking into the mic.

"But don't tell me you're going off to have the baby right now!" The audience laughed. I smiled and waved good-bye.

I thought, if you only knew! I reached Todd at the exit, and he eyed me with a grin, "Love this state, but we can't have a fish picker born in Texas."

(...) Many hours and two plane flights later, with Todd and our daughters nearby, I delivered Trig Paxson Van Palin into the world at Mat-Su Regional Medical Center.


Nomoosestew posted a link to the website Babycenter, where air travel during pregnancy was discussed:

Reviewed by Aaron Deutsch, M.D., August 2006

If you have a normal, healthy pregnancy, it can be perfectly safe to fly during most of it. Discuss your trip plans with your doctor or midwife, however, before booking your flight. In certain high-risk cases, your healthcare provider may advise you to stay close to home throughout your pregnancy.

You may find that your second trimester — weeks 14 to 27 — is a perfect time to fly. Once you're past the first trimester, in all likelihood your morning sickness will be behind you, your energy levels will be higher, and your chances of miscarriage will be low. However, you shouldn't travel after 36 weeks.

Before you leave, have your prenatal caregiver refer you to an obstetrician or midwife at your destination in case you need medical attention during your vacation. If you'll be traveling during your second or third trimester, it's a good idea to carry a copy of your prenatal chart. The chart should include your age, the date of your last menstrual period, your due date, the number and outcomes of any prior pregnancies, your risk factors for disease, pregnancy-related lab tests and ultrasounds, medical and surgical history, and a flow sheet of vital signs taken at each visit.

In the comments section on the item "Is it safe to fly during my third trimester?" most moms-to-be take the issue of air travel a bit more seriously than Sarah Palin. They really don't want anything to happen to their babies. One of them had a cautionary tale about not being properly prepared.

"I flew with my second at 32 weeks and then had a prem birth (whether they were related or not I'll never know), with the third I flew a 12 hour flight at 16 weeks, and recently I've had two miscarriages before getting pregnant with my fourth. My doctor has advised me with the miscarriages and pre-term not to fly - which is disappointing (I really wanted to go away and used to be cabin crew so think of flying as nothing), but I understand it is best to avoid risks. I wouldn't want to be mid-flight if anything went wrong and it's really not worth the risk."

"I'm 34 weeks with my first and have a scheduled trip for work at 36 1/2 weeks. I work in administration for an academic medical center and even though I would be on a direct private flight traveling with a physician who happens to be a high risk obstetrician, I am forgoing the trip. My doctor explained that the minor change in air pressure (since we live at a relatively low elevation) can cause my water to break, which would force me to deliver in a hospital far away (and in this case, a small hospital with limited neonatal capabilities) without my husband and family. Despite the low odds of it happening, it's not a chance I'm willing to take. It would be one thing if the travel caution was about my discomfort, but I'm not forcing my daughter to enter this world sooner than she's ready, and definitely not because of my job. I appreciated knowing the precise risk from my doctor rather than the vague caution in the pregnancy materials I'd researched."

"These posts are right on! Including the one whose doctor told her there is a risk for water breaking and delivering away from home. However, for me, I traveled, boastfully at 29 wks w/ my first. I had dr's note and his blessing days before I left. I had no issues prior. On day 2 of my visit I felt some leaking and after 2 ER visits over 3 days, it showed positive for amniotic fluid. On the 1st ER visit they told me I was incontinent. I delivered at 30 weeks in WI when I live in VA. Very thankfully, my husband made it and I was visiting family in my hometown. The hospital is ranked 2nd & 4th in the nation for NICU and for the hospital. I was very lucky because I didn't check any of that out before I traveled."

Somebody totted up how many air miles Sarah Palin clocked in her the third trimester of Trig's pregnancy and the result was a staggering 18,000!

From Cathy Baldwin-Johnson's letter released during the 2008 election campaign

Dr Cathy Baldwin-Johnson appears to have a very laid back attitude to pregnancy. She had personally attended to Sarah Palin's second miscarriage and had informed the governor about genetic abnormalities and carried out tests regarding possible heart defects that could prevent Trig being delivered in the small community hospital in Palmer. Sarah Palin herself confirmed that Trig was born with holes in his heart.

It seems that Dr Baldwin-Johnson definition of "high-risk" is very different from what the lay person and other doctors would deem to be risky. The wild ride was only one of many, many flights Sarah Palin took while pregnant with Trig, never a problem with the good doctor...

This amazing doctor is also able to perform internal examinations through a phone line to check if the cervix is dilated and test fluids from thousands of miles away from her patient.

The Trig pregnacy and the wild ride, with all the contradictions in Sarah Palin's and her doctor's accounts of them, never cease to amaze!


Going Rogue has other fascinating stories about Sarah Palin's obstetric adventures and I'll look into them in a future post.


On Palin Deceptions, Audrey, in her very first post, tells us how the wild ride motivated her to start the blog.

Sarah Palin's "wild ride": Child endangerment or the fraud of the century?

Sarah Palin, 32 weeks pregnant, on March 26, 2008

We have covered this topic before, but it won't hurt to take a fresh look at Sarah Palin's wild ride...

It's very difficult to find straightforward medical advice regarding long haul flights in late pregnancy, but there are bits and pieces to be found on the forums. Funnily enough, when searching for medical advice about flying while leaking amniotic fluid and having contractions, the results are overwhelmingly about Sarah Palin and the wild ride!

I found an actual medical opinion and emphasized the relevant passages:

Women who fly during pregnancy, whether as passengers or crew, continue to fuel the debate over the potential impact on pregnancy outcome and fetal development, the two risk factors most commonly invoked being relative hypoxaemia due to the decreased cabin pressure and, more recently, cosmic radiation. On both theoretical and experimental grounds (altitude physiology and studies in pregnant women during flight), commercial flight poses no threat to the fetal oxygen supply in a normal pregnancy. As for cosmic radiation, only theoretical estimates are available of flight crew exposure: if annual doses approximate to background at ground level (3-5 mSv), the dose received during an individual pregnancy can be estimated from the fraction of annual flight time spent while pregnant. It is doubtful whether any epidemiological study could ever confirm or refute this theoretical estimate of a low increase in risk. Many airlines have opted to allow pregnant crew to continue flying. There is thus little if any ground for advising against passenger flight in pregnancy. Flying is probably the safest and most comfortable way to travel long-distance in pregnancy. The few relative contraindications include flying close to term, a history of miscarriage and premature delivery, heavy smoking, severe anemia, cardiopulmonary disease, and a serious fear of flying.

We all know that Sarah Palin's pregnancy with Trig was not normal and her own book revealed that she had two miscarriages.

From a forum:

After reading the postings regarding flying when pregnant, and having had a trip planed for my 30 week of pregnancy, I realized that perhaps I also should contact my doctor to get their advice. I belong to Kaiser and can tell you that the advice nurse all but laughed at me when I told her my situation. She said that she would forward the message to my doctor but could tell me immediately that the doctor was NOT going to approve it. Granted, my situation is slightly different as I was planning on flying to a wedding one day, and returning the next. Wanting to get a second opinion, and make sure that Kaiser was not overreacting to prevent a potential lawsuit I sent email to my father-in-law who is a retired general practitioner. Below is his reply. Hence, my trip has been cancelled.

"The third trimester is a time when complications occur, which can be abrupt. As an example, if membranes rupture in the seventh or eighth month, labor can be very rapid, all within the period of an airplane flight. Although the odds are fairly low, such complications, unfortunately are common, and you would have much better chances for a favorable outcome if you are near your physician and hospital. My answer was always no. My usual response was that, although you'll miss the wedding, it is far better to visit later, and show off your new baby."

I don't think doctors anticipate having to advise their patients about flying in the late stages of pregnancy after they start leaking amniotic fluid. Their advice is normally about one or the other, not both! The same goes for contractions.

Article on the ADN:

Palin said she felt fine but had leaked amniotic fluid and also felt some contractions that seemed different from the false labor she had been having for months.

Sarah Palin reinforced the story about the contractions in Going Rogue, but left the fluid leakage out:

The next month, Todd and I checked into a hotel in Dallas. The following day I was scheduled to keynote another oil and gas conference. My pregnancy was going fine, and with five weeks to go, I felt great. But at 4 a.m., a strange sensation low in my belly woke me and I sat up straight in my bed.

(...)

Later that afternoon we entered a packed house at the energy conference, where I’d speak on the urgent need to tap conventional supplies and innovate on stabilizing renewable sources.

(...)

Then I took the podium and opened by teasing the audience about how great it was to be in our "little sister state of Texas."

Big laughs. More contractions.

Dr Cathy Baldwin-Johnston found herself in a very unique position, having to advise her patient on three different aspects of pregnancy, all at the same time.

On the same ADN article, we find this quote:

"I don't think it was unreasonable for her to continue to travel back," Baldwin-Johnson said.

Advice about leaking amniotic fluid: (Preterm Premature Rupture of Membranes -- PPROM)

How is it diagnosed? If you are leaking amniotic fluid, the diagnosis is easy. The doctor will do a pelvic exam to look for amniotic fluid leaking from the cervix. A speculum will be inserted much like when a Pap smear is done. A fluid sample will be taken. The fluid will be tested by putting a drop on special paper. Amniotic fluid will cause this paper to change color. The fluid can also be tested by looking at a drop under the microscope. When amniotic fluid dries, it looks like a fern pattern. An ultrasound will tell if there is less amniotic fluid around your baby.

Based on the information we have, Dr Baldwin-Johnston performed this test and an ultrasound over the phone.

How will the affect my pregnancy? PPROM can lead to other problems such as premature labor, infections of the mother or baby, kinking of the umbilical cord, delivery of the umbilical cord before the baby (prolapsed cord), and poor growth of the baby’s lungs.

The sac around your baby helps to protect the baby from germs that normally live in the vagina. When this sac breaks, these germs can cause an infection in the mother and/or baby. This is called chorioamnionitis.

The umbilical cord could get pinched with less fluid to protect it during uterine contractions or when the baby moves. In rare cases, the umbilical cord can come out of the vagina before the baby is born (prolapsed cord). An emergency delivery would be needed because the baby would not be able to get oxygen. Without enough amniotic fluid, the baby’s lungs may not grow well. If the lungs are too small, (this is called pulmonary hypoplasia), it may be hard or impossible for the baby to breathe after birth. There is no way to predict this problem.

Apparently, Dr Baldwin-Johnston was able to make many predictions based solely on telephone examinations.

There are two ways of looking at the good doctor's behaviour:

1. She gave very, very bad advice over the phone. I can't imagine any other doctor thinking that it would not be unreasonable for a 44 year old multipara leaking amniotic fluid and having contrations to continue to travel back from Dallas to Anchorage, then travel a further hour to reach a hospital without appropriate facilities. Did I mention that the baby in question was already known to have Down syndrome?

2. It was not unreasonable for Sarah Palin to continue to travel because she was not pregnant at all.

Whichever of these options is true, it leaves Dr Baldwin-Johnston facing a conundrum. Either she gave appalling advice or she's covering up a major fraud.

The third option is that she was caught in one of Sarah Palin's many instances of using people as she pleases, then discarding them. Dr Cathy Baldwin-Johnston has been awfully silent and virtually unseen since the April 2008.

I wonder why!

(Previous post about the wild ride)

Click here to hear Sarah Palin's own description of the wild ride on April 22, 2008:

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