– I remember every pregnancy I terminated. I always feel regret, mourning. I am not an advocate of abortion on demand. As a mother, I would not be able to terminate a healthy pregnancy. But the patient should have the right to make a decision in accordance with her conscience, not mine, says the gynecologist in an interview with Medonet, who asks for anonymity. What is the current situation of women in Poland from the doctor’s perspective?
- We are between the hammer and the anvil. Nobody who thinks rationally will now break this law, i.e. even terminate a pregnancy with Down syndrome, because he may go to prison for it – says the doctor about the situation of gynecologists
- The gynecologist admits that although eugenic abortions are prohibited in Poland, their number has certainly not decreased. – A patient who does not want to give birth to a child will not bear it. Women have always done well and will continue to do so, he says
- The doctor also tells what could have happened in the hospital in Pszczyna and what could have been the causes of septic shock in the patient
- You can find more such stories on the TvoiLokony home page
The text is part of Action # 20 million reasons. Articles, editorial materials and analyzes will be published on the TvoiLokony website and on the websites: Ofeminin.pl, Noizz.pl, Onet Women, Plejada and Medonet, as well as on Forbes Women. the situation of women, family planning and the situation of prenatal medicine in Poland.
Agnieszka Mazur-Puchała, Medonet: What pisses you off the most now?
Gynecologist: I don’t even know where to start. It pisses me off a lot. But the most important thing is that the patient, or rather a couple, is doomed to a dramatic change in her life caused by the necessity to give birth and often also raise a child that can be extremely handicapped. Of course, if someone feels strong enough to do it, wants this solution, I am full of admiration, but not everyone is ready for it and should have every right to do so. After all, it is deciding about the life of the whole family, because not only mom and dad, but also siblings who will have to take care of a sick brother or sister when their parents are gone.
Nobody asks us for our opinion. We have been deprived of constitutional freedom. We cannot force people to get vaccinated against COVID-19, jointly and severally protecting the weakest in society (the old, the sick), because it restricts the rights of the unvaccinated. But someone can decide such things. The freedom of the fetus puts itself above that of a woman, a man. There is something in it all very wrong.
Now there is a civic project that shows the ignorance of the people who signed it. About ignorance of biology. Reproductive medicine textbooks are straightforward: only 25 percent. all pregnancies will have a baby. Everything else is shedding, mainly at the stage of the so-called preclinical pregnancy, i.e. before you hear your heart beating on ultrasound. But there are also miscarriages between 4 and 12 weeks or later. And now someone figured we should punish miscarriages. Will we educate enough prosecutors, police and other services over the next few years to control every woman whose cycle is delayed? Because that could mean she just had a miscarriage. Will the pregnancy tests be prescription? Name? That there would be control over it? Of course, this project is probably a smokescreen, but someone had to subscribe to it. 130 thou. citizens who thought it was a good idea. And in vitro clinics? If the embryo transfer to the uterus fails, will the prosecutor come and check why? Is it not our (doctors, patients) fault? Will he have the knowledge to judge it? It is a curiosity on a global scale, the Middle Ages.
Witch-hunt. A bad gynecologist is waiting for the fetuses to kill them with an abortion pill. I want to spoon, murder …
Murderers, gynecologists, and in this law also murderous mothers. And we are between the hammer and the anvil. The law is law, ignorance of the law does not absolve you from responsibility. Neither can disagreeing with the law. Nobody who thinks rationally will now take up the violation of this law, i.e. even termination of pregnancy with Down syndrome, because he may go to prison for it. And even if in the office he takes pity on this couple and helps them, e.g. by pointing to a place where such termination can be made, it is quite likely that a couple who are grateful at the beginning may find in two years that it is possible to do so. earn. And they will win such a case. No doctor will leave his family for two years to go to jail for the sake of the patient.
- The editorial board recommends: “We foresaw it”. Moving confessions of Polish gynecologists
Could it be like that in Pszczyna?
The situation in Pszczyna, although tragic, has one positive aspect: suddenly society began to realize that it could also apply to them. That what is passed may end badly.
And when it comes to the case itself, I would not judge it unequivocally, because it is not an easy matter. We know from the media that there was anhydrous in the 22nd week of pregnancy, that there was a lethal defect of the fetus, that no action was taken until the baby’s heartbeat stopped. She developed sepsis within 24 hours and died. We don’t have word of mouth to find out more details, we can only guess. And now, did this patient go to the hospital with sepsis, or did she develop it in the ward? And did she want to have a baby? Because maybe she wanted and wouldn’t even consider abortion?
Dogs are hanged on these doctors, but we don’t know how it was. Maybe they made a mistake in not sending the patient to a center with a higher level of referentiality. In the 22nd week, when the amniotic waters are draining, it should be the third degree. It was a mistake, unless she was hospitalized too shortly and they didn’t make it or there was no place in such a center.
There’s a lot of guesswork here. If this happened before the introduction of the law, the patient found out about the defect in the 18th week of pregnancy and decided to terminate the pregnancy, it is known that this death would not have occurred. But it is possible that she did not want to terminate this pregnancy at all. And now, she goes to the hospital with amniotic fluid draining out. We know that there is a lethal defect and the patient’s risk of death. After the formalities, we induce a miscarriage in such a situation. So we are giving measures so that the fetus will have a spontaneous miscarriage. It takes several hours. And if it fails, the pregnancy is terminated by surgery, i.e. by curettage of the uterine cavity. First, we might not make it anyway. Second, curettage of the uterus, which may already be inflamed, because the amniotic fluid rarely drains away for no reason, is also a great risk. Either way, there was a risk that the patient would go into sepsis and die.
The rest of the conversation under the video.
Do I understand correctly that Iza could have been hospitalized with sepsis, but it was not visible?
Of course. We had such a situation that the patient came to us with diarrhea. It was the only symptom that something was happening. After 12 hours it was already known that it was sepsis and the cesarean should be done immediately.
I will say something that is not talked about aloud. Pregnancy is terminated in third reference centers. Those that develop in a caesarean section scar or when the mother is at risk of dying. The patient writes an application for termination, the matter is analyzed by the commission, she stamps the stamp and an abortion is performed. It can be done, but the procedure is ongoing.
In fact, termination can be done at any level of reference, but the truth is that first-level hospitals refer these patients to second- or third-level. Because the third is relatively easier to defend themselves from.
The application from the patient, the commission examining it, then the stamp … It sounds like a long process. It was like that a year ago?
Yes, it has never been quick or easy. Formalities were always needed. In the case of a fatal defect detected on ultrasound, it took two weeks and the opinion of two experts, while in Down’s syndrome three weeks, because we had to wait for the amniocentesis results. In the case of a patient from Pszczyna, these formalities could take up to three days, so it might turn out that the decision would come too late anyway.
In the case from Pszczyna, I bumped into the wall. I wrote a text about the mechanism itself and I was looking for an expert who would explain to me what septic shock in pregnancy is, and where it comes from. Nobody wanted to talk to me about it …
I am not surprised by this. It was known that it was about this subject, even if you had no questions about this particular situation. It was a clear analogy. And do you know what is the most common cause of septic shock in pregnancy? Untreated urinary tract infection. The second possibility is infection of the fetal egg – this cannot be cured. And only the section will give us the answer to what we were dealing with there. But this is unlikely to be told.
Is it not the case that gynecologists in Poland have been afraid of this matter from the very beginning?
I think any rational person would be afraid. I would probably also be afraid of the doctors from Pszczyna. But when it came down to it, you had to apprentice. Only if it would do anything – it is not known.
I wonder if the gynecologists talk to each other about the law, about the situation. Is this a topic that is unlikely to be discussed?
We are talking. Patients also talk to us. I was recently knocked off my feet when I heard from one of them about a register of doctors, nurses and midwives who do not deal, attention, with IVF pregnancies. No and that’s it. Officially, by name and surname. Not only abortion, but also IVF is pure evil. These are the eggs.
On the other hand, I understand doctors who, relying on the conscience clause, do not want, for example, to terminate pregnancies.
I terminated many damaged pregnancies with lethal defects. And I must say that I am not an advocate of abortion on demand. By all means, I am in favor of a woman being able to buy an abortion pill and take it until 8-9. week. But as a mother, I would not have been able to terminate a healthy pregnancy at 12 weeks pregnant. For the hell, I couldn’t mentally take it.
I remember every pregnancy I terminated. Each one. I have a sense of inner regret, mourning after each of them. I explain it to myself with the good of the patient, but it can be difficult anyway. The patient should have the right to make a decision, but with her conscience, not mine.
After the situation in Pszczyna, more and more Polish women say that they do not want to get pregnant. They are afraid that the fetus will have some serious defect. What’s the risk? What if they don’t have a genetic predisposition?
Unfortunately, there is always that risk. Even very young girls can give birth to a baby with Down syndrome. In fact, 90 percent. these are young girls, because the older ones are examining themselves. The young do not do it because they do not expect that they may be at risk.
With Down syndrome there is a spontaneous mutation – you do not need to be a carrier of the gene. It can happen to anyone like a heart defect. A mature mother and a young mother. This cannot be prevented. Neither a healthy lifestyle nor “good driving” will help. Sometimes I hear that she was driving badly, ate unhealthily and that is why she has a sick child. This is complete nonsense. It is not that a woman has eaten fast food, drank cola and therefore has a child with Down syndrome.
It does not encourage childbearing at all …
Exactly. At the same time, contraception has a black PR in our country, women cannot legally sterilize themselves, although gentlemen have such a right. I don’t know what this is about. So that the numbers match? It doesn’t matter what kind of babies are born, will they make it through life or not? And then the parents of such children are absolutely left to themselves. It irritates me a lot.
Just like the picture of people with Down syndrome. The picture is now being drawn that these are children who may look a bit different, but can be independent, have their dreams, and are coping in life. Only that there is literally a percentage of such cases. And we are usually talking about the so-called mosaic whenever part of the genome has been damaged. Most children with Down syndrome are severely handicapped, seriously ill, often malnourished for two years.
I recently read an interview with the father of a child with Down syndrome. He decided to organize a camp for children and parents. Little kids and bigger kids. It turned out that no one had signed up in the group of young children. No parent wanted to see what would happen “next”. That it is usually not possible to rehabilitate such a child and that aggression begins at the stage of puberty. This is not talked about.
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Down’s syndrome can be detected through prenatal testing. A year ago, when the mutation was detected in the baby, the mother could decide to terminate the pregnancy. Now that it is known that there is no termination, is there any further prenatal testing?
Going on, sure. The only question is whether there will be no obligation to officially register such a study soon. Especially that in January this year, an ordinance passed in secret which obliges all offices – including private ones – to register all medical events. And it would seem that there are complications, but no. We have to report every medical visit. It doesn’t matter if it was a gynecological examination or a lip augmentation in an aesthetic medicine office. All this goes to the P1 portal. This means that one day someone may request access to medical records and will be given consent.
For now, we are still in the EU, and the patients have a choice – virtually every Polish border. But we’ll see what happens next. Because if doctors report pregnancies and prenatal test results, it will be known which woman went abroad to terminate the pregnancy.
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This is the last question: has the judgment of the Constitutional Tribunal reduced the number of abortions performed by Polish women?
Eugenic abortions are not legally performed in Poland because they are illegal. But a patient who does not want to have a baby will not have one. No matter what. Thanks to all the confusion about the law, women know that they are not alone, they know the addresses. Nobody forced women to bear children for a long time. They managed somehow and they will continue to do so. Maybe not with a hanger, but still. If not chemically, during pregnancy, then after childbirth.
This is where we have come. This is the life of a Polish woman in the XNUMXst century.
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