Being kept alive for the sake of the unborn baby..

[QueenofmyPrinces]

A bit random, but just after some other people’s thoughts about a discussion I had with my husband last night and some of our friends.

We had all been watching Kill Bill and were chatting about the fact that the main character had been shot whilst pregnant, and was in a coma for ‘x’ amount of time and then when she woke up she saw her bump wasn’t there - I guess she assumed the baby had died but in the second film, she learns that the baby didn’t die and had been living with the father for 6 years.

I then said that if I was pregnant, and something happened to me that resulted in me being clinically dead, I would want doctors to put me on a ventilator, to keep me ‘alive’ in order to preserve my baby‘s life and then deliver it at 40 weeks.

DH said that hypothetically he would want the same as we would both want the baby to be allowed to live even if something happened to me.

One of our friends was pretty horrified by the idea though and said she couldn’t put her finger on the reason why, but she just didn’t like the thought of it.

I asked why wouldn’t she want the doctors to keep her ventilated to keep the baby safe and ultimately be born, but she couldn’t give a specific reason and just said it didn’t seem right.

We didn’t get into any big debate about it or anything but I’m just interested in what other people think.

I would absolutely want to be “kept alive” to enable the safe delivery of my baby and allow it to have a chance at life.

AIBU to think most women would feel like that?

People are giving emotional responses.

Which is fine, as long as emotion is not allowed to over ride science/reality and be made law.

There also appears to be confusion between comas and brain death.

I would want to be kept alive for as long as it took to deliver a live baby. I'm actually quite shocked anyone wouldn't want that.

You wouldn't be alive though. Your oxygenated corpse would be gestating the fetus.
Shocked why? That some people find the idea of trying to sustain a fetus in a breaking down dead body pumped full of drugs horrifying and not in anyone's best interests?

I would want to be kept alive for as long as it took to deliver a live baby. I'm actually quite shocked anyone wouldn't want that.

Have you read the judgement about that poor woman in Ireland to see what happened to her body before they let her go? Her body was swelling and her brain was liquefying and poisoning her body. Her dad had to bring the case to get permission to let her go - she was his baby, and he had to watch that happen, I can’t even begin to imagine. I’m actually quite shocked that you can’t understand why some people would find that grotesque at best. It would not be for me, I would not want my family to go through that for the very very slim chance of a good outcome for the baby.

I think it’s grotesque actually. And will the baby really be delivered mentally healthy having lived in a dead body without any of the normal experience of growing in their living, moving, speaking mother?

There have been cases where healthy babies have been born after the mother has been brain dead/comatose for a long period.

There's an article with quite a helpful summary by Lisa Rose Erlinger, ‘Guidelines for supporting a pregnant patient with brain death: A case discussion and literature review,’ Journal of Nursing Education and Practice 7.8 (2017): 86-92.

She gives details of the known cases she could find. The longest verifiable time a foetus spent in utero when the mother had suffered brain death/was comatose was over 100 days; she records a wide variety of outcomes including foetal death, neonatal death, and mild or severe disabilities. But she does record quite a lot of babies who were born without any apparent disabilities, not just at birth (where it's hard to tell) but also some months later.

I think the ethics of this are very complicated, and I'd hate for the pro-life crew to be the people who got to make the decision, for me or anyone I loved. But, I do understand why some women would want to make an attempt at this after they died.

I’d want to be kept alive, even brain dead if I was carrying my unborn child. I don’t understand why you wouldn’t want this? Surely you’d want them to live and have the best chance of survival, so being as far on into the pregnancy as possible. I’d have thought it’d be more distressing for my family losing me and an unborn child, than keeping me alive to save the baby?

Cross-posted with BelieveInPeople grotesque is the word.

Btw, just to give an example, Erlinger cites a case where the foetus was at 16 weeks gestation; the mother was kept on support for 100 days and the foetus was delivered at 31 weeks, and that child was developmentally normal at 18 months (which is not to say milder disabilities might not show up later, but if a child is normal at 18 months it is less likely a severe disability is present).

She has a few examples like this.

I admit, I had no idea either, and I am in no way an advocate of attempting to save a foetus at the expense of a pregnant woman's dignity. I just thought it was interesting as I had assumed it was much more clear cut than the studies would seem to show.

The longest verifiable time a foetus spent in utero when the mother had suffered brain death/was comatose was over 100 days

just over 3 months.

in this case, the baby would have needed just under 6 months ... twice the time, give or take

@teaandcake31 - well, because one of the likely outcomes is your family would have to make a tragic decision to let you go later on, when it became apparent the baby was dying anyway.

Often, a baby will just die in these circumstances.

YY, @SeaEagleFeather

She does cite a case where the report was that the foetus was supported for 'several months,' and my understanding is that, while medics acknowledge you might support a foetus for this long, the proof is shaky.

TBH, even 1 - or even 100 - examples where you had supported a foetus for that long, would not mean very much. It's a Hail Mary situation, and very wrong when we know a woman would not have consented.

"Grotesque" is correct.

People are imagining movie comas where they just appear to be asleep. And plump healthy babies delivered from these sleeping women.

There are too many variables for me to say what I would want in these situations. But I know I do not value being alive above all else and firmly believe that it may not be in the best inetrests of a baby to be incubated and delivered in these circumstances versus dying along with their mother.

I think that beyond a certain gestation there is a responsibility to the foetus to deliver it if viable but I'm not sure that extends to keeping the mother artificially alive to do so.

Sorry.. haven’t read all the thread. But this may be if interest to some of you Unconscious and pregnant Ethics discussion on BBC Sounds

@SarahAndQuack the problem with that work is that it only reviews the cases that were published which are, by definition, most likely to be the situations with a good/less awful outcomes - so we’ve no idea how often this happens and how often it does/doesn’t work and what the implications are for the baby or for the woman’s body.

I distinctly remember reading about the case of that poor woman in Ireland and what her family were put through.

Looking at the reality of what brain death means and what will happen to the body I can't imagine putting my parents, my husband or my existing children through that on the off chance that there may be a baby at the end of it. The thought alone is horrific. As sad and tragic as the case may be, unless the baby was viable (post 24 weeks) I would want for my family to let us both go.

The idea of being used as some kind of cadaveric incubator, rotting in a hospital bed, pumped full of drugs to keep me 'alive' fills me with horror.

@BelieveInPeople, did you actually read the report?

The author makes that point almost immediately.

@EarringsandLipstick This case came after the Law and Order episode, but www.google.co.uk/amp/s/people.com/crime/woman-vegetative-state-gave-birth-likely-been-pregnant-multiple-times-docs/amp/

I think the protocol in most countries is if the mother has just died, they will attempt to deliver the baby by c section.

@SarahAndQuack No I didn’t - most people on this thread aren’t going to read it either. I’m saying it because it’s really important to acknowledge that survival cases represent the extremes. If you can post to summarise cases in the paper with a good outcome, why can’t I post to highlight this really quite important point?

However, when pregnant with my second son he said that now that he knows what it is like to have a father a child, he would save the baby over me.

QueenofmyPrinces. And are you still married to this man who would have chosen for you to die?

And are you still married to this man who would have chosen for you to die?

Yes.

Because I’m pretty sure if I had to choose between him dying or one of my children dying, then I would rather him die.

I think it’s completely normal for a parent to choose the life of their child over the life of their partner.

Isn’t it?

AlexaAmbidextra don't be so dramatic. If both me and my child/ren were in mortal peril and my husband could only pick one to save, he better pick his child/ren over me.

I don’t think I’m the one being dramatic in this situation. 🙄

I think, as has been said, there is a huge difference between being in a coma and being brain dead on life support just to act as an incubator.

And yes, that Irish story was properly horrific - and shows that it wouldn't work long term.

I understand your feelings but no, I wouldn't want to be kept "alive" (not really though) just to act as an incubator, unless the baby was very near term. Not an option for me any longer as I'm too old now, thankfully but I don't think my feelings would have been any different 10 years ago.

@SarahAndQuack

You misstate the article

As its summary says

There are 30 cases reported in the literature between 1982 and 2010 on brain-dead pregnant women whose somatic non-neurological functions were maintained successfully to facilitate fetal maturation in the uterus. However, of the cases reported, 12 viable infants were born and survived the neonatal period.[1]

So less than one surviving infant every two years born from a corpse on ‘life’ support