Here we go again

A number of mainstream media outlets are reporting on the tragic case of a Sicilian woman, Valentina Milluzzo who became pregnant with twins following IVF treatment and then died after miscarrying them.

Scant detail has been reported, but according to reports, Mrs Milluzzo was admitted to the Cannizzaro hospital in Catania, Sicily, after falling ill and going into labour at just 19 weeks in pregnancy, on September 29 where she remained in a stable condition for a couple of weeks.

On October 15 her condition worsened and one baby was then stillborn, Mrs Milluzzo’s condition then rapidly deteriorated, her family then asked for the other baby to be aborted, doctors refused supposedly on the grounds of conscientious objection, then it appears that the other baby was miscarried, shortly after which poor Valentina Miluzzo died too.

The various media reports seem muddled. In the Daily Mail the family’s lawyer allegedly reported that one of the unborn twins was suffering from from a ‘breathing complication’. This doesn’t stack up because a baby in utero does not actually breathe through their nose and mouth, but rather exchanges oxygen and carbon dioxide with the mother through the placenta and umbilical cord. Clearly there was some kind of complication causing foetal distress which may have led to the miscarriage, but ‘breathing difficulty’ seems to be an overly-simplistic term. That said, this could simply be a translation error. But in any event the account in the Daily Mail, has the doctor refusing to abort both babies.

The BBC has a similar account, namely the doctor apparently refused to intervene to abort both babies after one got into difficulty, but the Guardian claims that having given birth to one stillborn baby, poor Valentina was in agony for 12 hours with the doctors refusing to intervene on the grounds that the other baby was still alive. The family begged for the doctors to abort the other child to save her life, the doctors refused and shortly afterwards the baby was born dead and Mrs Milluzzo died of septic shock.

The Guardian of course carries a photograph of pro-life nuns, just in case you hadn’t got with the programme about these evil Catholic types. It also runs a load of irrelevant copy with implied supposition about the recent decline in abortions in Italy being due to a shortage of doctors willing to perform them and whether or not Italy actually has enough people to carry out abortions because, shock horror, there’s a high rate of conscientious objectors. A decline in abortions, can never be seen as positive news now can it, and what this unsubtle inference fails to mention is Italy’s catastrophically declining birth rate. Maybe, just maybe, fewer women are getting pregnant and those who do actually want to keep their babies?!

First off, nobody should be blamed or jump to conclusions because the fact is that we do not know what happened. Of course the family would have been enormously distressed by the way events unfolded and one cannot blame them for wishing medics to take whatever action necessary to save the life of their beloved wife and daughter.

But in this situation, when we have the very sketchiest of facts, it is a revolting political opportunism that wishes to capitalise on a terrible tragedy of a woman, who is not yet buried, to claim, as the profiteers at International Planned Parenthood Federation (who  make money from abortion) have done, that the right of medics to conscientiously object to abortion, puts women at risk and must be removed. Medics are not disrespecting the law, they are acting in accordance with it. Italian law in common with other European laws, allows for abortion in certain specific prescribed circumstances, and also allows doctors who feel that their remit is to save lives not end them, to opt out. Freedom of conscience ought to take primacy. Nobody should be coerced by the law into carrying out acts which they find to be morally abhorrent.

In the case of a woman who has achieved a much-wanted pregnancy via IVF, one can well understand the reticence of doctors to abort the child, if there was a chance that they might survive. Secondly, and perhaps more importantly, in the case of miscarriage, the best clinical approach is to conservatively manage a miscarriage, which negates the risks and complications of surgery. It’s not clear how aborting the surviving twin would actually have saved her life – an unborn baby is not some kind of toxin, poisoning a woman’s system from within.

There seem to be several terrible parallels with the case of Savita Halappanavar going on here. Both women would appear to have died of septic shock. The HSE inquiry ruled that Mrs Halapannaver died of sepsis which went undiagnosed for too long. An abortion would not have saved her life, but prompt administration of antibiotics could well have done, though sepsis does require extremely swift diagnosis and intervention.

Dr Sam Coulter-Smith, master of the Rotunda hospital in Dublin commented that Ireland’s pro-life laws had little to do with Mrs Hlappanavar’s death and echoed the view of most gynaecologists saying

 “I think most of us who work in obstetrics and gynaecology, there may be individual differences, but the majority would be of the view that if the health is such a risk that there is a risk of death and we are dealing with a foetus that is not viable, there is only one answer to that question, we bring the pregnancy to an end.”

Here are the known facts. At 22 weeks, Mrs Milluzzo’s much-wanted child was viable and potentially had a chance of life. Abortion is not on the protocols of treatment for pregnant women with sepsis. Patients and family wishes must of course be taken into account, but the fact that they may have been understandably begging for a course of treatment which they believed was the best chance of saving this woman’s life, does not mean that aborting the baby was the correct medical solution. Wishing to save both the life of the baby and the mother, if at all possible, does not mean that the doctors were negligent, uncaring or adopting a rigourist approach.

The hospital is strongly disputing the family’s account. They have said the following:

“There was no conscientious objection on behalf of the doctor that intervened in this case because there was no voluntary termination of the pregnancy, but (the miscarriage) was forced by the grave circumstances…I rule out that a doctor could have told the family what they say he told them.”

Italian law forbids doctors to withhold life-saving treatment when a mother’s life is at risk. This has been reiterated by a national association of Catholic doctors who said that when a mother’s life is at risk, doctors must do whatever is necessary to save it.

Regardless of what may or may have been said to the family by the doctor (and I think we also have to allow for misunderstandings, especially in such a traumatic situation) there is nothing as yet, which demonstrates that doctors wilfully refused to save the life of a dying pregnant woman and sacrificed her for the sake of her unborn child. We do not have enough evidence and we should not speculate or seek to vilify the doctors, who were the ones actually dealing with the situation and who had the medical knowledge to ascertain the best course of action. Presumably when Mrs Milluzzo went into hospital she was hoping that the doctors would do everything possible to save her children. The request for an abortion was a response to ease suffering and save her life when her condition deteriorated, but chances are that by this stage it was already too late.

There are always two sides to every story, what happened to innocent until proven guilty?

But sadly, that won’t stop the pro-choice bandwagon from using this story as further proof of the uncaring pro-lifers forcing women to die for the sake of their unborn children and trying to remove the conscience rights of doctors, even though tragic cases such as these are very few and far between. With an absence of backstreet butchery upon which to hang the need for compassion, any maternal death with any possible tenuous link to abortion must be milked to ensure every drop of righteous indignation and anger is directed at those who wish to protect the lives of the unborn, who must be portrayed as uncaring misogynists. Especially if they happen to be doctors.

Valentina Milluzzo was a beautiful woman with everything to look forward to. May she and her babies rest in peace.