‘Incompatible with life’: Mother’s account of her difficult decision to request a late-term abortion sheds light on ‘live-born’ debate

Tristin Hopper | Feb 6, 2013 7:21 PM ET | Last Updated: Feb 7, 2013 12:31 PM ET
More from Tristin Hopper | @TristinHopper

Ian Waldie/Getty Images      In 2010, 537 Canadian women underwent abortions after 21 weeks of pregnancy, not including Quebec.

Twenty-one weeks into her second pregnancy, when the fetus was diagnosed with a rare bone disease, Carol determined she had two options: Miscarry the baby naturally and deliver a child with a shattered skeleton that would live for a matter of seconds or request a rare late-term abortion.

“I found out when I was five months pregnant, and … by the time you’re five months pregnant you’re all in,” said Carol, not her real name. “There’s no great outcome in these situations.”

Babies without lungs, kidneys, spines, bones or brains: These are the rare “incompatible with life” conditions that clinicians say prompt most, if not all, of Canada’s contentious “live born” abortions. According to Statistics Canada, 491 such abortions occurred in Canada between 2000 and 2009.

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But while three MPs drafted a Jan. 23 letter to the RCMP citing these “live born” abortions as evidence of premeditated “homicide” in Canadian hospitals, clinicians and veterans of the procedure maintain that in Canada, the only fetuses terminated in late-stage abortions are those whose fates are already sealed.

Carol’s fetus was killed by the procedure, but it was virtually identical to those that result in live births.

“I want people to understand what these women have been through before they start accusing the doctors who helped them of being murderers,” said Carol.

In 2010, 537 Canadian women underwent abortions after 21 weeks of pregnancy, not including Quebec. According to Wendy Norman, a clinical professor at the University of British Columbia, “almost everyone” in those cases “has some different anomaly.”

Some have fetal anencephaly, a condition in which the fetus fails to develop a brain.
Others fail to develop kidneys, a condition known as Potter’s Syndrome that kills the infant hours after birth.

Many times, said Dr. Norman, the specific defect is so rare that it does not even have a proper medical name.

After an ultrasound at 21 weeks, Carol’s fetus was diagnosed with osteogenesis imperfecta, a genetic disorder that results in severe bone fragility.

Less severe versions of the condition are survivable, although they result in physical deformities into adulthood. Carol’s fetus, however, had one of the most extreme cases.
“What I was told was that it could die at any moment,” she said.

If the baby was naturally stillborn, said Carol, she would have needed to select a name, learn the child’s gender and make funeral arrangements.

Carol requested a late-stage abortion, adding that the procedure was never broached by medical staff, and even finding a physician qualified to perform it was a challenge.

“They’re not offering these things up. It wasn’t even presented as an option,” she said.

If anything, she said, hospital staff made sure to explain why some women will carry a known stillborn to term simply for the “ritual” of a natural birth.

Blogs and online pregnancy forums abound with testimonials from women who carried their children to term with full knowledge that they would not live more than a matter of minutes.

“I savored every kick and turn she made inside my growing belly,” wrote one woman of her decision to carry a fetus with fetal anencephaly to term.

Wrote another woman whose fetus was diagnosed with Potter’s Syndrome, “I chose to carry to term and made it to 37 1/2 weeks when we had a C-section … He lived just under three hours, the happiest and saddest hours of my life.”

Speaking to the Post in November, Dr. Douglas Black, president of the Society of Obstetricians and Gynaecologists, speculated that similar sentiments may underlie the 491 “live-born” abortions between 2000 and 2009.

As hospitals will routinely administer a lethal injection to a fetus prior to a later-stage abortion, Dr. Black guessed that any aborted fetus that emerged exhibiting “evidence of life” was due to the “private choice” of a mother.

Such fetuses are “subsequently allowed to pass away, depending on what the circumstances are, sometimes in their mom’s arms,” he said.

For Carol, there were physical risks of carrying the fetus to term over another four months, but she said it was also a psychological decision.

“The idea of having the pain of childbirth compounded by the really emotional trauma of losing a child, it was a lot to take on. … I don’t think I would have been able to think about having more babies subsequently,” she said. She has since given birth to a second child in a complications-free pregnancy.

National Post