(Image credit: http://www.ccsf.edu/NEW/en/student-services/admissions-and-registration/records/evaluation-and-graduation.html)
In commemoration of Mother’s Day this year, I have decided to share some stories of mothers I have encountered during my training as a neonatology fellow and my budding private practice as a consultant.
Back during my training days I have met one of the worse mothers I have known by far. She was 20 years old, graduating student for the course BS Psychology at some university. During the early days of March, she was 29 weeks pregnant (barely 7 months). But her graduation was fast approaching. She did not want to march through the stage and receive her diploma pregnant. She wanted to deny her real state to the academe and campus. She did the most unimaginable resolution to her quandary: ABORTION. She bought some abortifacient pills sold around the Quiapo Church, took in some, and inserted the rest through her vagina.
(Not the actual patient. Photo credit: http://www.prematurebabies.uk.com/)
bitch (errr…. sorry) mother delivered vaginally to a 29 weeker 1.15 kgs baby boy, who as expected, went into severe respiratory depress, thus requiring assisted breathing (with mechanical ventilator). The baby also required surfactant but due to financial constraint, the mother and her partner couldn’t afford it. The baby was also treated for a potential infection with antibiotics. As a charity patient in a private hospital, no laboratory tests nor medications can be done or started unless the parents provide them, but due to compassion of our physicians, they remedy things at an extent to provide initial management. The mother and her boyfriend was able to pay the deposit for the mechanical ventilator (which was rented from outside source) but nothing came from them thereafter. Meanwhile, the resident physicians have been contributing from their own allowances for the labs and meds of the poor baby, who was already struggling as his treatment were getting delayed. Worse, the baby acquired a bad infection leading to his deterioration. We prodded the mother and her partner to provide us the new antibiotics the baby needed to no avail.
On the seventh day of life, as baby’s condition keeps on worsening, the mother decided to bring home the baby against medical advice (even if it would mean baby’s death). It was also the day of the mother’s graduation. Guess what she settled first…
Yes, she marched on stage first, with flat stomach, with the degree, Bachelor of Science in Psychology. (Really now?…) After which, she came to the hospital, partially settled the bills of the baby and decided to bring home the baby, to DIE. The baby’s status was just like the picture posted above — intubated, meaning, he can’t breath on his own and requires mechanical ventilator to assist him.
Sending a baby home against medical advice is a very painful and difficult, traumatic experience on our part as care providers. I don’t know how a parent view this. But thing considered, we have to respect the parent’s decision after full disclosure of the what’s and ifs, dos and don’ts. Often than not, what prompt parents to bring home their ill babies home even if still requiring sophisticated treatment is financial constraint. You will really see the parents over laden with emotions, tears pouring non-stop. But in this case, the mother was just soooo apathetic, no exaggeration, but she seem unaffected at all. Guess I think because she got what she wanted: to march up that stage NOT LOOKING PREGNANT. I wonder how she feels, knowing she is a Psychology graduate.
How do we discharge a baby who is breathing with the assistance of a mechanical ventilator? It’s a very tedious process.
1. We disconnect the baby from the mechanical ventilator, then attach a bag resuscitator to manually pump oxygen into the baby’s lungs as illustrated in the following image.
(Not the actual patient. Photo credit: http://www.trekmedics.org/projects/projects_haiti_earthquake/haiti_day2_transport/)
2. Someone pushes an oxygen tank attached to the bag until the entrance of the exit of the hospital. Another one does the bag-ventilation of the baby and another one carries the baby.
3. Once at the exit of the hospital, the relatives receives the baby. The care provider then removes the tape that secured the endotracheal tube. Once removed, it is then pulled out. The parents-patient can now go home.
Whether the baby dies immediately, or along transit or at home, the hospital is already free of any liability. (By the way, the parents/guardians signed a waiver that it was their decision to discharge the patient against medical advice.) This is indeed a very emotional event. It is too heartbreaking, both for the care providers and the parents. I just can’t fathom how mothers take this. But for this particular case, I really wish and wanted to slap this bitch of a mother. It really upset everyone when she decided to end her pregnancy just so she could attend the graduation ceremonies “un-pregnant.” Then when she can’t sustain the expenses her baby needs, she decided to bring him home even if this would mean his death. And she even prioritized going to the graduation rites before bringing her baby back home.
On a different note, I like to share this video also that I have viewed through facebook. Should she have aborted her baby, what do you think?