In 2021, a 30-year-old pregnant woman in Poland tragically died of septic shock after she experienced a preterm premature rupture of membranes (PPROM). Her water had broken at 22 weeks, and doctors allegedly instructed her to keep her legs up because they couldn’t treat her until her baby’s heart stopped beating.
If this information is accurate, the hospital and doctors failed to provide the woman with the basic standards of care for PPROM. Though Patients’ Rights Ombudsman Bartlomiej Chmielowiec is claiming the woman needed an induced abortion, in reality, she needed a specific standard of care that it appears she did not receive.
Induced abortion — a D&E procedure that would have involved dilating her cervix and then dismembering her child — would not have been the standard of care as Chmielowiec and pro-abortion activists argue. An induction abortion, in which the doctor stops the child’s heart before delivery, also would not have been the standard of care to treat this woman.
Standard of care for PPROM
Dr. Christina Francis, CEO of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), previously explained in a statement to Live Action News that the treatment for PPROM is to admit the woman for observation to monitor her for any signs of infection or bleeding, stepping in to separate mother and child when necessary.
“There are signs of developing intrauterine infection that any physician who is well-trained in obstetrics can identify long before sepsis develops,” she explained. “This is why these patients are monitored very closely and often as inpatients, at least for a few days.” She added that even pre-Dobbs in the United States, doctors did and should still “offer expectant management with close observation in this circumstance…”
Expectant management, as explained by the Children’s Hospital of Philadelphia (CHOP), involves careful observation and waiting, as in some cases, the membranes may re-seal and the amniotic fluid may stop leaking. Medication can be given to stop preterm labor and to strengthen the baby’s lungs in case she must be delivered, and antibiotics are administered if signs of infection are present.
Additionally, in an article for the Charlotte Lozier Institute, Dr. Ingrid Skop, a practicing OB/GYN and Vice President and Director of Medical Affairs for the pro-life Charlotte Lozier Institute, shared the recommendations for the treatment of PPROM.
“For 30 years my management of this devastating situation has been, and remains, the same,” she wrote. “… I offer immediate delivery due to the potential dire outcomes, but I also offer watchful waiting if the mother desires. Either is appropriate, even if there is no evidence of clinical infection present at diagnosis. I have had some patients who desired to wait in hopes that their child would remain undelivered until a gestational age at which she could potentially be saved.”
Age of ‘viability’
Children born as young as 21 weeks have survived with medical assistance, and since the pregnant woman in Poland was at 22 weeks, there was a definite chance her baby would survive. If the woman’s labor could not have been prevented, delivering her baby prematurely would have been the proper method of treatment, according to the standard of care spoken of by both Skop and Francis.
Regardless of the child’s age, however, Skop explained, “I would immediately admit my patient to the hospital where antibiotics would be started, fetal well-being assessed, and clinical infection and labor ruled out. Equally important, medical professionals and hospital staff would rally around the mother and family, providing physical, emotional, and spiritual support as they walk through this health crisis and anticipate the potential loss of their child. Perinatal hospice or palliative care might be initiated, so the family can plan the interventions they desire for their young child, and this approach has been shown to help offset the grief and trauma these families experience.”
Pro-abortion and pro-life OB/GYNs agree on PPROM standard of care
Skop noted that even the pro-abortion American College of Obstetricians and Gynecologists (ACOG) agrees, stating in its 2020 practice bulletin Prelabor Rupture of Membranes, “Women presenting with (P)PROM before neonatal viability should be counseled regarding the risks and benefits of expectant management versus immediate delivery. Counseling should include a realistic appraisal of neonatal outcomes. Immediate delivery (termination of pregnancy by induction of labor or dilation and evacuation) and expectant management should be offered.”
Both organizations agree that the standard of care for PPROM includes offering separation of the mother and her preborn baby in order to reduce the risks to the mother. Refusing to offer such intervention “is not supported by any medical guidance and, in fact, appears to violate the standard of care,” said Skop. Where ACOG gets it wrong, however, is in advising a D&E dismemberment abortion as an option. While termination of pregnancy may be necessary, the baby doesn’t have to be intentionally and directly killed in order to achieve this.
The woman in Poland should have been offered proper treatment. Whether that included medication to attempt to stop labor or 48-hour monitoring for infection, she should have been offered intervention to separate her baby from her in order to reduce the risks to her own life, as well as treatments to help her baby’s lungs, especially since her baby was at 22 weeks. But she should not have been offered an induced abortion.
Induced abortion would have ended the pregnancy but would have involved intentionally killing her child prior to delivery. On the contrary, induced labor or an emergency C-section also would have ended the pregnancy, but without intentionally and directly killing the preborn baby, and would have given the child the possibility of surviving while also saving the mother’s life.
