To wonder who's life would be prioritised, mother or baby?

[splendidisolation]

Just one of those random train of thought questions that popped up in my head.

Imagine this theoretical scenario, a mother is giving birth and the doctor's have to decide whether to save her life or the newborn on its way out.
Ethically, which would they be forced to choose and why?

Imagine the mother's partner or a family member is present. Obviously horrific, but would they be asked to decide? Who makes that decision?

It was nearly a factor when DS was born unexpectedly quickly at home. Just one midwife was there and DS needed resuscitating whilst I was haemorrhaging. Midwife worked on bringing DS round first, but told me afterwards that she only did that as I was still vertical. If I had fainted she would have left him to look after me instead.

It depends on who is more likely to survive.
For example: mother is suffering a severe antepartum haemorrhage and the bleeding is not stemming even with serious intervention.
Mother is close to flatlining.
Attention will surely then be turned to getting the baby out alive.

The treatment for a very severe antepartum haemorrhage is getting the baby out and potentially doing a hysterectomy. It's nothing to to with the who is more likely to survive.

As I was taken to the OR i told my husband if it came to it, save the baby. Deadly, deadly serious.

Laurie, it's not just Catholic based medicine, it's in the constitution!

Beggars belief. I love this county, but sometimes .......

And yes, for whoever expressed disbelief earlier in the thread, Ireland does have (historically) Catholic and Protestant maternity hospitals.

I wasn't questioning their existence. Although I can see my post is written in a way that implies that. It was more the idea that the poster would just trot off to a Protestant hospital. No can do. There aren't any. Not anymore.

I'm not even sure I love the country face. I'm back about a year after 10 years abroad and settling back has been a struggle. But the hold of the catholic church is particularly repugnant.

I had this scenario with my second. For me, it was my son without question but the staff would have prioritised me. I made my wishes very clear but they were put in an extremely difficult position

As a doctor, I know that the baby is saved only when you know the mother is unable Save able. I only had to do this once, when worked overseas in a and e. Mother was brain dead following massive trauma, baby delivered by c section in casualty. Awful situation, still haunts me.
As a patient, my dexh... Was told that it was unlikely that either dd2 or I were going to survive her delivery. He was never asked or told there might be a choice...

Dh and I were on the way to theatre for an emergency section and I was very clear to him. If the doctors could only save one of us it was to be the baby. I surprised myself how firm I was being. I don't know who told me but I was told the medics would save mum. She can always have another baby . Can't get another identical wife. .

There are still Protestant maternity hospitals in Dublin backie. They may not be officially classed as such, but they are universally known and it is widely understood that medical priorities within them would be different to a catholic maternity hospital.

Oh fgs I've just checked my post and the first half of the sentence is missing. It's should have read "are you sure you would go to a protestant maternity hospital" sorry for the confusion.

It's the mother. I had pre-eclampsia with both mine and it was explicitly stated, that whatever your wishes, medical policy was absolutely prioritise saving the mother.

You don't get a say in their decision.

@notaflyingmonkey couldn't agree more. I also insisted on my baby being prioritised before consenting to surgery. And mine was an ELCS.

No one raised an eyebrow. (At least to my face.) And my husband, though aghast at the thought, agreed not to fight my wishes.

Which, as @Nan0second points out, is the rub: advance consent.

As with anything you want that might fly in the face of convention and over which you will have no enforcement ability (end of life care, as another example): if you have a preference, speak it and document it. Early.

I haven't heard talk of Protestant hospitals in a looong time.

My DSis had a high risk pregnancy before the pre Enclampsia, low amniotic fluid, gestational diabetes. What they did do for the baby was stimulate the lungs, so that she would have a better chance of survival. So yes, the mother is prioritised but they do try to give the baby the best possible chance as well.

Bloody hell hopefully the mother!!

Very, very interesting question.

Legally the mother is the only one that doctors owe a duty of care to until the baby has been born, even during delivery. So the mother is the answer, except in the rare events described here where a mother's injury is unsurvivable.

Brandnewhouse you are right.. apologies.
I for one am delighted that in the UK at least, women are prioritised as more than baby factories. *

• not that I would wish either baby or mothers demise

Mother should be prioritised.
For both pragmatic and ethical reasons, every time.

Saying that, when I had been in Labour for a while and was convinced things were going badly wrong (they weren't, I was pissed off my face on gas and air) I got a bit melodramatic and started insisting that they should "save the baby not me". But I was very far from rational at that point in time. It sounds awful, but much as I love my dd and would give my life for her now, I would not want to martyr myself for a child I have never met.

Rationally, it should be the mother. It sounds horribly cold but I do think that an adult (or a child) has more of a right to life than a full term foetus. Many ancient cultures did not really consider a baby to be a person until it was a month old - I am not saying that was right, but it was probably largely based on the survival chances of a newborn vs the survival chances of an older baby.

Even now, when infant mortality rates are much lower, a baby born in the kind of circumstances where such a dilemma would arise is surely going to be more at risk in the following days and weeks than the mother.

I completely disagree that the father or NOK should decide for the reasons given by posters above.
Has anyone seen Pan's Labyrinth? There's a horrible bit where the nasty fascist stepdad orders the doctor to "save my son if it comes to a choice". The mother is not asked for her opinion.

I'm with you too gummy goddess...

in A&E with severe haemorrhage during miscarriage.... all I could worry about was my kids at home and getting back to them in one piece. They need their mum more than a sibling. Being abruptly widowed is unspeakably sad too.

It's not really about prioritising self over infant, especially as you would have to live the rest of your life knowing that loss

I don't really understand this whole "it's only a real baby once out of the womb", so not considered an actual person with equal rights until born?

Baffles me. Interestingly enough, children take priority at all other times

As pp said, the mother is the patient, so she has priority. Yes in Ireland officially the life of the baby was supposed to be saved at any cost, but in reality it's well known and accepted that doctors in that situation would prioritise the mother.

I don't really understand this whole "it's only a real baby once out of the womb", so not considered an actual person with equal rights until born? hmm

Yes that's right. It isn't a person in law with equal rights as an already born person.

Baffles me. Interestingly enough, children take priority at all other times

Born children. Ones already living independently of an other human body.