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Dr Jen Gunter writes, "On the gurney lay a young woman the color of white marble. The red pool between her legs, ominously free of clots, offered a silent explanation. 'She arrived a few minutes ago. Not even a note.' My resident was breathless with anger, adrenaline, and panic. I had an idea who she went to. The same one the others did. The same one many more would visit. A doctor, but considering what I had seen he couldn't have any formal gynecology training. The only thing he offered that the well-trained provers didn't was a cut-rate price."

Unsafe and poorly-performed abortions are a major cause of maternal mortality and morbidity. Banning abortion does not reduce the numbers of women who attempt it. (photo: Charlie Shoemaker/Corbis)
Unsafe and poorly-performed abortions are a major cause of maternal mortality and morbidity. Banning abortion does not reduce the numbers of women who attempt it. (photo: Charlie Shoemaker/Corbis)



Anatomy of an Unsafe Abortion

By Dr. Jen Gunter, Wielding the Lasso of Truth

15 February 12

 

was in clinic when I heard the overhead STAT page to the emergency room.

As I sprinted down the stairs, I ran through the possible scenarios. I wasn’t on call, so the day to day gynecologic emergencies weren’t my purview. I hadn’t operated on anyone in the past few weeks, so unlikely to be one of my own patients with a complication.

Logically there was only one conclusion.

A nurse was holding the staff entrance to the ER open. From the look on her face I surmised this was to save the minute or two it would take to punch in the numbers on the lock and inquire at the desk for patient’s whereabouts.

"Down there," she pointed.

On the gurney lay a young woman the color of white marble. The red pool between her legs, ominously free of clots, offered a silent explanation.

"She arrived a few minutes ago. Not even a note." My resident was breathless with anger, adrenaline, and panic.

I had an idea who she went to. The same one the others did. The same one many more would visit. A doctor, but considering what I had seen he could’t have any formal gynecology training. The only thing he offered that the well-trained provers didn’t was a cut-rate price. If you don’t know to ask, well, a doctor is a doctor. That’s assuming you are empowered enough to have such a discussion. I was also pretty sure his office didn’t offer interpreters.

I needed equipment not available in an emergency room. I looked at the emergency room attending. "Call the OR and tell them we need a room. Now." And then I turned to my resident. I was going to tell him to physically make sure a room, any room, was ready when we arrived, but he had already sprinted towards the stairs. He knew.

We didn’t wait for an orderly. A terrified medical student and I raced down the hallway with the gurney. The amorphous red pool dripped onto the floor as we rounded the corner to the elevators.

The double doors that led to the operating rooms swung open. "The urology room. They’re between cases," my resident shouted.

I saw an anesthesiologist out of the corner of my eye. "You. Now!" Most emergencies can wait a few minutes to check in at the front desk and for the anesthesiologist and nursing staff to take stock of the situation. This was not one of them.

The urologist, whose room I appropriated, blustered and sputtered in behind me. "What the fuck are you doing barging in, I’ve got another case…" but as we moved my patient over to the operating table and he saw the blood, he stopped. He grabbed a tray of instruments and opened. "I’ll be your scrub."

The anesthesiologist was pissed. Not really mad, more riled up than anything. No one likes to be blind sided, no matter how well intentioned. And he probably thought I was over reacting. That is until he put in another intravenous.

"Fuck." What looked like blood tinged water flashed back.

And now they all understood what I knew the second I laid eyes on this patient. Abortions that go horribly wrong bleed out. Quickly.

The room filled with surgeons, nurses, and students eager to help. To do something. Anything.

I opened the vagina and by feel clamped through the holes on either side of the uterus where I knew from experience I would find the uterine arteries, the likely site of the puncture. I didn’t know which side, and at that point it didn’t matter. I just needed to stop the blood flow. It took less than a minute. She would have bled to death if I had opened her belly.

As the bleeding had stopped, it was up to the anesthesiologist to fix the hematologic tempest. A vascular system so traumatized by sheer blood loss that it had run haywire and lost the ability to clot. Disseminated intravascular coagulation. This is how many young women die when an abortion goes wrong.

My hands started to shake. Everything from leaving my clinic to this point had been one crescendoing adrenaline-fueled reflex. Now that there was nothing physically for me to do the energy had to go somewhere.

I looked around. A forest of IV poles, laden with blood instead of fruit. Everyone not directly helping was running back and forth to the pharmacy or blood bank. A nurse and another surgeon started to clean the floor. We were all bonded by this nameless woman whose life we were desperately trying to save. And we were bearing witness, because we knew if she died it was unlikely anyone would read about her in the paper. It was unlikely her family would protest. A myriad of potential reasons. Shame of the abortion. Distrust of government. Fear of immigration officials.

The urologist, a grizzled older man with whom I had nothing in common except a medical degree and this patient, rested his hand on my shoulder. It was a kind, fatherly gesture. The weight was comforting.

"You done good." He said. And then he added, "Those bastards."

I knew he was referring not just to the physician who did this procedure, but to everyone in society who had contributed to a disadvantaged woman finding herself in such a desperate situation.

 

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+39 # Trish42 2012-02-15 08:54
This is was not a rare occurrence when I was a teenager and all abortion was illegal. Just as is true today, you didn't read about them, primarily because of shame. The perpetrators continued their nasty business.
The situation was very similar to the reactions of a large segment of society to rape---she probably deserved it.
The next time you question why we need more women in government, think about this story....
 
 
+19 # portiz 2012-02-15 14:10
Until abortions are SAFE, LEGAL, and RARE we will continue to have work to do!!

It's not just an issue of 'women's rights', it's an issue of 'human rights'.
 
 
+32 # Karlus58 2012-02-15 09:29
I don't know about your own reaction to reading this, but, there are tears flowing down my face.
 
 
+52 # GeeRob 2012-02-15 09:40
In essence, this trauma brought to you by the wingnuts, the states of Oklahoma, Texas, Mississippi, South Dakota and Virginia, the Personhood bills, Mitt Romney, Rick Santorum, Newt Gingrich, Ron Paul, Eric Cantor, John Boehner, Mitch McConnell and every citizen who will vote Republican this coming November.
 
 
+34 # Lolanne 2012-02-15 12:23
Quoting GeeRob:
In essence, this trauma brought to you by the wingnuts, the states of Oklahoma, Texas, Mississippi, South Dakota and Virginia, the Personhood bills, Mitt Romney, Rick Santorum, Newt Gingrich, Ron Paul, Eric Cantor, John Boehner, Mitch McConnell and every citizen who will vote Republican this coming November.


If I could give you more than one "thumbs up" for this comment, I would. These people you named are sorry excuses for human beings -- they are truly despicable. That people will vote for them leaves me wondering just how ignorant (or homicidal, or hate-filled, or bigoted - take your choice) they have to be to do such a thing. And even worse, how on earth does anybody reason with such voters???? They do not seem to comprehend reason at all!
 
 
+41 # Glen 2012-02-15 10:02
Rabid anti-abortion folks are, in truth, toying with lives far beyond their knowledge and beliefs. A great many of them weren't even alive, or were very young prior to abortion being made legal. They are not aware of how many lives were lost, the unimaginable shame in getting pregnant to begin with, or the lack of responsibility on the part of the father. Hundreds, possibly thousands of girls went into hiding to then put the baby up for adoption, unless they, in desperation, chose abortion.

Always fight for human rights, especially that of women. There is no reason in hell to go back to the days of shame and death rather than enlightening folks early to the use of contraceptives and the option of abortion when necessary.
 
 
+43 # Bev 2012-02-15 10:04
Would that the religious hierarchy who so vehemently oppose women's rights would instead act to counter pedophilia.
 
 
+21 # giraffee2012 2012-02-15 10:08
If you live in a state who has government who ares establishing rules to prevent abortions - send him this article with a vow to help his opponent gain his office.

Be sure to send this URL summarizing Roe v Wade
http://en.wikipedia.org/wiki/Roe_v._Wade


NEVER EVER VOTE REPUBLICAN or TP - if you want the USA to remain free and return to pre-Bush "W" era (pre-Reagan era) - how deep does the corruption go? Don't know but as Clint Eastward said at Super Bowl ad "Let's start the 2nd half of the birth of USA" (I know he said something about a car company but you get my drift)
 
 
+37 # sheila Cee 2012-02-15 10:50
And these right-wing bastards want to stop legal abortions? ....especially the women....these religious fanatics who think a few cells constitute a person. They are not only crazy, they are disgusting.
 
 
+28 # angelfish 2012-02-15 10:53
"Those Bastards" says it ALL! How DARE "those Bastards" continue the disgraceful policy of discrimination against those who can LEAST afford to be horrified by a System that ALREADY makes them second Class citizens? Women's Reproductive Rights Should and MUST not be a thing to be "legislated"! Men have the freedom to do as they please with their bodies but women, especially poor and disadvantaged ones don't have that luxury! The American Taliban (See Rick Santorum, Mitt Romney and their ilk) are now trying to dictate to this Country who will be able to avail themselves of Safe, effective recourse to unwanted pregnancy. It has been this way for-EVER but it's getting worse as they are removing needful SKILLS from our Medical Schools Curricula! The well-to-do have ALWAYS had access to abortion, as the jingle says, "The Rich get rich and the Poor have children..." in the meantime, in between time, we're NOT having fun at All! NOW, they want to limit a woman's access to safe and effective Birth Control! This is MADNESS! They are trying to march us back into the Dark Ages when a woman was labeled a "Witch" and burned at the stake if she displeased anyone! The Religious Fanatics should take comfort in the fact that ALL of us will stand in front of our Creator and have to read our page out of the Book. HE will be the final Arbiter, NOT them! I believe it is the THEY who will be found Wanting, not the poor woman who did what she KNEW was best for HERSELF and her Family!
 
 
+15 # Windy126 2012-02-15 14:00
This was the America I grew up in. Then there are those who died from infection
from dirty instruments, or from kidney failure, or where never able to have any children at all. All of those politicians
should be required to adopt these children and feed, clothe and educate them. Then they should be castrated. Then the men need to have a rectal exam for prostate cancer every time they go to the Doctor for anything. Also their scrotum palpated for testicular cancer.
 
 
+16 # DIAMONDMARGE 2012-02-15 15:10
Before Roe, in CA; I was told by my doctor to ask my hairdresser for an abortionist, who did an incomplete job;one night, terrified, I bled and bled. Then, my "doctor" did a D&C. WOMEN MUST NOT EVER RETURN TO THIS.
DON'T EVER VOTE RETHUGLICAN! TREAT WOMEN AS THINKING HUMAN BEINGS!
 
 
-9 # winson 2012-02-16 10:29
It is so sad to me that our culture is so immoral and cruel.
When people treat sex as fun and disregard its purpose to procreate a family, then the consequences are horrible. The children are disposed of as callously as a used tampon. Please, Dear Lord, forgive us.
 
 
+5 # Glen 2012-02-17 09:46
Cruel, yes, but immoral is a debated concept in a country at large.

Winson, sex IS fun, but there does not have to be heinous consequences for having fun. Smart, adult approaches to reproduction and that fun, are what is required, but that is an education that must begin early in life.

As so many have asked, why is it so many folks, especially the religious, don't see the value of children and adults as much as they do a fertilized egg. Why are they so much against sex education? Why against sensible approaches to a woman's welfare and health?
 

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