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| Dr. Jen Gunter |
“I have a 20-year-old with what I can only describe as a poorly repaired heart defect and, uh, suboptimal follow-up,” the cardiologist’s voice was rushed.
“That’s no good,” I said.
“Yeah, well, it gets worse. She had baby two years ago. Went into heart failure around 36 weeks. I’ve got the records. I have no idea how she made it home.” And then he added, “She had a c-section, but no one tied her goddamn tubes.”
“That happens,” was all I could say.
Actually, failing to do a tubal for a young woman with a very serious medical condition happens a lot. Patient refusal, Medicaid issues, or an OB dissuaded by her young age and the hope that advances in medicine might make it safe for her to be pregnant sometime in the next ten years. However, it was also possible that this young woman was so critically ill during her c-section that the doctors were just desperate to close her belly and get her off the table as soon as possible. Sometimes you just don’t have the five minutes.
“She came in short of breath. Eight weeks the radiologist says.” He added.
“So, uh, we have a problem…” I started, but he interrupted.
“Yeah, the pregnancy needs to be over. Today. Before she goes into heart failure,” he pressed.
I was fully aware of the medical urgency. That the amount of extra fluid the body accumulates in the early 2nd trimester can easily cause a damaged heart to decompensate. She’d already proven her heart wasn’t up to the challenge of the third trimester.
“I have to tell you something,” I said. I’m sure I closed my eyes, because even though I had nothing to do with it, I hated myself for what I was about to say. “There’s a new law. Maybe you don’t know about it? When the hospital’s budget was submitted this year to the state there was an additional clause. No abortions in this facility unless it’s life or death. Doesn’t matter if we can get insurance to pay or even if everyone is willing to waive their fees. The hospital is owned by the state.”
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