Saturday Reads: Abortion, Loss, Grief, and Privacy

Rick and Karen Santorum

Good Morning!

Tonight is the New Hampshire Republican debate. Will there be fireworks between Newt and Mitt or even Newt and Rick Santorum? Newt is still on the warpath. Tonight Wonk the Vote is planning a very special live blog with drinks and maybe drinking games.

I liked the suggestion I heard from Willie Geist on MSNBC yesterday morning. He said people should take a drink every time Rick Santorum says “partial birth abortion.” And then he played audio of Santorum saying it over and over. Okay, I know that’s tasteless, but it did make me laugh yesterday around 5AM. Anyway, be sure to drop by tonight for Wonk’s live blog!

Speaking of late-term abortions (or not-abortions), I’ve been thinking a lot about Rick and Karen Santorum and the story of how they reacted after Karen lost a pregnancy at 19-20 weeks in 1996. Once I started writing, it ended up being the focus of this post. I hope some other people also think it’s worth thinking and writing about and you won’t think I’m too “weird” for doing so.

There has been quite a bit of discussion around the internet about the couple’s decision to bring their dead baby (actually a second trimester fetus) home with them for their children to hold and cuddle. Karen Santorum subsequently wrote a book about the family’s experiences, Letters to Gabriel. Dakinikat wrote about this in a recent post that I can’t seem to locate at the moment. From 2005 NYT article (previously quoted by Dakinikat):

The childbirth in 1996 was a source of terrible heartbreak — the couple were told by doctors early in the pregnancy that the baby Karen was carrying had a fatal defect and would survive only for a short time outside the womb. According to Karen Santorum’s book, “Letters to Gabriel: The True Story of Gabriel Michael Santorum,” she later developed a life-threatening intrauterine infection and a fever that reached nearly 105 degrees. She went into labor when she was 20 weeks pregnant. After resisting at first, she allowed doctors to give her the drug Pitocin to speed the birth. Gabriel lived just two hours.

What happened after the death is a kind of snapshot of a cultural divide. Some would find it discomforting, strange, even ghoulish — others brave and deeply spiritual. Rick and Karen Santorum would not let the morgue take the corpse of their newborn; they slept that night in the hospital with their lifeless baby between them. The next day, they took him home. “Your siblings could not have been more excited about you!” Karen writes in the book, which takes the form of letters to Gabriel, mostly while he is in utero. “Elizabeth and Johnny held you with so much love and tenderness. Elizabeth proudly announced to everyone as she cuddled you, ‘This is my baby brother, Gabriel; he is an angel.'” ”

Pitocin is a synthetic form of oxytocin, a hormone with important roles in childbirth, breastfeeding, and attachment (love). As a drug, it is used to induce labor contractions. Therefore, many people see what happened as a late term abortion. At 19 weeks, the child when delivered is fully formed, but is still technically a fetus because it cannot live outside the womb.

In fact, hospital forms about the death read “20-week-old fetus,” according to a 2005 Washington Post story, but the couple insisted the form be changed to read “20-week-old baby.”

Of course most people would agree that the Santorums did the right thing to save Karen’s life. But since Rick Santorum was the author of the legislation that banned “partial birth abortion” (a made-up medical procedure), some have seen hypocrisy in their choice. Others have mocked them for bringing the corpse home and encouraging their children to handle it.

Alan Colmes was heavily criticized for “mocking” the Santorums on Fox News, and he later apologized to them personally. Eugene Robinson called the Santorums’ actions “weird” in an appearance on MSNBC, and the Washington Post Ombudsman felt the need to weigh in on the reader reaction. According to ABC News,

The Internet lit up with comments this week after Santorum’s meteoric rise to second-place in the Iowa caucuses, nearly tying him with presidential candidate Mitt Romney. Some described Santorum’s story as “weird” or “horrifying.”

So of course now the “experts” are being consulted for their opinions on the Santorum family drama. From the ABC News story:

In the context of the times — the year was 1996 when the family buried Gabriel — their behavior was understandable, according to Dr. David Diamond, a psychologist and co-author of the 2005 book “Unsung Lullabies.”

Helen Coons, a clinical psychologist and president of Women’s Mental Health Associates in Philadelphia, said couples are not encouraged to bring a deceased fetus home.

Apparently at the time, couples were being encouraged to express their grief over miscarriages and stillborn babies.

Diamond said that 20 years ago, around the time that the Santorums suffered their loss, professionals encouraged their response.

“It was getting to be more in fashion,” he said.

“The trend was, rather than ignoring, to help people with their grieving and make it a real loss rather than something stuck in their minds and imagination for years,” he said. “Even before that, they allowed families to hold the dead infant or fetus and spend time with them — as much as they wanted.”

A corpse was not often taken home, but might be kept in the refrigerator for “a couple of days,” so the family could have access, according to Diamond.

“It was kept in the hospital, but of course you can’t do that for too many days,” Diamond said. “But there were cases were they basically allowed the family to handle and be with baby and say goodbye.”

I can certainly identify with the grief the family felt, and I could even understand having the children view the child’s body in the hospital; but I admit to feeling uncomfortable with the idea of taking the body home. I’m not sure how long they kept it either; none of the articles I’ve read are specific on that point.

Charles Lane, a columnist at the Washington Post, wrote about his own and his wife’s experience of losing a baby in the third trimester.

Nine years ago, my son Jonathan’s heart mysteriously stopped in utero — two hours prior to a scheduled c-section that would have brought him out after 33 weeks. Next came hours of induced labor so that my wife could produce a lifeless child. I cannot describe the anxiety, emotional pain, and physical horror.

And then there was the question: what about the corpse? Fortunately for us, our hospital’s nurses were trained to deal with infant death. They washed the baby, wrapped him in a blanket and put a little cotton cap on his head, just as they would have done if he had been born alive. They then recommended that we spend as much time with him as we wanted.

My wife held Jonathan for a long while. I hesitated to do so. At the urging of the nurses and my wife, I summoned the courage to cradle Jonathan’s body, long enough to get a good look at his face and to muse how much he looked like his brother — then say goodbye. I am glad that my love for him overcame my fear of the dead.

We, like the Santorums, took a photograph of the baby — lying, as if asleep, in my wife’s arms. We have a framed copy in our bedroom. It’s beautiful.

Lane says that his six-year-old son asked where the baby was, and Lane now regrets not letting his son see the body.

I think part of the squeamishness that I feel–and I’m probably not alone–is that the Santorums chose to share their experience with the public. Santorum’s general fetishizing of fetuses and his absolute anti-abortion stand–even to the point of saying a victim of rape or incest who gets pregnant or a woman whose life is in danger should not be able to have the procedure–naturally leads people to question why he agreed to doctors inducing labor to rid his wife’s body of a fetus that was endangering her.

Here is what Rick Santorum has said about abortions to save the life of the mother:

ABORTION EXCEPTIONS TO PROTECT WOMEN’S HEALTH ARE ‘PHONY’: While discussing his track record as a champion of the partial birth abortion ban in June, Santorum dismissed exceptions other senators wanted to carve out to protect the life and health of mothers, calling such exceptions “phony.” “They wanted a health exception, which of course is a phony exception which would make the ban ineffective,” he said.

So the second part of the public discussion of what I think should really be a private issue (but the Santorums are the ones who made it very public) is did Karen Santorum have an abortion or not? At Salon, writer Irin Carmon reports that an unnamed “expert” says no, it wasn’t an abortion.

Of course, without direct access to Karen Santorum’s medical files, we have to take their word for what happened, and with only sketchy details. But according to a nationally respected obstetrician-gynecologist from a Center for Cosmetic & Reconstructive Gynecology who has long been active in the reproductive health community and who provides abortion services — who spoke on condition of anonymity due to not having treated Santorum directly — by their own account, the Santorums neither induced labor nor terminated the pregnancy.

“Based on what is presented here in these couple of pages, it looks to me as if there’s confusion with some people about what the word ‘abortion’ means,” the doctor told me today. “The word ‘abortion’ probably shouldn’t even be used in this context.” (It is technically correct to say that Karen Santorum had a septic spontaneous abortion, but that’s a medical term for an involuntary event that is different from “induced abortion,” which describes a willful termination.)

After rumors spread in Pennsylvania that Karen Santorum had an abortion, the Philadelphia Inquirer spoke to the Santorums for a story that has served as the main source for the recent chatter. In the 19th week of pregnancy, the paper reported, “a radiologist told them that the fetus Karen was carrying had a fatal defect and was going to die.” They opted for a “bladder shunt” surgery that led to an intrauterine infection and a high fever. The Santorums were told that “unless the source of the infection, the fetus, was removed from Karen’s body, she would likely die.”

There is no mention in the Salon article or in the Philadelphia Inquirer article about the injection of Pitocin that is mentioned in the longer NYT piece. So did Karen have an abortion. I’d say so. Even the “expert” in the Salon story says that what happened was “a septic spontaneous abortion.” So what’s the basis for saying it wasn’t an abortion? I guess the the “expert” feels some compassion for Karen, and so do I. Unlike Karen’s husband, I can empathize with people who are experience something terrible–even if it’s something I’ve never personally experienced.

But it is important when the person is running for President of the U.S. and he promises, if elected, to do everything in his power to ban all access to not only abortion, but also birth control. From the Salon article:

Rick Santorum did tell the Inquirer that “if that had to be the call, we would have induced labor if we had to,” under the understanding that the fetus was going to die anyway and intervening would save Karen’s life. And it is accurate to say that the direct experience of a life-threatening pregnancy and a tragic loss did not leave Rick Santorum with any empathy for women who do have to make those difficult decisions in extremely murky circumstances.

As the doctor put it, “One takes from this that pregnancies can go very, very wrong, very quickly.” Moreover, the kinds of legislative hurdles Santorum wants — or hospital administrative committees that seek to supersede the family’s decision-making — can certainly slow down the process and endanger women’s lives in the process.

Carmon writes that she feels “uncomfortable about having gone this far up Karen Santorum’s womb,” and I do too. But let’s face it: Santorum wants every woman’s womb to be invaded and her every decision about her pregnancy analyzed by strangers on committees. For that reason, I do think it’s important to talk about the choices made by Rick and Karen Santorum.

To summarize, I think grief over a miscarriage, even early in a pregnancy is normal and natural. When it happens late after the baby’s body is fully formed, it’s probably even more traumatic. In fact, according to Dr. Andres Bustillo, many women opt for cosmetic surgery as a way to cope with grief and extreme stress. Charles Lane’s story gave me a lot to think about, and after reading it, I agree that having young children view the body in the hospital could be appropriate.

However, I really think “kissing and cuddling” a corpse “for several hours is a little strange. Keep in mind that the other children were only 6, 4, and 18 months at the time. I also think frequently talking about the dead baby in public in the present tense and showing it’s photo to people is extremely weird. But that’s just me.

The people who are trying to absolve Rick Santorum of hypocrisy by claiming what happened wasn’t an abortion are mistaken. What happened is indistinguishable from the experience of many women–women who would not be able to receive the treatment Karen Santorum got if her husband achieves his political goals.

I’m sorry for the pain this public discussion is probably causing Rick and Karen Santorum and their children. But that’s the price of running for president. Think of the public discussion of the Clinton’s private lives that the media has engaged in for decades! In Santorum’s case, it will probably be over soon, because he’s not likely to get the nomination or ever become president.

Bottom line, this man wants to take away women’s constitutional rights. We’re talking about a politician whose main focus as Senator and in his campaign has been denying women privacy and control over their own bodies. Therefore, I think it’s normal for people to discuss the Santorums’ somewhat unusual, even arguably odd, behavior and to explore the question of whether Karen Santorum had an abortion or not.

I promise you some links to other news in the comments. What are you reading and blogging about today?