Monday, September 1, 2008

Palin's Cowboy Judgment, Confirmed

By now we've all heard that Bristol Palin wasn't pregnant last winter, but she's pregnant now. There's no room for schadenfreude. She shouldn't be made the poster child for the failure of abstinence-only approaches to teenage sexuality; we have too many such poster children already. She's going to face the difficulties of early motherhood with the added burden of publicity. She'll also find deep joy in her baby, I'm sure - a point too rarely mentioned for all the moralizing about "teenage mothers." She's embarking on an amazing adventure in one of the hardest ways possible. I wish her well.

But as I wrote yesterday, it's Sarah Palin's conduct that's at issue. We now have no reason to doubt that after her water broke, Palin first delivered a speech in Dallas and then traveled all the way back to her hometown. Yes, she beat the odds by not going into labor. It was a foolhardy maneuver, just the same.

Here's what eMedicine says about premature rupture of membranes (ROM, or "yikes, my water just broke!"):
Most patients (90%) enter spontaneous labor within 24 hours when they experience ROM at term. ...

All patients with ROM should be asked to come to the hospital to ensure fetal well being.
(For a solid discussion of this issue in laywoman's terms, see this article at

In other words, this is not a situation where there are two reasonable alternatives, such as accepting or refusing pain relief in labor. (Yeah, I know some people will condemn epidurals, but I'm not willing to go there in this post.)

After one's water has broken, the major risks to the fetus are infection (which remains fairly modest within the first 24 hours) and a prolapsed cord (which can occur if the fetal head is not securely engaged, thus blocking the cervix). Cord prolapse is less likely in second and subsequent deliveries because the head is usually engaged during the last few weeks, covering the cervix as it begins to dilate. Since Sarah Palin was only at 36 weeks, it would have been prudent to be checked by a doctor, since cord prolapse can threaten the baby's life.

The very great risk in Palin's case was that she'd deliver the baby on the plane. As I wrote in yesterday's post, the time between her water breaking and her arrival at the medical center in Wasilla appears to have been about 16 hours. Afterward, she said she was confident it was safe to travel due to her previous pregnancies. As far as I've gathered, none of them involved a child with congenital anomalies or premature labor. I assume she didn't take to the air with those pregnancies, either, after her water broke. As much as I respect women's body-knowledge, there were too many known unknowns here.

She played chicken with delivering her baby in the air - and won. If she hadn't gotten so lucky, an Alaska Airlines attendant might well have caught her baby. This happens occasionally, and mother and baby are usually just fine. But this was a risky call with a baby four weeks premature and known to have Down syndrome, thus at high risk of heart defects and other physical problems.

You can say this was a personal decision about her body and her baby. Yes, it was. I'm not suggesting Sarah Palin be treated as a criminal like those expectant mothers who've been subjected to court-ordered cesarean sections or who've been jailed in South Carolina for admitting crack cocaine use. I'm only suggesting we consider what this publicly-performed instance of private decision-making says about her judgment and temperament.

I'm not even saying she should be held to a much higher standard just because she has presented herself as a paragon of Christian motherhood. (The hypocrisy of being "pro-life" but then risking your baby's life just to get home is so manifest, I'll spare you my sermonizing.)

I'm just saying that this incident shows reckless behavior more befitting a cowboy than a national leader. We've already had eight years of cowboy governance. We know what comes from arrogance and ignorance of risks.

And if Palin's judgment looks pretty poor here, it's topped by John McCain's in choosing a candidate whose main qualification is her appeal to the Christian Dominionist wing of the Republican Party.


Laura said...

I dunno. Two thoughts:

1) I'm not comfortable judging her based on decisions she makes with respect to labor and delivery. Yes, it was reported in the newspaper and hence is de facto public information, but on a visceral level, this strikes me as non-public domain. I felt the same way about Bill Clinton receiving oral favors. Reckless, yes, but not within the proper scope of public inquiry.

2) If I were to "go there" and cast judgement, you make some interesting points. But there is a counterpoint: the OB establishment is patriarchal or at least has its roots in patriarchy. Who wrote the wiki to which you link, anyway? Shunning an OB can be a valid feminist choice. And it may well be a prudent choice as well. Ricki Lake made a documentary about this. I'm not saying she made a prudent decision. I just don't think it's black and white.

Carla said...

sg, "Cowboy" indeed. I think one of the most interesting parts of this whole affair is her ignorance of irony. She says she made a "decision" to have her baby, in spite of the DS diagnosis. Then she said they are proud of their daughter's "decision" to keep her baby. Isn't the definition of decision "to make a choice"? And isn't that what puts the word choice in "pro-choice"? If Palin is serious about her anti-choice stance, then her rhetoric should be: We're pregnant. We oppose a woman's right to choose abortion but in our case, "choice" is moot because while legally we have a "choice", morally this matter is sealed.

I think Palin's teen should be left alone now that the rumors are quashed (although it is technically possible that the daughter had two back-to-back prenancies). But mother Palin's situation is fair game because SHE put it on the table by patting herself on the back that she knowingly and willingly gave birth to a DS baby. If she didn't want to make herself look all noble, then she would have shut up about it and let the media discover it on their own. Which they most certainly would have done and then she'd look all the better: the quiet martyr.

Sungold said...

Laura, whatever birth choices her daughter makes are private. So are yours. EXCEPT if you were to get on an airplane with your water leaking! Then you'd be making a decision for everyone on that plane, potentially creating an onboard emergency that would impact all the other passengers. I didn't belabor this point, because ethically "causing inconvenience" is less severe than "risking another creature's safety and life."

Sure, there are downright misogynistic elements in the history of ob/gyn and they influence practice up until today. The history of episiotomy is one of the more vivid examples - maybe I'll write about that sometime. (My research field is the history of childbirth, so I am *steeped* in this stuff, for better or worse.)

BUT, it's one thing to defend home birth as a rational choice for low-risk pregnancies (which I do) and another to say it's OK to risk delivering 1) a preemie with 2) the potential for life-threatening anomalies due to trisomy 3) on an airplane 4) without a trained attendant. Any one of those factors shows either recklessness or stupidity, and I truly don't believe Palin is stupid.

We can have the home birth discussion another day. This is the airplane birth discussion. :-)

Sungold said...

Hi Carla. John Nichols wrote a great column at The Nation today, expressing points similar to yours. I'd love to smuggle you into the campaign as Palin's speechwriter; I think you just nailed it!

I think it's highly unlikely that Bristol Palin got pregnant, delivered, and then got pregnant again a few days later. That would have to be the timeline. I still think there are oddities about Sarah Palin's story. You'd think she'd have to make her medical records public, as all presidential candidates do, and that would settle the matter.

In any event, it's pretty clear that McCain bought a pig in a poke and now he's as surprised as we are by much of what's come out.

Laura said...

what if it were just her mucuous plug?

(See what I mean about feeling uneasy about the scope of inquiry?)

Carla said...

sg, I'm glad you are steadfast in your argument, because the judgment question regarding the flight is relevant, ESPECIALLY because she publicly airs the "pro-life" issue. If you feel like your fetus is sacrosanct from Day 1, then you'd better get on board (and I don't mean a plane). And when you behave this way when your delivery is imminent, you damn well better take your new baby home and in the privacy of your own living room give yourself a big ole V-8 smack on the forehead.

I have never had a baby, though I have been a birthing partner and feel I know a lot more about childbirth than most nonbreeders. Her behavior was indisputably and unforgivably reckless. To me, it honestly sounds like something Britney Spears would do.

Oh, and I was kidding about the lightning-speed re-impregnantion. That would be some f----d up shit of branch-Davidian proportion.

I doubt the traditional media will even dare to go here. The "liberal" media is already taking a thrashing for less egregious "offenses."

Sungold said...

Laura - Don't forget you're talking to someone who can happily converse about mucous plugs over dinner - I'm afraid my profession has warped me. :-) In any event, it *was* her water breaking, otherwise the doctors wouldn't have induced Palin when she finally arrived at the hospital. I do trust her (and any reasonably alert woman) to recognize the difference after having borne a baby (or four).

Carla, I'd see the flight as relevant even if Palin were pro-choice. But you're quite right that the element of hypocrisy makes it all the more so.

And you're also right - unfortunately - that the aggressive tone that one diarist took at the Daily Kos is now standing in for the whole "librul media." For the record, I think that the questions that diarist posed were legit, but it was not OK to overreach and call Palin a "liar."

I'm still mystified by the pictures. In the one I posted here, Sarah Palin looks less pregnant at seven months than her daughter does at five. And her daughter is not unusually large in any way; she just looks healthy.

I'm still waiting for those medical records to be released. Maybe they contain the Holy Grail of how to look slim throughout pregnancy. :-)

Carla said...

sg, of course. It certainly goes for the pro-choice mommies as well. I didn't mean to imply those gals can lay around smoking cigs and downing bourbon shots. ;-)

Sungold said...

But in that 18-year-plus postpartum period, an occasional bourbon shot - judiciously applied - can be *very* beneficial. (Ditto for surviving the Republican National Convention.)