About St Gianna's death

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There has been a bit of discussion over at Mark Shea's place on this. What follows is my contribution to the comments boxes
Speaking here professionally as a midwife.
I have been very frustrated by the incomplete medical information on St Gianna. However, I do think that we need to remember how truly limited we were in 1961.

Ultrasound was an experimental technique, X-rays were fairly primitive and realistically there were no good imaging techniques for soft tissues. Radioactive dye uptake techniques were being developed and were occasionally used in late pregnancy to attempt to locate placental bleeding - but it was also becoming known that taking X-rays of pregnant women might not be the smartest thing in the world (although they were routinely done by at least SOME physicians well into the 1970s).
We have here in 1961 a woman with a large pelvic tumour that is causing considerable pain. She is a member of the medical profession (which actually tends to mitigate AGAINST getting quality care, believe it or not). She is also pregnant in her first trimester, and (if what I have read is accurate) also suffering from extreme vomiting of pregnancy (Hyperemesis gravidarum). The surgeon (gynecologists are surgeons, not primarily physicians - it is a very different mentality) has no way to tell if this large pelvic mass is cancer or not. It was well known (even then) that pelvic tumors whether malignant or benign tend to grow explosively during pregnancy. If a tumor obstructs normal body processes (as this one seems to have done) it is almost moot (at least initially) if it is cancerous or not.
So the medical choices that were offered to her were 1) abortion (to see if the tumor would regress spontaneously without the influence of the pregnancy and/or to make surgery less involved or risky) 2) hysterectomy (with concomitant loss of the pregnancy - the thinking here would be that if the tumor were cancerous that would be needed anyhow and the thought in those days was that repeated surgery would increase the risk of metastases) 3) remove the tumor and see what happens. knowing that even that surgery could risk mother and/or baby. Moms make these kinds of decisions even now - even with good diagnostic and surgical techniques. I have personally known women who delayed treatment for breast cancer till after delivery, women who have had ovarian tumors removed during pregnancy, etc. So Gianna made a choice that was consonant with her faith.
Nowadays, a woman with the degree of uterine scarring that she had would be automatically booked for a cesarean delivery, but that is NOW! Standards were different then, and there was a great reluctance to perform that first cesarean and thereby mandate further cesareans (which at the time involved a risk of maternal death between 7 to 17 times higher than a vaginal birth). Obviously (now) the decision to try to induce labor for >24 hours after the waters broke was a bad one - especially in the absence of good availability of the antibiotics that we take for granted ( I think that it was basically penicillin and a couple of others - not the palette we now have). So her death from post-cesarean sepsis was probably indirectly related to her choice to have a myomectomy earlier in her pregnancy. But it was not as directly related as some have thought or publicized.


I have not read the discussion at mark Shea (I will after this), but I often get the impression when people talk about St. Gianna, this is a situation that would not happen today. But you say this very well could? Not that it makes a difference, I am sure many of us would choose the same given the same choices.

Ok, your comments post in perspective of Mark Shea's comment box shed more clarity on the discussion.

Still, I think it is interesting about many discussions I have had that she would not have had such an opportunity for sainthood had this gone on today. Not to say she would not acheived sainthood by other means...

Alicia, thanks for bringing some sanity to a discussion that was going nowhere.

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This page contains a single entry by alicia published on May 17, 2004 11:00 PM.

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