Abortions….primum non nocere….

Replacing the receiver with trembling hands the midwife looks at me, the call she has put out comes crackling through my pager “major haemorrhage ward 3……obstetric emergency ward 3”.

 The doors swing open, the ambulance crew letting in a blast of icy air as they run down the corridor pushing the trolley.  On it a waif-like figure, translucent with pallor.  In stark contrast to the heavily blood-stained towel rolled between her legs.

 Unknown clinics, nameless back-alleys, unrecognised qualifications.  Different faces, all with the same story.  They are just kids and a soft voice telling them everything will be alright is all they hear.  An adult, a doctor, a surgeon, a gynaecologist; details deemed unimportant when their perceived wrong will be made right.

 The emergency theatre prepped for caesarians fills with bodies ready to receive our patient.  Eager to help stem the blood flow, desperate to help save her life.  Scrub nurses squeezing through bags of O-Neg as the surgeons set to work. Records already set by the anaesthetist; driven by fear, using adrenaline as an ally.

 The constant shrill beeping a reminder of how all her physiological parameters are straining under the sheer volume of blood loss.  The 40kg body going into a state of shut-down in an effort to preserve the vital organs.  In an effort to preserve her life.

 A perceptible change comes about.  The shrill alarms remain constant, the number of people, drugs, fluids, drivers, lines and wires remain.  But the movements are slower.  The frenetic motion is more controlled.  The eery disquiet is being replaced by speech.  The bleeding has stopped.

 We are all wearing her blood attesting to the fact her circulating blood volume is no longer her own.  Time is going to be critical.  Will her body somehow find the strength to make it clot.  Or will disseminated intravascular coagulation counter all our efforts.  Will abortion claim another life?  Will our nameless patient lose her life to statistics, to a law passed before she was born?  Will her life be lost because her voice wasn’t heard? Or will her life be lost because we lack the courage to use ours?

 As my consultant takes off her gown she squeezes the anaesthetists arm on her way past.   Words could never do justice to the look exchanged between them, tears threatening to betray the nightmare they have both endured.  The nightmare they have endured countless times before.  The recurrent nightmare which has aged them beyond their years.  Which has caused immeasurable suffering, pain and morbidity for those both living and working in a developed country in the 21st century. 

 And the recurrent nightmare which is set to continue for as long as the law dictates.


6 thoughts on “Abortions….primum non nocere….

  1. Very powerful writing Dr Marbles, but I’m a bit confused. Is this person a child? 40kg is very small, so I’m assuming that’s the case. Is it impossible to help someone under age before they go to the backstreet clinics? Would a very young girl not have easy enough access to gynaecological services? I confess I know absolutely nothing about this subject, and I’m quite shocked that this can happen in the UK. Are you able to explain a little more without giving anything away?

    • It is really quite frightening what happens if you scratch below the surface. Sadly a lot of young people, and those in whom language is a barrier are scared of the repercussions whether it be from families, the community or immigration services. They are afraid being below the age of consent will prevent them from being treated and their confidence will be breached. They don’t really pay a second thought to the process just so long as the help is given. It really is incredibly easy to be helped on the NHS, for obvious reasons services aren’t advertised and girls don’t often know who to turn to for help. Hope that explains a little…..x

  2. What frightens me the most is that here in the US, we have a fairly large percentage of the population that think we should go back to the days when back street abortions were the only option. They say that women/girls get what they deserve. It’s still the dark ages for at least some people.

    • It’s so interesting to hear what happens elsewhere and how such an emotive subject divides populations. It never fails to amaze me how black and white views often are, it is so often debated on when life begins, rights of the foetus etc. I’m not saying this is wrong but I do feel sometimes the young mum-to-be’s life and future welfare is disregarded. ‘What she deserves’, you are so right with this comment, I’ve heard it too. It is a complex decision which no one can really presume to understand without being in that pivotal decision-making position, however everyone is more than willing to judge. Thanks for taking the time to comment.

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