A better choice than late-term abortion: perinatal hospice care
My teenage daughter recently developed a headache and fever bad enough for her to tell me: “Mom, I need to go to the emergency room. Please, take me now.” At the E.R. we learned that not only was she running a fever of 102, but her heart rate was well above what it should have been for a 15-year-old. “We’ll start an I.V.,” the nurse said. “Oh, and her swab just came back positive for Influenza A. You’re going to be here for a while.” My daughter began to cry; I held her hand as she lay on the gurney. As any parent knows, there is nothing worse than seeing your child in pain.
That particular fear—having to witness a suffering child—was repeatedly cited in the coverage of New York’s new abortion law, which permits elective terminations up until the moment of birth, as well as similar legislation in Illinois and other states. Much of this coverage was based on the assumption that late-term abortions involved dire medical conditions which would either be fatal to women who continued their pregnancies or result in the child being born with disabilities. One woman, a member of the abortion-access lobbying group Naral, wrote in USA Today about the “crystal clear” choice to have the procedure out of “the purest mercy” for her child. Late-term abortion was portrayed as a zero-sum game in which a mother had no other option but to abort.
This concern does not match the data on late-term abortions, which suggest that most are not done for reasons of maternal or fetal health. For example, in 2013 the Guttmacher Institute (which advocates for greater access to abortion) published a study by two University of California researchers who concluded, “data suggest that most women seeking later terminations are not doing so for reasons of fetal anomaly or life endangerment.” More common reasons included the fear of raising a child alone, addiction problems and delays in seeking an abortion after discovering a pregnancy.
The idea that late-term abortions are sometimes the only way to spare children from a life of constant pain is also unsupported. Conspicuously absent from this debate, and even from the typical conversation between doctors and women receiving adverse prenatal diagnoses, is any mention of perinatal hospice and palliative care. Perinatal (which means “around the time of birth”) hospice care employs many of the principles of compassionate care that the standard, more well-known hospice provides for other patients with terminal illnesses: nutrition and hydration, comfort care, pain control, and time with family for bonding, prayer and expressions of love.
The idea that late-term abortions are sometimes the only way to spare children from a life of constant pain is unsupported.
Perinatal hospice does not seek to hasten death. Rather, it “follows the child,” presenting a model of accompaniment for both the child and his or her parents. Physicians, nurses, social workers, chaplains and other trained professionals work to ensure that families are able to cherish the time they have with their child, however brief.
I was made aware of perinatal hospice when one of my friends discovered her unborn daughter had a rare form of anencephaly. Although she was strongly encouraged by doctors (pressured, actually) to end the pregnancy, she declined and asked for a cesarean section to give the baby the best possible chance of extended survival. Although she lived only six hours, Mary Bernadette was baptized, held, sung to and even taught a few words of Czech by her grandmother (so she would be ready to meet her relatives in heaven, grandma explained). She died peacefully and painlessly in her father’s arms, surrounded by her family.
Women who opt for perinatal hospice have far better outcomes than their counterparts, especially related to anxiety, depression and grief.
A few days later, Mary Bernadette’s parents learned that her donated heart valves had been used to save the lives of two critically ill infants. This is not always possible for such infants, but to her parents that knowledge was a tremendous consolation.
Studies report that women who opt for perinatal hospice have far better outcomes, in both physical and mental health, than their counterparts, especially related to anxiety, depression and grief. Nebraska has recognized this and now requires health providers to provide information about perinatal hospice care to any “pregnant woman who finds out that her baby has a life-limiting condition and who chooses to continue her pregnancy.” In contrast to the narrative of a zero-sum gameof termination, which pits mother against child, perinatal hospice is a positive-sum game, one in which all participants benefit.
Beyond who wins or loses, perinatal hospice promotes the dignity of all, especially those who will travel with us for just a short time and go to wait for us until we can join them.
This is vital, timely information, beautifully expressed with very relevant examples and authoritative sources! Thank you, Ms. Fiorito!
We should always strive to support women in crisis pregnancies, no matter the circumstances. Thank you for your beautiful story. Loving and respecting the mother and child is so vital.
And until the child is an adult.
Michael-Yes, absolutely, if need be, although I think most mothers would prefer they receive help whereby they can earn enough to support their child on their own.
I don't see anything wrong in offering women this choice in this extreme situation if they have decided to continue the pregnancy anyway but I do have a problem with pressuring women into doing this If they have not shown an interest. For starters the woman in the story had to undergo a c section to take part in this option so already you are making a woman have surgery she would not necessarily require with an abortion of a fetus that is not going to make it. Also for those pain sensitive folks, suffocating over six hours because your lungs are not mature enough to breath for your survival which is probably why the child died the same day is not a pleasant way to die compared to never being born conscious to the pain. Again, in such cases, the mother, doctor and family's wishes should prevail.
Nora- I'm just curious if you have an issue with women being pressured to abort, as was the case of the woman in this story? Do you fight with the same vigor for all the women who feel pressured into making the 'choice' to abort, or is your passion strictly aimed at those men and women who want it when they want it, no questions asked?
To answer your question, I am definitely against anyone pressuring any woman to abort their pregnancy. I have no problem with any woman choosing to do what this woman did in the story because I am not in her shoes so she is the most just person who can make these choices. She more than anyone will have to contend with her decision, physically, mentally, financially, spiritually no matter what her choice.
For the record I believe personally that abortion is a sin as it is an act which shows forth a lack of faith at its core. So I judge the act but not the often desperate women who have it performed.
I don't blame women for the fact that abortion is desired in any country. I agree our country and its mostly still male led government is as much if not more to blame.
Notice it is a conservative wealthy republican white man trying to push this bill through, and he is the very sort of politician who attacks the affordable Care act, mandated equal pay for women, and government provided quality day care, another words the very things that have proven globally to cause abortion rates to drop. He has had people do the research by now and he knows these kinds of laws only increase abortions everywhere in the world but he tries to push this through anyway. Don't be these men's fool. These rules cause more deaths to the born and unborn alike - do the research yourself.
These kinds of laws are a wrong answer to the right question of how should we decrease the demand for abortion?
The greedy male politicians only want to try to control women. They are only interested in illegalizing abortion. They have zero interest in actually preventing abortions.
I cannot really think of a reason i would abort except if the chances of the baby making it were next to none and the fetus might turn septic and kill me if it should unexpectedly die inside me, or if I had early onset pre-eclampsia and would stroke out before five months and so I am robbing my other kids and husband of a wife and mother and yet I am not saving the baby anyway. However, I fully believe that the choice is and should legally be mine.
I believe people need the right to decide what they will do with their own organ's and bodies even if deciding not to let another human use their body or organs means that the other person will die.
We do not demand people give blood or donate organs so that others can live, not even ones we can live without like kidneys or marrow. We do not even make dead people donate their organs after death to save others lives even children's lives. So I don't believe women are as free as men If we legally force them to gestate others or the unborn against their will while we demand no such equivalent mandated use of men's organs and bodies in similar life saving situations. There exists no laws that anywhere near approach the intimately intrusive laws some people have been throwing out there to restrict women's rights over their own bodies and organs.
I don't believe God cares more about the lives of the unborn or babies than he cares about the lives of women. If God wanted the liberty of choosing what to do with their bodies taken from people God would not have put the tree of the knowledge of good and evil in the garden of Eden. From the beginning God has supported the liberty of people to choose how they will use their own bodies even though God knew they would choose a self destructive path with that free will.
There are present two potent sins in the abortion dilemma. The first sin is the desire to abort. The second sin is the desire for men to control and manipulate women rather than treat them with equal respect and help them as they would wish to be helped while making certain greed and competition for power over the situation are not allowed to play any part in the equation. Unfortunately, pro life groups tend to only recognize one of these sins. I believe this is why they fail to gain what they seek.
My advice, stop seeking laws, and you will find the answer that truly will make all the difference and that answer will save lives and set women free rather than cage them or corner them into desperation.
Have a little more faith in God and women. Women have already proven that when we give them freedom to choose and offer better options, in huge numbers, women stop aborting on a global scale.
This fine article reminded me of two different events in my life, one which I only experienced indirectly, another in my family. Years ago, I financially supported a crisis pregnancy center founded by a physician. He and his wife (a remarkable woman) sheltered pregnant women of all races and religions in their home. The doctor's wife, who became pregnant after being raped at a young age, had the courage to give birth and released her child for adoption. This inspiring couple not only raised their own children (the physician is on the board of a home for pregnant woman which I occasionally financially) but the couple also adopted from a woman considering abortion an infant who was severely disabled. They cared for and loved their son for the brief time that he lived outside the womb. Although I was unfamiliar with perinatal care until I read this article, I believe it is a compassionate approach for women and families in a difficult situation.
On a personal note, in 1994 my parents took into their home my aunt who was terminally ill. My aunt, who was a widow without children, had brain cancer (who had surgery which was unsuccesful) and could no longer live alone, such were her needs. Along with my parents and an excellent hospice program, I assisted my parents in caring for the personal needs of my aunt. (I might add that my Dad had serious health problems at this time, and died of congestive heart failure after being comatose for a month in the summer of 1994,-fortunately, he died peacefully when my Mom and me were visiting). My aunt received excellent care from the hospice staff, and also went into a coma for several days while being cared for at home by hospice with assistance from my family. I believe that caring for human beings in difficult circumstances at any stage of life is the best course of action. May the Holy Spirit give the gift of fortitude to people in difficult circumstances.
1) It is a lie to state that the NY law permits abortions "up until the moment of birth".
2) the idea that women should give birth to fatally ill babies so that they can suffer for hours, days, weeks, before dying is disturbed. Most people would not make even a pet go through this, mush less a child.
Yes Crystal I agree. There is much lying going on with the pro-lifers regarding these laws. They are being intentionally unclear when referring to time of birth.
If a woman has a late term abortion, say in her fifth month because she has pre-eclampsia so the fetus is aborted to save the mother from having a stroke, which would likely kill both mom and fetus, by using drugs to induce labor this is not really up to the time of birth abortion because the abortion is causing the birth.
In these cases often the baby does not have mature enough organs to survive long.
A law demanding that these aborted fetuses be hooked up to every machine imaginable to try and save them knowing the child will likely be severely deformed or go thru prolonged and extreme agony in the attempt to save it against the mother's desires does not really represent allowing abortion up to the time if birth since the fifth month is not even close to normal birth timing and this fetus is really being aborted and that was understood from the beginning. However, pro-lifers will refer to this misleadingly as allowing abortion up to the time of birth on demand.
I agree there are simply some life and death decisions that need to be left to the pregnant women, their drs and the women's family.
Where abortion exists as a procedure known to man, someone is always choosing not to abort every pregnancy. So the question is who is the right person or persons to make that choice, the pregnant women and their doctors or government? I believe the first one is the only just choice.
Our bishops who choose to use misleading statements regarding these laws are not helping themselves because it just strengthens the opposing sides argument that there is no point dialoguing with pro-lifers since they will lie and omit truths and exaggerate to get their way, and they clearly only care about illegalizing abortion instead of actually preventing it.
Crystal: It is 100% accurate to say NY law permits abortions "up until the moment of birth." I analyze the law here. https://thefederalist.com/2019/02/04/dont-let-ralph-northams-racism-controversy-obscure-democrats-sickening-abortion-policies/ I can only assume you have been mislead by other media, so I encourage you to read the article which analyzes the actual statutory language. And I think you missed the point that hospice alleviates the suffering, while a late-term abortion causes deadly suffering.
1) The Federalist is not what I would call a non-partisan source of information. Numerous articles detail why saying that the New York law allows abortions up to the moment of birth is disingenuous ... https://www.cnn.com/2019/02/06/health/late-term-abortion-explainer/index.html ... https://www.factcheck.org/2019/02/addressing-new-yorks-new-abortion-law/ ... https://www.politifact.com/facebook-fact-checks/statements/2019/feb/01/viral-image/no-new-york-abortion-law-doesnt-let-mothers-abort-/ ... https://www.newyorker.com/news/news-desk/how-abortion-law-in-new-york-will-change-and-how-it-wont
2) I didn't miss your point, I just disagreed with it. I'm not sure how to compare the level of suffering between an abortion (which takes minutes) and the hours, days, weeks, that a doomed baby would suffer in hospice, even if drugged to the point of unconsciousness. Why put the child through this?
As a person suffering from chronic illness, I'm certainly glad no one decided for me that I didn't want to be born and exist. It's almost like some of y'all don't have any charity. I'll gladly suffer to be alive, it's better than being killed with no consent.
As a person suffering from chronic illness, I'm certainly glad no one decided for me that I didn't want to be born and exist. It's almost like some of y'all don't have any charity. I'll gladly suffer to be alive, it's better than being killed with no consent.
This isn't about babies with chronic diseases, it's about babies with *fatal* diseases .... they are terminally ill and are not going to survive.
More would know if Catholic hospitals would advertise that they would do these procedures. Also, define late term. 3rd trimester? It seems unlikely for selfish reasons. Would Catholic hospitals do this for a second trimester mother whose infant was doomed or the mother if she carried to term? That would take some doing. As for the other reasons, financial support of every child at $1000 a month would stop a lot of abortion any trimester and is much preferable to going after providers. Providing respite care to parents of Down's children and full support for the children when adults, including making sure they can never work themselves out of support in a meanial job and you will really decrease 2nd trimester terminations. Good luck getting the movement to back such measures.
This was a beautiful, well-researched, and well-written article on this topic. I have been involved with perinatal hospice as a volunteer at a local level for a several years, and found this piece consistent with my experience.
I found it frustrating that the comments did not share this same commitment to truth, but perpetuated many of the false beliefs regarding the lives of these fragile infants and their mothers which prevent many from receiving compassionate care in this area.
First, the suggestion that these brief lives are full of suffering doesn’t square with the reports from the field; the lives and deaths of these children are often described as “gentle” and “peaceful”, with any discomfort relieved by typical palliative care measures.
Second, I have never heard of any woman forced into a perinatal hospice program, while I have heard from many women who feel pressured into abortion in the same situation. The fact that 80% of parents choose perinatal hospice when offered by a supportive physician suggests that this choice deeply resonates with mothers.
Finally, the comment about fetishizing the beauty of a life of suffering also fails to acknowledge the real experience of families who have gone through perinatal hospice. Although certainly grieving for their children after death, they almost universally describe the lives of their children in terms of “gift” and “joy”. The beauty of these lives is real.
Thank you so much for advocating for this most compassionate model of care for these infants and their parents.
And thank you, Mary O'Callaghan! Magnificent!
Pain and suffering cannot always be removed by drugs, without actually killing the patient, and sometimes it is hard to know how much a patient is still suffering from the outside. I don't doubt this practice makes it easier for some parents because they don't have to feel responsible for making a life/death choice. The whole situation is set up to make them feel better. But the child's experience should be what matters here, not that of the parents.
Crystal- It is a little disingenuous of you to advocate for abortion on the one hand, in all circumstances since you have put forth the argument (in previous posts) that it is a woman's right, and then argue that the child's experience should be what matters. Am I missing something?
I do and always have cared about the suffering of existing persons. A baby who has been born is a person. Most abortions happen very early, when suffering (and personhood) are not applicable.
My second daughter died of heart failure about seven hours after birth. During her agony, I observed my own discomfort and that of the medical staff, who did everything they could to ‘help her die’ faster (perhaps even preventing a chance for recovery). She seemed so peaceful, by contrast. When she died, I had to overcome my own discomfort with death to take my sweet baby in my arms. Then, for months, rare were the people who would approach me and my husband, for fear of our grief. We are the ones who are most uncomfortable with death and dying—not dying babies. Hardness of heart and love of comfort masquerades as compassion. The only thing an abortion does is add violence to death and keep it hidden, so that no one has to be uncomfortable—except the mother whose body knows this violence. Thank you for this beautiful article.
Lauren-Thank you for your comment, and I'm sorry for your loss of your daughter. I find it very odd that people advocate for abortion because the ill child will suffer. What in the world do they think happens to the unborn child? Do they think there is no suffering? And we who advocate for life are the ones deceiving?
A couple points: first, as noted by others, the NY law permits abortion after 24 weeks in cases in which the fetus is not viable OR the mother's life or health is endangered.
Second, the paper that Ms. FioRito cites to show that most women opting for late term abortions do not do so for reasons of fetal anomaly or maternal risk actually ruled out such cases: "Our data are limited by the exclusion of women who sought later abortions on grounds of fetal anomaly or life endangerment. Because of waiting time for testing and diagnosis, delay in seeking care among that population likely differs significantly from the delays faced by women in our study." You cannot use a data set that excludes fetal anomalies and life endangerment to prove that fetal anomalies and life endangerment are not relevant to women's choices. Further, the studies cited in THAT study also do not support the conclusion that is drawn. One does not consider third trimester abortions at all. The other considers abortion rates, not reasons for seeking abortion. Notably, the cases the authors note in which women sought late-term abortions principally for financial reasons would seem to be disallowed under NY law. Ms. FioRito offers no studies, even spuriously cited ones, to support her assertion that babies with conditions that will kill them soon after birth do not suffer. In some cases--anencephaly, e.g., that is likely true. In others, that is likely not true, absent aggressive pain management, perhaps up to terminal sedation. Perinatal hospice sounds like a fine option to offer women, especially those trying to decide whether to bring a non-viable fetus to birth. Cases like that are very often extraordinarily painful for the parents. But why present that option with misleading "data" that serve to cloud the very real and often very painful situations under which women opt for third trimester abortions? Supporting a good cause--perinatal hospice--with misleading arguments does not serve the cause.
Wonderful and insightful article, Mary!
"The idea that late-term abortions are sometimes the only way to spare children from a life of constant pain is also unsupported." Exactly! The push for late-term abortion as the ONLY option for pregnant women and as THE way to numb suffering is just not correct. Women and their children, born and preborn, deserve better options, one of which being perinatal hospice care.
"Studies report that women who opt for perinatal hospice have far better outcomes, in both physical and mental health, than their counterparts, especially related to anxiety, depression and grief." Abortion doesn't solve any problems, and it sure doesn't take away suffering, it just adds pain to the physical and mental health of the mother.
Thank you for offering such a beautiful, loving perspective. Late-term abortion is not only horrific, the stories from women are of such devastating loss, especially if they make this choice because they feel it is the best thing for their child who is suffering. There is no opportunity to have the life-giving experience you share of Mary Bernadette and her family. Perinatal hospice and palliative care is such a gift! Many women and families fear they could not possibly face watching their child die, but in reality those are gifted moments they will treasure. Abortion just leaves everyone empty with no beautiful memories. Thank you so much for sharing this. Hopefully, with greater exposure, more families can find this option and reap the benefits both at the moment and for the rest of their lives!
While I cannot speak for those who have cared for a dying child, I can say that I am grateful everyday for having had the opportunity to provide palliative care for my mother for weeks, following months of care for her as a result of cancer. Even with the help of two sisters, and nurses, it was exhausting, emotionally draining, sad, painful, but was both a blessing and an honour to do so. I am so very grateful, despite some very difficult moments. Rushing or hiding death doesn't lessen our pain, it only hardens our hearts by demanding anyone who causes us physical and/or emotional discomfort, even if through their own discomfort, must be removed from us, of course under the guise of love and compassion through abortion or euthanasia.
A both a physician and a mother, I found this piece to be far from "manipulative." Perhaps you might not be aware that the flu is a serious illness, killing several hundred American children each year. Even so, Ms. FioRito was NOT comparing the flu to lethal fetal illnesses, as any fair reading of her introduction shows. I thought her opening story was brilliant, as it evokes the fear that every mother feels when our children are sick, especially if they are hospitalized. But instead of capitalizing on this (understandable) fear to pressure a woman to terminate her child, the article points to the accompaniment model of compassion. I have diagnosed several babies with fetal anomalies, and it has been my privilege to support the model that Mary so beautifully writes about here.
My mother took a year and a half to die of lung cancer. She stayed at home, fought the cancer the whole time, and I lived with her. My mother suffered a lot, she was scared, hopeless, and depressed. It was awful. Suffering is bad. Dying is bad. Let's not romanticize them.
People who have been previously employed in Planned Parenthood abortion clinics and have now become woke are giving their testimonies freely.
You will find a representative sample on Youtube.
They are clear, law or no law, they have seen that sometimes the baby is still alive when it was supposed to be dead, and seen it killed or just put aside to die naked and without any care or protection.
Killing the young person is murder however long it has been since he or she was conceived.
The usual infanticide lobby has appeared amongst these commenting again. I have conspiracy theories, but abortion is such a huge and lucrative industry that I am convinced they could pay people to lobby for killing babies for convenience, on a whim or for population control and the like.
I doubt they are really Christian who come here to legalise homicide of people in their first year of life. Real Christians find abortion and euthanasia repugnant.
Pro-lifers lie about Planned Parenthood. PP performs abortions as part of gyn care, the same care that used to be provided in doctor's offices and hospitals and clinics before pro-lifers began murdering doctors and bombing clinics. Now PP is one of the few places brave enough and committed to women's health enough to refuse to be intimidated by pro-life violence and lies. I speak from experience as a past volunteer at PP.