Water broke at 19 weeks...induced labor

[TweetyBird]

I’m having some scruples about a “miscarriage” I had 5 years ago. My water broke at 19 weeks gestation - the baby was not viable and could not live outside the womb. The physician said labor would begin on its own eventually, but that the risk of infection in the meantime was very great. The doctor recommended inducing labor with pitocin - I was in the hospital on meds for 3 days before labor finally began. The baby was alive during this period. She died at some point during labor, because she was just too small and immature to survive the birth process. She was born at 19 weeks, 6 days gestation. We named her Abigail and she is buried at a local Catholic cemetery.

We did not have a direct abortion - that is, nothing was done to definitively kill the child, rather an early labor was induced knowing there was virtually no chance she would survive.

At that time, I had no idea of Church teaching in a circumstance like this, and we were heartbroken over the loss of our baby.

Does this constitute an abortion, or is it acceptable in a case like this to induce an early labor?

I did confess this, though I felt like I should have provided more details since we did not intend to have an abortion in the direct sense. Part of the penance was to have a mass said for the baby AND to attend said mass. However, the roads were iced over on the day the mass was said, and I was not able to make it to the Church for the mass said in her honor, so I am concerned about whether I ought to “re” confess this, or whether this is considered a sin at all.

Thanks in advance.

 

[StCsDavid]

Three months ago, my godson was born at 26 weeks gestation. I’ve learned a lot about premature babies over these last weeks. He’s still in the hospital, but getting better. Anyway, it’s very doubtful your child would have survived even if you had not induced labor. This was not an abortion. It was a miscarriage. Either way, you should have great hope that Abigail is with Our Lord and there’s no reason you could not ask her to pray for you. She is with the saints.

Please remember that in terms of eternity, there’s not much difference whether a person lives for 19 weeks or 90 years. Your daughter was willed, loved, and necessary in God’s eyes. Why she was called home so early is not a question we’ll ever have an answer for; however we can ask ourselves how we will cooperate with God’s plan.

Lay this burden down at the foot of the cross, and move forward with confidence that God loves you.

You are in my prayers this evening, and please pray for my godson as he continues his own battle.

 

[teachccd]

I fully agree with the last poster. You are guilty of no sin and your child is very much wanted and loved by you. This is not the usual mindset of one having an abortion.

No, it was the will of God that your child lived a mere 19 weeks to serve a purpose that only God knows and may or may not be revealed in your lifetime. God bless you and I suggest that you talk to a priest because all the posters here are on the outside looking in. You might be harboring the “what if’s” that can impede your healing of this traumatic event.

You are in my prayers…teachccd

 

[teachccd]

Three months ago, my godson was born at 26 weeks gestation. I’ve learned a lot about premature babies over these last weeks. He’s still in the hospital, but getting better.

…please pray for my godson as he continues his own battle.

Your godson is in my prayers…teachccd

 

[TweetyBird]

Thanks for your opinions and support (and your prayers!). As a recent revert to the Church, sometimes questions of moral theology can be confusing. I just wasn’t sure whether the early induction of labor was considered an abortion, and I sometimes do second guess whether she might have survived if we had just let nature take its course. If there was anything we could have done medically to save her life, we would have.

Thankfully, we are blessed with three beautiful daughters (ages 12, 6 and 3), and another daughter is due in 8 weeks. I think I will have another mass said for Abby anyway, and put my hope in Christ that she is with him safe in heaven.

StCsDavid, I will pray for your godson too…

 

[teachccd]

You have five beautiful daughters…One will see you in eight weeks and one will see you when you go home to the Lord…Peace…teachccd

 

[nova147]

Tweety - I’m so sorry for your loss. I don’t often frequent the moral theology forum (my moral theology knowledge being shaky), but I thought I would give you some thoughts from another mom.

To me, this situation is somewhat similar to an ectopic pregnancy, in which the moral thing to do is to remove the tube. In that case, the end result is the death of the baby but the continued life and health of the mother. In your case, your health was at risk from infection due to the membranes being ruptures. Intrauterine infections can be very dangerous! The intention of your induction was not the death of your child, but rather your continued life and health.

Again, I am sorry for your loss - and anxious to see your post in the parenting forum announcing your new baby’s arrival (hopefully in 8 weeks!).

MJ

 

[manualman]

Sounds to me like you did exactly the right thing. You did not purposely kill the child. The child was doomed by the water-break. Your doctor COULD have recommended a direct abortion and THAT would have been sinful. Instead, he recommended inducing. Neither you nor your doctor were TRYING to kill the child in order to save you. Rather, you were doing all that could be done to save both mother and child - even though it was 99.99999999% certain that the child would die in the process.

This is what is called ‘double effect’ in catholic moral theology.

 

[gardenswithkids]

…As a recent revert to the Church, sometimes questions of moral theology can be confusing. I just wasn’t sure whether the early induction of labor was considered an abortion, and I sometimes do second guess whether she might have survived if we had just let nature take its course. If there was anything we could have done medically to save her life, we would have…

TweetyBird, I am so sorry for your loss. I also miscarried a child and know how painful it is. How wonderful that you were able to have a burial for your child and have Masses said. It sounds like you did what you thought right.

I agree with you that questions of Catholic theology can be confusing. I will share that I am a bit confused by this question you pose because I do know some use early induction as abortion procedures, and I have also read of a baby that survived despite the mother leaking amniotic fluid. I’m not a doctor, nor a moral theologian, but I know doctors often don’t deeply consider moral theology when practicing medicine, nor do they always do everything they can to avoid crossing moral lines.

I don’t fault you, but I am not entirely comfortable either saying that it is simply double effect for the doctor to have induced labor in this case. Again I’m no doctor, but you say the doctor said there was risk of infection, but if there was no actual infection and since your baby was still alive before the induction, I wonder if they could have watched you and the baby very carefully and had a different outcome. Nineteen weeks gestation is not that far from viability. While double-checking my memory for viability, on the first click I ran across this article: http://findarticles.com/p/articles/mi_m0689/is_n3_v42/ai_18183977/pg_3

Again, I don’t find fault with you, but I am not certain that it is entirely moral for doctors to induce labor in this situation while the baby is still alive and with no active infection–only the risk of infection. Like you, I second guess whether your baby might have survived with careful medical monitoring by your doctor. And again, I am so sorry for you loss.

 

[Rebelecka]

I am a Newborn Intensive Care nurse and have been for 26 years. Currently we are saving babies at (occasionally) 22/23 weeks gestation. At 19 weeks you would have needed to carry Abby 3 more weeks at a minimum with any hope for her to live. If your membranes were completely ruptured and your amniotic fluid was gone, Abby could not have survived for those 3 weeks. Yes you would continue producing the fluid but nothing would have kept it in the “bag” and it probably would not have been enough anyway.

Do not feel guilt. Sometimes God wills things that we do not understand. Our Lord has blessed you in many ways. May He continue to bless you and may He free you from your doubts.

 

[gardenswithkids]

I hope my writing this doesn’t cause the op any guilt or pain. That is not my intention. She asked a question about the morality of inducing labor at 19 weeks, and I am giving my honest opinion for the sake of others who may face a similar dilema. No, I don’t think artificial induction is an acceptable moral choice if the baby is alive and there is no active infection or other maternal illness beyond the ruptured membranes. I think her doctor crossed a moral line.

I am a Newborn Intensive Care nurse and have been for 26 years. Currently we are saving babies at (occasionally) 22/23 weeks gestation. At 19 weeks you would have needed to carry Abby 3 more weeks at a minimum with any

hope for her to live. If your membranes were completely ruptured and your amniotic fluid was gone, Abby could not have survived for those 3 weeks. …Thank you for sharing that information. The article I linked earlier said, “the mean latency period between PROM and delivery is between 10 and 21 days.” And “Mercer’s analysis[3] of four midtrimester PROM studies using age-specific survival rates revealed a 23% rate of survival for PROM at 22 weeks EGA or earlier, compared with 53.9% at 23 weeks or more.” http://findarticles.com/p/articles/mi_m0689/is_n3_v42/ai_18183977/pg_3

Normal labor might have taken 21 days. Had that been the case, Abby would have reached 22 weeks gestation, which would have given her small chance at surviving. I didn’t read the PROM studies (pre-mature rupture of membranes) sited but this article indicates they shows a 23% rate of survival when PROM happens before 22 weeks. I believe artificially inducing is morally wrong before the baby has died or before any signs of maternal distress beyond her water breaking.

Yes, the odds are very high that Abby would still have died. But with a natural delivery, the mother would not sufferred from the doubts and guilt over the artificial induction. If membranes are completely ruptured and the baby won’t survived, then labor can be induced once the child has died naturally. This requires more careful medical monitoring of the mother while awaiting a natural delivery. If the mother shows signs of infection or other medical distress beyond ruptured membranes before the baby dies, I believe then the moral rule of “double effect” might justly apply. But otherwise, I think the artificial induction at 19 weeks is morally wrong of doctors.

I agree with those who say the original poster should not feel guilty. She didn’t know, and she’s also been to confession already over this. Let go of any guilt and trust in God’s mercy and love. But we all must learn to be careful when doctors say “no chance” because sometimes there is a small chance.

 

[Maria1212]

You had a miscarriage and not an abortion. Moreover, inducing labor did not kill your child. She wasn`t ready to live outside the womb, and since your water broke, you did the right thing. The doctor would not have suggested inducing labor if there was another medically sound alternative. The last thing a doctor wants to do is watch a patient lose loved and wanted child.

You should not feel any guilt over this. I recommend seeking spiritual counseling from a priest. You didn`t do anything wrong and the priest can help you work through your guilt.

Sincerely,

Maria1212

 

[TweetyBird]

I am a Newborn Intensive Care nurse and have been for 26 years. Currently we are saving babies at (occasionally) 22/23 weeks gestation. At 19 weeks you would have needed to carry Abby 3 more weeks at a minimum with any hope for her to live. If your membranes were completely ruptured and your amniotic fluid was gone, Abby could not have survived for those 3 weeks. Yes you would continue producing the fluid but nothing would have kept it in the “bag” and it probably would not have been enough anyway.

Do not feel guilt. Sometimes God wills things that we do not understand. Our Lord has blessed you in many ways. May He continue to bless you and may He free you from your doubts.

It was a gross rupture - there was virtually no amniotic fluid left. when we initially got to the ER, we were given a great deal of hope that sometimes the sac can reseal and the baby might be OK, but on U/S it became obvious that there was no fluid left - the tech was having a very hard time seeing anything because of the absence of fluid.

 

[TweetyBird]

I hope my writing this doesn’t cause the op any guilt or pain. That is not my intention. She asked a question about the morality of inducing labor at 19 weeks, and I am giving my honest opinion for the sake of others who may face a similar dilema. No, I don’t think artificial induction is an acceptable moral choice if the baby is alive and there is no active infection or other maternal illness beyond the ruptured membranes. I think her doctor crossed a moral line.

Thank you for sharing that information. The article I linked earlier said, “the mean latency period between PROM and delivery is between 10 and 21 days.” And “Mercer’s analysis[3] of four midtrimester PROM studies using age-specific survival rates revealed a 23% rate of survival for PROM at 22 weeks EGA or earlier, compared with 53.9% at 23 weeks or more.” http://findarticles.com/p/articles/mi_m0689/is_n3_v42/ai_18183977/pg_3

Normal labor might have taken 21 days. Had that been the case, Abby would have reached 22 weeks gestation, which would have given her small chance at surviving. I didn’t read the PROM studies (pre-mature rupture of membranes) sited but this article indicates they shows a 23% rate of survival when PROM happens before 22 weeks. I believe artificially inducing is morally wrong before the baby has died or before any signs of maternal distress beyond her water breaking.

Yes, the odds are very high that Abby would still have died. But with a natural delivery, the mother would not sufferred from the doubts and guilt over the artificial induction. If membranes are completely ruptured and the baby won’t survived, then labor can be induced once the child has died naturally. This requires more careful medical monitoring of the mother while awaiting a natural delivery. If the mother shows signs of infection or other medical distress beyond ruptured membranes before the baby dies, I believe then the moral rule of “double effect” might justly apply. But otherwise, I think the artificial induction at 19 weeks is morally wrong of doctors.

I agree with those who say the original poster should not feel guilty. She didn’t know, and she’s also been to confession already over this. Let go of any guilt and trust in God’s mercy and love. But we all must learn to be careful when doctors say “no chance” because sometimes there is a small chance.

No worries, I am not at all offended or hurt by your post. I’m just kind of mad at myself still for blindly trusting the doctor and not letting things take their natural course. I’m not obsessing over it, just reflecting on what I could have done differently and how my actions square with the Catholic faith. At the time, I was not even close to practicing my faith, though the baby was most definitely loved and wanted by us, and we would never have purposely ended her life. Had we known better, we would have taken a “wait and see” approach. As an aside, we were apalled that at 19w6d she was ‘just’ a miscarried fetus and could be cremated by the hospital with other medical ‘waste.’ At 20 weeks, she would have been considered a pre-term birth and would have had an official birth/death certificate. At 19w6d, according to the law she never even really existed. Thankfully, our local Catholic cemetery provided a plot for free, though we did buy her a headstone (they very generously allowed us to make small monthly payments).

Thanks again to all - I appreciate your kindness and your candor. Prayers for the new baby would also be much appreciated. She is due on 12/28. My full-term babies have all arrived between 2-10 days prior to their due dates, so a Christmas baby is entirely possible.

 

[utunumsint]

No worries, I am not at all offended or hurt by your post. I’m just kind of mad at myself still for blindly trusting the doctor and not letting things take their natural course. I’m not obsessing over it, just reflecting on what I could have done differently and how my actions square with the Catholic faith. At the time, I was not even close to practicing my faith, though the baby was most definitely loved and wanted by us, and we would never have purposely ended her life. Had we known better, we would have taken a “wait and see” approach. As an aside, we were apalled that at 19w6d she was ‘just’ a miscarried fetus and could be cremated by the hospital with other medical ‘waste.’ At 20 weeks, she would have been considered a pre-term birth and would have had an official birth/death certificate. At 19w6d, according to the law she never even really existed. Thankfully, our local Catholic cemetery provided a plot for free, though we did buy her a headstone (they very generously allowed us to make small monthly payments).

Thanks again to all - I appreciate your kindness and your candor. Prayers for the new baby would also be much appreciated. She is due on 12/28. My full-term babies have all arrived between 2-10 days prior to their due dates, so a Christmas baby is entirely possible.

My wife is due on January 12th for our second. We are very excited. My cousin’s wife was due three days before ours, but she has a premature delivery at 19 weeks just like you did and the baby did not survive either. She was not induced because she immediatly went into labour. I believe this is a common type of miscarriage.

God bless, and be at peace.

Ut

 

[Heart_Of_Love]

You are in my thoughts and prayers. May the Lord bless you.