Jill, Derick, Israel and the latest Dillard- Part 23

[Thorns]

1 hour ago, eveandadam said:

Can she deny such a life-saving procedure because religion abolishes it? Are they allowed to have a hysterectomy? I remember the one case in Ireland, where a woman died because the very catholic doctors refused to do a life-saving abortion on her.

 

 

I don't know, maybe?  She would probably be in no fit state to deny the procedure, if she needs an emergency c-section. Those are usually done in general anestetics, unless there already is an epidural/spinal established.

So, say a home birth was attempted, went wrong, and the woman arrives at the hospital bleeding profusely and/or in fetal distress. Then they won't wait for an epidural, they will just sedate with gas or drugs and get the baby out asap. If the bleeding is too large or the condition of the mother too fragile, they won't attempt to stop the bleeding locally when it is faster, easier and more sure to do a hysterectomy to save mothers life. 

Maybe some more law-savvy can chime in on the legal aspects? I presume the doctors risk getting sued? 

[imokit]

They have to consent for procedures including risks.  Even in dire emergency there is time to consent for section and associated risk.  I've seen a baby out within 5 mins from a decision to section, and even then mum was consented before her rapid anaesthetic.  I've seen some very big bleeds, and no emergency hysterectomies.  In that situation they clamp things until the bleeding stops/they can see it and fix it properly, while pouring blood into the patient.  To take out the uterus, they still need to find bleeding vessels and clamp them.  Hysterectomies 

 

In Ireland - it wasn't that the doctors were catholic and didn't want to.  It was that they were unsure of the law and thought they would get prosecuted for an illegal abortion if they did.

[Snarkle Motion]

1 hour ago, Thorns said:

I don't know, maybe?  She would probably be in no fit state to deny the procedure, if she needs an emergency c-section. Those are usually done in general anestetics, unless there already is an epidural/spinal established.

So, say a home birth was attempted, went wrong, and the woman arrives at the hospital bleeding profusely and/or in fetal distress. Then they won't wait for an epidural, they will just sedate with gas or drugs and get the baby out asap. If the bleeding is too large or the condition of the mother too fragile, they won't attempt to stop the bleeding locally when it is faster, easier and more sure to do a hysterectomy to save mothers life. 

Maybe some more law-savvy can chime in on the legal aspects? I presume the doctors risk getting sued? 

I believe that when life and limb are at stake yes they generally act and ask questions later. However someone with strong religious convictions may make their wishes known in advance and I believe that they must respect this. Like Jehovah's Witness who doesn't want blood transfusion. If Jill believes herself to be a martyr for the cause and has an elaborate enough birth plan she may have it documented that she would rather die than have a hysterectomy and I think they would have to respect this? It is her body. 

[RosyDaisy]

A male doctor delivered Izzy. So maybe it's no male doctors unless it's an emergency.

[2manyKidzzz]

Well, depending on everything we won't know, we might have to start lighting votive candles and embark on a "Prayer Chain" here on FJ when we hear first Jessa, and then JillyMuffin have gone into labor. Snarkie as we are, we want everyone out of this alive. 

This would be a non-denominational prayer chain of course, allowing for everything. Ho ho, 

Seriously. 

[missegeno]

1 hour ago, Snarkle Motion said:

 If Jill believes herself to be a martyr for the cause and has an elaborate enough birth plan she may have it documented that she would rather die than have a hysterectomy and I think they would have to respect this? It is her body. 

Given that we're talking about the person who thought it was so unusual to consider what she would do if Derick dies, and only did it because she lived in the land of falling shower racks, I think it would be a step forward if she thought through the risks associated with childbirth.

[jozina]

4 hours ago, Thorns said:

I don't know, maybe?  She would probably be in no fit state to deny the procedure, if she needs an emergency c-section. Those are usually done in general anestetics, unless there already is an epidural/spinal established.

So, say a home birth was attempted, went wrong, and the woman arrives at the hospital bleeding profusely and/or in fetal distress. Then they won't wait for an epidural, they will just sedate with gas or drugs and get the baby out asap. If the bleeding is too large or the condition of the mother too fragile, they won't attempt to stop the bleeding locally when it is faster, easier and more sure to do a hysterectomy to save mothers life. 

Maybe some more law-savvy can chime in on the legal aspects? I presume the doctors risk getting sued? 

Medically, that isn't really right. Emergency c-sections are done under spinal all of the time even if one isn't in place. A general is only used if there is very serious need to get the baby out ASAP, if a woman is unlikely to be easily given an epidural in the required time frame or if she isn't haemodynamically stable enough to tolerate the regional anaesthetic. I'd say about 5-10% of the category 1 caesars I've scrubbed for (so where we think the baby needs to be out in under 30 minutes from decision time) are under general anaesthetic. About a third of them already have a regional in place but they still get put under sometimes if the block can't be increased satisfactorily.

Hysterectomy is a last resort. Very briefly you're making sure all repairs have been sutured satisfactorily, all fetal/placental tissue has been removed, a whole lot of different drugs, compression of the uterine walls via balloon, embolising the uterine arteries and finally hysterectomy. It's a big operation.

Consent is tricky if someone is not able to consent for themselves, but I've been involved in perhaps ten cases where the patient was unable to consent for a c-section. A partner can sign a consent form in specific situations but legally we are protected in my state if someone is unable to consent and their life would be saved by a procedure if we're acting in good faith. If a woman has previously written a birth plan refusing to consent for a c-section and their partner refuses to consent then someone higher up than me would be involved, likely well before the birth. Thankfully we get very few dire ex-home births turning up. It'd be different in different US states too I'd guess?

You're unlikely to hit the hospital from a home birth or attempted home birth in a time frame where it could be necessary to act that quickly. Odds of you hitting there in the short time where it's that urgent but the baby and/or mum are still alive are very slim.  Odds of a mother hitting there bleeding out so badly she needs a hysterectomy or is unable to consent but hasn't died yet are slim. And it takes time to get a theatre ready and get someone who isn't admitted/expected into theatre, so getting appropriate anaesthesia may not be the time limiting factor there.

[Iamtheway]

3 hours ago, Snarkle Motion said:

I believe that when life and limb are at stake yes they generally act and ask questions later. However someone with strong religious convictions may make their wishes known in advance and I believe that they must respect this. Like Jehovah's Witness who doesn't want blood transfusion. If Jill believes herself to be a martyr for the cause and has an elaborate enough birth plan she may have it documented that she would rather die than have a hysterectomy and I think they would have to respect this? It is her body. 

Really? Does Derrick know about this?

[MotherOfDragons]

I've had some pressing family medical issues to attend to, and then I come back to find out that Jill is preggo again. This is NOT what I wanted to hear on Christmas Day, y'all... 

[Destiny]

I've had some pressing family medical issues to attend to, and then I come back to find out that Jill is preggo again. This is NOT what I wanted to hear on Christmas Day, y'all... 

I was gonna email you but got busy. I was thinking of you today. I hope things are better.

[MotherOfDragons]

1 minute ago, Destiny said:

I was gonna email you but got busy. I was thinking of you today. I hope things are better.

Out of ICU and stable. Thank Cthulhu for modern medical intervention.

Also, you and Mr. Destiny stepped up and saved my ass. I owe you both the alcoholic beverage of your choice if you're ever in my neck of the woods. 

[Scribber]

On the topic of emergency cesareans, I had one (pre-eclampsia verging toward eclampsia, baby plummeted heart rate, etc) I had been attempting natural labor for the previous 20 hours.

It was 30'minutes from decision to birth, and that included bringing my doctor in at midnight, getting a spinal and delivering.

They told me it's incredibly rare to have to go with anything other than a spinal. Even in dire emergencies.

[Melissa1977]

I think you're going too far.

Duggars are not against doctors. Jill was too naif with her first delivery because she had been helping in homebirths and she only knew about natural, easy ones. But Michelle had high risk  deliveries and Jill instead of learning It, probably felt too smug and superior and thought It couldn't happen to her. And when things got  hard with Izzy birth, Jill was too proud but also too brainwashed about natural deliveries, that she put herself and Izzy in risk going late to the hospital. But it wasn't a religious decision un my opinion. I know atheist women with the same radical views regarding pregnancy.

I'm happy she couldn't (or she didn't want to) got pregnant right after Izzy. It has been a long time between pregnancies, in fundie terms. Hope she is really recovered and learned the lesson. 

[3arrowsandnotcounting]

I think you're going too far.
Duggars are not against doctors. Jill was too naif with her first delivery because she had been helping in homebirths and she only knew about natural, easy ones. But Michelle had high risk  deliveries and Jill instead of learning It, probably felt too smug and superior and thought It couldn't happen to her. And when things got  hard with Izzy birth, Jill was too proud but also too brainwashed about natural deliveries, that she put herself and Izzy in risk going late to the hospital. But it wasn't a religious decision un my opinion. I know atheist women with the same radical views regarding pregnancy.
I'm happy she couldn't (or she didn't want to) got pregnant right after Izzy. It has been a long time between pregnancies, in fundie terms. Hope she is really recovered and learned the lesson. 

I agree, I'm hopeful that they will do the right thing this time and see an ob/gyn and deliver at a hospital for safety. With regard to consent for surgery etc., I delivered my second naturally but due to a haemorrhage I required emergency surgery to save my life. I was able to sign a consent form whilst bleeding out and knew that hysterectomy was one of the possibilities I was consenting to. I had a natural delivery with arrow three, but because of my history they actually had me sign consent forms before the scheduled induction of labor so that all bases were covered. You'd be surprised how lucid you can be, even in extremely painful and scary situations.

[Snarkle Motion]

I should add to my last comment that I highly doubt Jills birth plan included advanced directives. I'd hope that if it came down to the life of the mother they would receive proper medical care. I was more commenting that I believe there is precedent to deny life saving care for religious reasons and that doctors are supposed to respect these wishes when there has been proper documentation. I guess I find it interesting because I do believe this is her right to make decisions about her body as long as it is truly coming from her and not her headship.

[allthegoodnamesrgone]

23 hours ago, eveandadam said:

Can she deny such a life-saving procedure because religion abolishes it? Are they allowed to have a hysterectomy? I remember the one case in Ireland, where a woman died because the very catholic doctors refused to do a life-saving abortion on her.

 

 

I believe the abortion thing was in Ireland,  I can see Jill putting up a fuss but in an emergent case, depending on the situation, they may not have a choice, if it comes to life or death and she's rushed to hospital it maybe we'll do what we can but we can't make any promises we'll do what we can to save her life. 

I wouldn't think a hysterectomy would be against their religion when it is done to save the woman's life, like if she has cancer, or a rupture or infection.  They aren't doing it for birth control in that case, in this case God is saying you have enough kids. 

[ClaraOswin]

18 hours ago, jozina said:

Medically, that isn't really right. Emergency c-sections are done under spinal all of the time even if one isn't in place. A general is only used if there is very serious need to get the baby out ASAP, if a woman is unlikely to be easily given an epidural in the required time frame or if she isn't haemodynamically stable enough to tolerate the regional anaesthetic. I'd say about 5-10% of the category 1 caesars I've scrubbed for (so where we think the baby needs to be out in under 30 minutes from decision time) are under general anaesthetic. About a third of them already have a regional in place but they still get put under sometimes if the block can't be increased satisfactorily.

Hysterectomy is a last resort. Very briefly you're making sure all repairs have been sutured satisfactorily, all fetal/placental tissue has been removed, a whole lot of different drugs, compression of the uterine walls via balloon, embolising the uterine arteries and finally hysterectomy. It's a big operation.

Consent is tricky if someone is not able to consent for themselves, but I've been involved in perhaps ten cases where the patient was unable to consent for a c-section. A partner can sign a consent form in specific situations but legally we are protected in my state if someone is unable to consent and their life would be saved by a procedure if we're acting in good faith. If a woman has previously written a birth plan refusing to consent for a c-section and their partner refuses to consent then someone higher up than me would be involved, likely well before the birth. Thankfully we get very few dire ex-home births turning up. It'd be different in different US states too I'd guess?

You're unlikely to hit the hospital from a home birth or attempted home birth in a time frame where it could be necessary to act that quickly. Odds of you hitting there in the short time where it's that urgent but the baby and/or mum are still alive are very slim.  Odds of a mother hitting there bleeding out so badly she needs a hysterectomy or is unable to consent but hasn't died yet are slim. And it takes time to get a theatre ready and get someone who isn't admitted/expected into theatre, so getting appropriate anaesthesia may not be the time limiting factor there.

I may have missed it but what is your profession and where do you live? Just wondering where this info is coming from. Thanks!

[ljohnson2006]

If Jill has any sense, she'll be in a hospital for the second delivery. 

[RosyDaisy]

Yeah, Duggars and sense don't belong in the same sentence. I see Jill doing another homebirth.

[allthegoodnamesrgone]

18 hours ago, Scribber said:

On the topic of emergency cesareans, I had one (pre-eclampsia verging toward eclampsia, baby plummeted heart rate, etc) I had been attempting natural labor for the previous 20 hours.

It was 30'minutes from decision to birth, and that included bringing my doctor in at midnight, getting a spinal and delivering.

They told me it's incredibly rare to have to go with anything other than a spinal.  Even in dire emergencies.

The only person I know who nhad general anesthesia was laboring in the hospital and having a natural birth but the new RN hadn't been monitoring the baby but mom, and when the doc came in a noticed it and tried to find the baby's heart beat it was down to under 60 bpm at 2:00 am on a Saturday morning, and the only anesthesiologist was in the middle of another epidural and had to hurty up to knock my friend out and deliver the baby, it was 20 minutes total time from when doc realized she wasn't properly monitored until baby was born, but it was still to late, lack of oxygen left the baby profoundly brain damaged she also had a massive brain hemorrhage when she was 2 days old, they wound up turning off her life support when shew as about a week old because they felt the damage was to much for her little body to have any quality of life, and I wont hear any other opinions of that. 

[JesusCampSongs]

2 hours ago, RosyDaisy said:

Yeah, Duggars and sense don't belong in the same sentence. I see Jill doing another homebirth.

Same. I think she knows that if she goes the hospital route from the get-go, the medical professionals involved will strongly suggest that she have another c-section, and we all know that repeats of those aren't conducive to birthing 93864238746872346 children in two decades. 

I therefore predict that she'll attempt a VBAC at home and it won't go well. Hopefully, they'll make it to the hospital more quickly this time so that nothing truly catastrophic occurs. 

[KelseyAnn]

On 12/24/2016 at 3:47 AM, PartriarchydefyinValkarie said:

When she did that BS with Izzy I wanted to give her a fish slap lol jk but seriously. If your kid isn't progressing correctly after all that time, you SHOULD be able to figure out there is something truly wrong. 

Jill keeps this up and she'll end up needing a C section again in SA and possibly end up like Lori Grimes (I really hope it won't happen as Israel doesn't deserve that) minus her turning into a Walker as a Walker has more common sense than Jill.

 

And just like Lori, Jill doesn't seem able to keep an eye on her damn son. 

[VineHeart137]

2 hours ago, RosyDaisy said:

Yeah, Duggars and sense don't belong in the same sentence. I see Jill doing another homebirth.

I could have sworn I read somewhere that it's actually illegal in Arkansas for a midwife to attend a VBAC? Or am I remembering incorrectly?

If that's true then wouldn't she have no choice but to go to a hospital?

[KelseyAnn]

On 12/25/2016 at 3:32 PM, Snarkle Motion said:

I believe that when life and limb are at stake yes they generally act and ask questions later. However someone with strong religious convictions may make their wishes known in advance and I believe that they must respect this. Like Jehovah's Witness who doesn't want blood transfusion. If Jill believes herself to be a martyr for the cause and has an elaborate enough birth plan she may have it documented that she would rather die than have a hysterectomy and I think they would have to respect this? It is her body. 

 

But my Dad's family converted to being Jehovah's when he was only 10. And when he was in the hospital, much later and as an adult, his mom wouldn't allow him to receive any blood even though my mom was telling the doctors it was fine to do so. 

[Chevreuil]

On 25/12/2016 at 3:31 PM, Thorns said:

I don't know, maybe?  She would probably be in no fit state to deny the procedure, if she needs an emergency c-section. Those are usually done in general anestetics, unless there already is an epidural/spinal established.

So, say a home birth was attempted, went wrong, and the woman arrives at the hospital bleeding profusely and/or in fetal distress. Then they won't wait for an epidural, they will just sedate with gas or drugs and get the baby out asap. If the bleeding is too large or the condition of the mother too fragile, they won't attempt to stop the bleeding locally when it is faster, easier and more sure to do a hysterectomy to save mothers life. 

Maybe some more law-savvy can chime in on the legal aspects? I presume the doctors risk getting sued? 

When my husband was in a serious accident, i made the medical decisions on his behalf (it wasnt life or death but he was not in a position to make these decisions) i would assume if jill were to be in a position that prevented her from making the decision herself, that derick would make that decision. I am only speculating though from one experience.