Category Archives: Human Rights

Holding Our Heroes Accountable

I’ve struggled a bit with whether and how to post this, but after reading Mona Darling’s post on her reactions to the keynote address at last weekend’s fantabulous CatalystCon (and make no mistake, CatalystCon 2014 WAS fantabulous – quite possibly the best conference I’ve ever attended, and I’ve been attending conferences for more than a decade now), I felt I had to share my reactions as well.

Let me first start by saying, again, that this year’s CatalystCon East was a great conference. From its organizer – Dee Dennis – to the speakers, to workshop presentations, to the swag bag (huzzah for the Aneros lanyards and StockRoom goodies) to the give-aways (free wevibes for nearly everyone! Best conference EVAR!) to the attendees (the real stars of the conference, in my humble opinion), CatalystCon was simply amazing.

But all of that? That I’m saving for another post. This post is really about what happened at the very end of CatalystCon during the closing keynote between two legends in the sexuality world – Carol Queen and Betty Dodson.

The session opened to an enraptured audience – how could we not be, when faced with two such amazing women? The interview, of sorts, started out wonderfully: a witty repartee that had the packed room laughing uproariously, applauding, and gasping, in turns.

Things started to take a turn for the worse when Betty talked about her experiences in the 1960s:

At that point, the temperature change in the room was palpable.  A few attendees even got up and left.

And Twitter was abuzz with commentary.

Others who have written about the keynote have seemed to hint that this is the point that those of use who were left feeling disturbed by the last hour or so of the talk are most upset by. Though many were upset by this discussion, that’s not the focus of this post. It was not the discussion of bestiality that had me (and several others) the most upset during the keynote. It was the way in which the idea of consent was trivialized.

Towards the end of the keynote, both Carol Queen and Betty Dodson stood together on the podium, and Carol quipped that Betty was grabbing her ass. A statement was then made to the effect that, “She [Betty] will probably grab your ass, too. If she does, just tell her to stop.”

At this point, I think a few of us in the room began tweeting questioning comments about consent. Because, no, that’s now how consent works. No one should get to touch my body unless I tell them to. Isn’t that what we’ve been fighting against? The idea that silence equals consent? Isn’t what we’ve been fighting for all along ENTHUSIASTIC consent, meaning NO ONE gets to touch my body unless (and UNTIL) I say yes?

What came next was even more problematic. Betty Dodson then piped up with something along the lines of, “If they don’t want me to grab their ass, they should just stay seated.”

NO. Just no.  Again, that’s not how consent works. Ever. And at least one twitter user pointed that out:

At this point, I know I was feeling a little uneasy about the conversation, and I know several others were, as well.  I think it was also at this point that my tweeting frequency drastically slowed.

What came next, however, was even worse. At the very end of the keynote, Carol Queen stood once again to reassure all of us that Betty Dodson really DID understand consent. And had she stopped there, somehow I think this could have all been forgotten as a simple slip of the tongue, as a joke between two old friends. It’s what came next that had me doing triage care in the lounge for someone who was panicking after being triggered by the discussion of nonconsensual touching. Carol Queen stood on stage and scolded the audience for being upset at the flippant comments about consent by lecturing us about Betty Dodson being a trailblazer, about her being in this river before any of us, insinuating that her history with the movement excused her comments about consent, that they gave her a free pass. This was a flagrant abuse of the power dynamics between the older, more experienced generation in the movement and those newer to the movement, something that I had hoped someone who had just given a workshop on consent earlier in the day would have recognized.

It was that, dear readers, that had me holding a fellow CatalystCon attendee as they shook with tears. They had felt they were in a safe space, and that safe space had just been torn apart by those words.

I know some of the responses on twitter and in blogs don’t want to acknowledge that people were hurt by the dismissive (and sometimes hostile) discussion of nonconsensual touching, but please know that people were. I know they were, because I was there helping them. I know that they were because I was one of those people.

I’ve had people tell me since Catalyst that we can’t put our heroes on a pedestal, hinting that we should accept them unconditionally, faults and all. And they’re right – we shouldn’t place our heroes on pedestals. And that’s precisely why it’s appropriate for us to expect the same from our heroes as we would from any of us. I can (and do) respect Betty Dodson and Carol Queen for the absolutely amazing work they have done (and continue to do) for this movement. But that doesn’t mean that they should be given a free pass. When our heroes do or say something that is wrong, we should hold them accountable for their words and actions the same as we would hold anyone else accountable.

And I do feel as if Carol Queen and Betty Dodson need to be held accountable for their comments about nonconsensual touching during the closing keynote. The best way for this to happen would have been through a robust Q&A dialogue immediately following the session where those who were uncomfortable with the statements could have raised our concerns and hopefully a resolution could have been reached with everyone in attendance.

Unfortunately, this didn’t happen. Whether it was due to time constraints, or people being unwilling / unable to raise their concerns (for whatever reason) in public at the plenary,* or because people had left the plenary early due to their response to other comments, negative reactions were not raised during the brief Q&A session. Instead, a few people took to Twitter, a few to blog posts, and many more to private conversations to discuss their discomfort with what had happened. What had started as a fantastic closing keynote to a fantastic conference ended on a very sour note for many.

Barring a more robust Q&A at the conference, I still think that dialogue needs to happen. Because while I have a billion and one great memories from CatalystCon, this is going to stick in my mind as an unresolved issue that will, sadly, mar the event for me. And I think it will for others. Fortunately, the fantastic Dee Dennis has shared that she has audio of the keynote that she plans to make available soon as a means to open up a robust conversation about reactions to what was said. And I’m hopeful that out of that conversation will come a greater discussion about consent, power dynamics, and possibly even about ways to make people who feel deeply troubled by something that occurs at CatalystCon (especially at the very end) feel safe in sharing their concerns on site with the person(s) involved, instead of just on Twitter, or blogs, or in private conversations with others.

Until then, I guess I’m going to try to push that last hour to the back of my mind, and focus instead on the utterly amazing other 71 hours of CatalystCon East.

Till next time,

– H

*I know that I personally didn’t feel comfortable raising my concerns (1) as a first-time attendee at the conference,  (2) because I have fairly severe anxiety disorders, and (3) because I found myself slightly triggered by the comments.

UPDATED: WTF OTD: FB Post Teaches Men How to Rape Children; FB Won’t Remove IT

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This piece is part of a daily “What the Fuck of the Day” series here on Antigone Awakens, where I briefly discuss one thing each day that has me seriously saying, WTF?!?!

********TRIGGER WARNING******

UPDATE:

Shortly after publishing this post to Twitter and Facebook, I received the following notification from Facebook:

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It looks like Facebook finally had a live human review the post I reported (only after I sent a not-quite-so-politely worded response to their original denial of my request) and have removed the post in question.

—————————————————————————————————————————————

Readers, I can’t even explain to you the rage I am feeling right now at this situation. A fellow twitter user (@blackdove) pointed this out to meet last night.  It is a post on Facebook from a user known as Ukachukwu Anokuru.

******TRIGGER WARNING TRIGGER WARNING TRIGGER WARNING******

On September 10th, in response to the death of an eight year old child on her wedding night in Yemen due to injuries she sustained when her 40-year-old husband raped her, THIS was what he posted:

yes we all vent anger and frustration no doubt,that’s ok.But we must realise that we still cannot stop this practice.In order to save the lives of future victims,we should educate the men on how to do it.If that Yemeni child husband had rubbed his limp penis(I don’t know if it’s the same with uncircumcised men)up and down the little girls vagina,he would have ejaculated within 15-20 seconds.Wipe her clean with tissue or clean cloth she wears back her panties and runs along to play,she would certainly have been alife today,safe,healthy, all forgotten.Nature permits this than Obama’s man marry man legality.I am talking from experience,I am not a hypocrite.Child sex,if done well is even safer and sweeter than adult sex.No injury,no pregnancy,nothing.The Yemeni bride was not ready for penetration and her husband must be arrested for murder.He is a mad man.How can he seek to enter a child sexually,instead of standing up the moment he notices that he has become erect.

After reading the link, and breathing for a few minutes to keep myself from vomiting or throwing my Macbook, I started going through Facebook’s reporting process. The first thing I noticed is that Facebook has absolutely NO mechanism for reporting sexual violence. You can either report something for violence, for which there is no option for reporting sexual violence:

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Or you can report something as sexually explicit:

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I attempted to report the post under the only option under which it fell (sexually explicit content), and received the following message from Facebook:

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RAGE. Unbridled rage.

Facebook gave me an option to comment on their refusal to remove the post, in which I may or may let have let a few choice words come out to play in explaining why a freaking BOT should never review these complaints. (Because I am POSITIVE that had a live person reviewed my complaint, this post would have been removed IMMEDIATELY).

So what can you do? You can go to Ukachukwu Anokuru’s page and report that disgutingly vile post in hopes that enough reports will force them to review it manually.

I’ve also created a Change.org petition asking Facebook to add a sexual violence option to their abuse reporting feature, and to hire more staff to review reports, so if you’re in the mood to do more, please sign that, as well.

If you found this post informative, or educational, witty, etc., you can click on the subscribe button just a few inches up and to your right to receive updates when I post on new womensy topics (you can unsubscribe at any time – I promise I won’t be offended). If you feel so inclined, you can also click the Donate button to help support the work I’m doing and keep me fighting the patriarchy. Thanks!

© Heather Parker and Antigone Awakens, 2012-2013.

WTF OTD: Rapist Gets Only 31 DAYS in Jail???!?!?

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This piece is part of a daily “What the Fuck of the Day” series here on Antigone Awakens, where I briefly discuss one thing each day that has me seriously saying, WTF?!?!

Today’s WTF OTD comes to you from Yellowstone County. Montana, where this man:

enhanced-buzz-7092-1377640981-13Stacey Rambold, a 54 year old former high school teacher was sentenced to just 31 days (yes thirty-one DAYS) for repeatedly raping a 14-year-old student. This same student later committed suicide just weeks before her 17th birthday.

Want even more shocking details from this story? Apparently Mr. Rambold could have avoided sentencing COMPLETELY if he completed a sex offender treatment program and agreed to other conditions. Yes, dear readers, you read that correctly. A 50+ year old man had sex with a FOURTEEN YEAR OLD student REPEATEDLY and could have received ZERO jail time had he simply completed a sex offender treatment program and stayed away from minors.

Read that again. A RAPIST could have avoided prosecution for his crimes simply be completing a sex offender treatment program? WTF?!

Moving on.

So what did he do to warrant this “terrible” punishment of 31 days in prison (with one day credited for time already served)? He skipped out on his treatment program and began spending time, unsupervised, with minors!

And instead of of agreeing with the prosecution’s request of a twenty year sentence, with a minimum of serving ten, the judge determined that the fact that Mr. Rambold had lost his teaching career, his marriage (the poor man!), and his home, had received an internet scarlet letter because of the publicity about the case, and (I’m not even joking here folks) that his victim “was older than her chronological age” (read: the slut must have been asking for it), the judge decided that leniency for this statutory rapist was in order, and gave him a mere 31 day sentence.

This might be my biggest WTF OTD yet.

Till next time,

– H

If you found this post informative, or educational, witty, etc., you can click on the subscribe button just a few inches up and to your right to receive updates when I post on new womensy topics (you can unsubscribe at any time – I promise I won’t be offended). If you feel so inclined, you can also click the Donate button to help support the work I’m doing and keep me fighting the patriarchy. Thanks!

© Heather Parker and Antigone Awakens, 2012-2013.

WTF OTD: Missing History Class is Problematic

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This piece is part of a daily “What the Fuck of the Day” series here on Antigone Awakens, where I briefly discuss one thing each day that has me seriously saying, WTF?!?!

Good afternoon, lovely readers. My apologies for not visiting you in forever, but the non-digital world has been taking up quite a bit of my time as of late. I promise to try and get back to a more regular blogging schedule sometime soon. My goal is to get back to at least one “regular” blog per week, and my regular once a day WTF OTD by September, so be looking for those.

In the meantime, here’s today WTF OTD:

I found this “lovely” gem on Facebook, which is a treasure trove of the worst of the worst of antichoice vomit-inducing vitriol (it’s amazing what they say when they thing you’re not looking). This morning (before I had my coffee, I might add), I came across this picture, pointed out to me by a friend:

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Photo credit Jonathan O’Toole and Christian Gallery

Now, just take a moment to let that picture sink in. Because my immediate reaction was the standard WTF??? But then I actually took a moment to LOOK at it. And then my reaction became a WTF?!?!?!?!?!??!!?

I’m going to try not to delve to deeply into the fact that this isn’t even a relatively close depiction of member of ANY Native American tribe (and actually seems to be rather gender amorphous – I mean, good for antis if that’s what they were going for, but somehow I doubt they really believe that not all persons who give birth are women).

Instead, I’m going to focus on the fact that, once again, they named a woman a PLACE. A woman’s body is not a fucking location. You cannot find my uterus on google maps, thank you very much.

I’m also going to focus on the fact that they’ve chosen to put a GIGANTIC undeveloped fetus –  covered with a Davey Crocket hat and armed with a non-period correct firearm – INSIDE the body of a supposedly Native American pregnant person. And then proceed to tell us that this arrangement is meant to be symbolic because settlers were “unjustly” attacked by those “savage Indians,” just like fetuses are “unjustly” attacked by their “savage” mothers and doctors during abortions.  W.T.F.

[Excuse my while I go laugh and then vomit]

Okay, I’m back.

What these antis don’t seem to realize is that neither the settlers NOR fetuses actually had/have a right to be where they were/are. Settlers were STEALING lands from Native American peoples, and fetuses are NOT persons – they do NOT have the right (NO ONE does) to use a pregnant persons body without that person’s permission. Just as Native American peoples had every right to tell the settlers to get the fuck back to where they came from and to protect their lands with force*, so, too, do pregnant persons have every right to terminate a pregnancy they do not wish to carry to term.

It really IS that simple.

Till next time,

– H

* Can I also just point out the utter laughability of the idea that Native Americans were behind the worst of the atrocities during that time period. A cursory reading of any introductory history text will show that while certain tribes did commit violence against settlers, the vast VAST VAST amount of violence was committed against Native Americans by settlers and by the US government. So, yeah…STFU antis.

If you found this post informative, or educational, witty, etc., you can click on the subscribe button just a few inches up and to your right to receive updates when I post on new womensy topics (you can unsubscribe at any time – I promise I won’t be offended). If you feel so inclined, you can also click the Donate button to help support the work I’m doing and keep me fighting the patriarchy. Thanks!

© Heather Parker and Antigone Awakens, 2012-2013.

Ask Governor Chris Christie to Support A3371 and Put an End to Conversion Therapy

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Guest post by @brazenqueer

I was raised in a conservative, fundamentalist Christian household.

From as early as I can remember, it was made clear to me that being queer was a sin, and that those who chose such a lifestyle were destined for hell.

Imagine my surprise then when, at the age of 13, I fell in love with my best friend. A girl.

I was terrified.

Continue reading

“Gender, Health and Poverty: Applying a Humans Rights Framework to Maternal Mortality”

I gave a presentation at the 2nd Annual National Association of Latina Nurses Meeting in 2010, and apparently someone recorded it. Thought I’d post it here because, well, maternal health is still important, and I actually did give a lot of good information about applying a human rights framework to it.

Enjoy!

The Truth About the Tragic Death Of Savita Halappanavar

Photo courtesy William Murphy.

Photo courtesy William Murphy.

Last October, Savita Halappanavar became a household name around the world in both prochoice and antichoice circles as news of her tragic death spread.

Ms. Halappanavar was a 31-year-old dentist in Belfast, who emigrated from India. She was 17 weeks pregnant with a very much wanted pregnancy when she began to miscarry. She and her husband went to the hospital where, despite their requests for a termination, they were denied and forced to wait to miscarry “naturally.” During this waiting process, Savita became incredibly ill, developing chorioamnionitis after her membranes ruptured, which progressed to sepsis, and then septic shock. She later died from a cardiac arrest, a week after being admitted to the hospital.

Her death sparked off vigils and protests around the world and calls for a change to Ireland’s draconian laws which prohibit abortion in all but the most extreme cases.

Just this week, however, the Prime Minister of Ireland, Enda Kenny, presented the new Protection of Life During Pregnancy Bill of 2013 – drafted in large part as a response to Savita’s death – which lays out ground rules for when abortions may be performed to save women’s lives in Ireland.

Unfortunately, since her tragic death, antichoice advocates have continued to claim that lack of access to abortion care was not a factor in Savita’s death. For instance, in response to a reblogged tumblr post that I tweeted, the antiabortion gang made the following remarks:

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Well, antiabortion gang, yesterday the experts DID tell us what happened. Yesterday the Irish Health Service Executive published its full investigative report into her death.

A  summarized timeline of the relevant medical facts in her case (from the report) is as follows:

Sunday, 21 Oct 2012, 9:35AM

Savita, 17 weeks pregnant, arrives at the hospital complaining of back pain (though it is noted she has a history of back pain due to sacral disc problems). Her vitals are taken and a urinalysis is performed. Neither show any signs of infection.

Sometime after 11:15 am, she is discharged from the hospital with the suggestion to take an OTC pain medication for her back pain.

Sunday, 21 Oct 2012, 3:30 PM

Savita returns to the hospital and informs staff that she “felt something come down” and pushed it back in. A midwife reported that she believed Savita would immediately miscarry and conducted a visual inspection.

Later, a senior house officer conducts a speculum examination and notes that her gestational sac (aka membranes) are bulging.

Sunday, 21 Oct 2012, 2:20 PM (This time has come into question as this entry was made AFTER entries made at 3:30 PM)

The Obstetrics and Gynecology Specialist Registrar (O&G Spr) performs a speculum examination, noting that Savita’s membranes are bulging almost to the entrance of her vagina, but are not cloudy (indicating no infection). The reviewing doctor notes that a miscarriage is imminent, and a “await events” approach is ordered and explained to Savita and her partner. No other treatment options are offered or explained.

Savita complains of pain that is “unbearable.”

A full blood panel is ordered due to the risk of infection associated with bleeding during miscarriage.

NB: Pain during a miscarriage, particularly severe pain, may indicate intrauterine sepsis and should have warranted further investigation.

Monday, 22 Oct 2012, 12:30 AM

Savita vomits copiously as her membranes spontaneously rupture. She is helped back to bed and told to rest.

Monday, 22 Oct 2012, 8:30 AM

The O&G Consultant 1 discusses the risk of infection and sepsis with Savita, and reiterates that the treatment plan is to “await events.”

Monday, 22 Oct 2012, 6:00 PM

Savita’s pulse rate begins to go above normal. (102 bpm)

Monday, 22 Oct 2012, 10:00 PM

Savita is administered a first dose of 250mg of erythromycin, to be delivered every six hours. The rationale given was ruptured membranes.

NB: Concerning the administration of erythromycin in this case, the investigators stated that:

Erythromycin is indicated for use prophylactically in preterm pre-labour rupture of the membranes in the absence of signs such as a faster pulse or lower blood pressure or raised temperature (Green-top Guidelines No 44 (2006 with amendment Oct 2010)). Erythromycin has also been shown to delay delivery which is beneficial in the management of preterm pre-labour rupture of the membranes but not in cases of inevitable miscarriage. However, in cases of preterm pre-labour rupture of the membranes where signs of sepsis occur, best practice guidelines promote that delivery is expedited.

Tuesday, 23 Oct 2012, 8:20 AM

Savita is continued on a course of erythromycin.

Savita and her husband ask about the possibility of using medication to induce a miscarriage, but are informed that, “Under Irish law, if there’s no evidence of risk to the life of the mother, our hands are tied so long as there’s a fetal heart”. They were informed that if risk to Savita’s life were to increase, a termination would have been possible, but it would have to be based on an actual risk and not a theoretical risk of infection as, “we can’t predict who is going to get an infection”.

Tuesday, 23 Oct 2012, 7:00 PM

Savita’s pulse rate increase to 114 bpm.

Tuesday, 23 Oct 2012, 9:00 PM

It is noted that Savita has been complaining of weakness.

NB: Weakness is an indication of infection / sepsis.

Wednesday, 24 Oct 2012, 4:15 AM

Savita is found shivering and with chattering teeth in her room. Her temperature has increased to 37.7 Celsius (99.86 Fahrenheit). Savita is given an extra blanket, and medication to lower her temperature.

NB: Shivering and chattering teeth are a sign of sepsis.

Wednesday, 24 Oct 2012, 4:20 AM

Savita vomits.

NB: Vomiting can be a sign of early toxic shock.

Wednesday, 24 Oct 2012, 6:30 AM

Savita’s complains of weakness and general body aches. Her vitals were as follows:

→ Temperature 39.6 degrees Celsius (103.28 Fahrenheit). ABNORMAL

→ Pulse rate 160 per minute ABNORMAL

→ Blood pressure 94/55mmHg, ABNORMAL

→ Respiratory rate 15 per minute

→ Oxygen saturations 97% on room air. ABNORMAL

Wednesday, 23 Oct 2012, 7:00 AM

Savita’s medical notes indicate nausea and vomiting, fever of 39.6 C with chills and rigors, palpitations, and tachycardia (160 bpm).

Her medical examination revealed extreme sensitivity upon examination of her suprapubic regions, and a significant amount of foul smelling brownish vaginal discharge.

The Senior House Officer diagnosed her as suffering from chorioamnioitis at this point, with possible sepsis.

An additional antibiotic was ordered administered at this point (Augmentin) as well as medication to reduce her fever. Blood samples were ordered, as well as a serum lactate test (due to concern about hypoperfusion that might indicate sepsis).

NB: the the suprapubic sensitivity and foul-smelling discharge are indicative of intrauterine infection.

Wednesday, 24 Oct 2012, 7:00 AM

Savita’s vitals continue to deteriorate. Her temperature remains high, her blood pressure continues to drop, her heart rate remains high, and she is placed on 40% oxygen supplementation.

Wednesday, 24 Oct 2012, 8:25 AM

Savita’s vitals continue to decline. Chorioamniotis is officially documented and she is started on another IV antibiotic: Metronidazole. A high vaginal swab and a mid urine stream are collected and sent to determine what infection is present. The medical team decide to wait on the results of the earlier blood test to change treatment plans.

Savita’s consultant OB/GYN inform she and her husband that if the source of the infection cannot be determined, a termination may have to be considered.

Wednesday, 24 Oct 2012, 12:00 PM

Savita’s blood count returns with a white cell count of 1.7 x 109/L at 8:29 AM.  A normal range for a white cell count in a second trimester pregnancy is between 6.2 – 14.8 x 109/L.

NB: A low white blood cell count or an elevated blood cell count outside the normal range in the second trimester is indicative of sepsis.

Wednesday, 24 Oct 2012, 1:20 PM

Savita’s condition continues to deteriorate rapidly. Her blood pressure has dropped to 81/40 mm/Hg, while her pulse rate has increased to 150 bpm. She is suffering from hypotension, dyspnoea and myalgia.

A diagnosis of septic shock is made, with the cause queried as chorioamnionitis.

Wednesday, 24 Oct 2012, 2:09 PM

Tazocin (an antibiotic) is added to Savita’s antibiotic regimen.

Wednesday, 24 Oct 2012, 3:00 PM

Savita’s condition deteriorates even further. An ultrasound is carried out and shows no movement of the fetal heart.

Wednesday, 24 Oct 2012, 3:15 PM

During insertion of a central venous line for monitoring and medication dispersal, Savita spontaneously miscarries the fetus and placenta.

Swabs of the maternal and fetal surfaces of the placenta are sent for culture and analysis.

After this point, Savita’s condition RAPIDLY deteriorates.

Thursday, 25 Oct 2012, 9:00 AM

Savita’s condition is still rapidly deteriorating. Diagnoses of severe septic shock, acute respiratory distress syndrome (ARDS), and disseminated intravascular coagulation are made.

Thursday, 25 Oct 2012, 12:00 PM

Based on preliminary results from placental swabs, the microbiologist recommends a change to Savita’s antibiotic regimen, removing the Tazocin and replacing Meropenem, and adding Gentomicin.

NB: The local Guidelines for the management of sepsis recommend using Tazocin and Gentomicin.

Friday, 25 Oct 2012, 12:00 PM

Cultures from placental swabs are complete, indicating the bacteria in question is ESBL E.Coli, proven susceptible to Tazocin and Meropenem.

Savita is continued on an antibiotic regimen of Meropenem, Gentomicin, and Metronidazole.

Sunday, 28 October 2010, 12:45 AM

Despite continued treatment, Savita condition continues to rapidly and severely deteriorate, and she suffers a cardiac arrest. Resuscitation efforts are made, but she is pronounced dead at at 1:09 AM.

I included the above timeline not only to provide readers with a background to the case that has been largely hidden from the public prior to now, but to highlight just how glaring the errors in her medical treatment were.

In addition to providing a complete timeline of events, The investigative team laid out three causal factors for Savita’s death, with the first being:

Inadequate assessment and monitoring that would have enabled the clinical team to recognise and respond to the signs that the patient’s condition was deteriorating due to infection associated with a failure to devise and follow a plan of care for this patient that was satisfactorily cognisant of the facts that: (1) the most likely cause of the patient’s inevitable miscarriage was infection and (2) the risk of infection and sepsis increased with time following admission and especially following the spontaneous rupture of the patient’s membranes.

While second trimester miscarriages are rare (occurring in only 1 – 2% of pregnancies), when they do occur, 77% are the result of infection, and, with chorioamnionitis, 0.5% will develop sepsis, and 0.1% will die.

A wide variety of bacteria is naturally present in the normal vaginal flora of pregnant women, including anaerobes and E.coli. However, these bacteria can also cause ascending infections, such as the one experienced by Savita, usually after membranes rupture, resulting in chorioamnionitis.

Chorioamnionitis, in turn, can lead not only to preterm labor, but to maternal and fetal morbidity. While maternal mortality in Ireland is normally listed at about 1 in every 10,000, the risk for women with chorioamnionitis increases to 1 in every 1,000. As the infection progresses to sepsis and septic shock, the risk increases exponentially.

To summarize Savita’s case, Savita presented at the hospital on Sunday, miscarrying an unviable fetus. In the middle of the night between Sunday and Monday, her membranes ruptured, opening her up to the risk of infection. Tuesday morning, she and her husband asked for medication to induce the miscarriage, but were denied. Instead, her medical team administered an antibiotic – erythromycin – that has been proven to prelong pregnancy with preterm prelabor rupture of membranes, a useful medical tool for viable pregnancies, but the exact opposite of what doctors should have been doing when faced with Savita’s inevitable miscarriage.

By Tuesday evening, she was already showing signs of sepsis, which were missed (or ignored) by her medical team. By Wednesday morning, her septic symptoms were severe, and she was diagnosed with chorioamnionitis, yet still the medical team forced her to continue with an “await events” approach to her miscarriage. Savita then naturally miscarried the fetus and placenta Wednesday evening. Afterwards, she became even more ill, dying from a cardiac arrest on Sunday.

While it is not clear exactly when Savita’s condition of severe sepsis progressed to septic shock, based on all available evidence, the investigative team felt it most likely that this happened sometime between the hours of 4:15 to 10:30 AM on Wednesday, 24 October 2012.

As Dr. Sabaratnam Arulkumaran, a London professor of obstetrics and gynecology, and author of the investigative report has stated: “When sepsis sets in, it is difficult to say who is going to live and who is going to die. We are just guessing here.” He also described the death rate from severe sepsis as 40 percent and septic shock as 60 percent, and said that if Halappanavar had received an abortion and aggressive doses of antibiotics early into her hospitalization, “the risk [of her death] would be much less.”

At the point at which chorioamnionitis was discovered, and most likely sooner, a termination should have been IMMEDIATELY performed. A woman who was miscarrying a nonviable fetus, had been lying in a hospital room for more than 48 hours with ruptured membranes (when clinical literature shows that the risk of infection – and therefore the need to empty the uterus – greatly increases after 24 hours), was showing signs of sepsis, and had been diagnosed with chorioamnionitis.

Had Savita received the termination she requested on Tuesday (more than 24 hours after her membranes had ruptured), and had swabs of the placenta been sent for analysis THEN instead of waiting the 30+ hours for her to miscarry naturally, Savita would have had 30 additional hours of aggressive antibiotic therapy, and 30 fewer hours for the infection in her uterus to spread throughout her body.

There was NO chance of saving Savita’s fetus. NONE. Fetal demise is a certitude in an inevitable miscarriage at 17 weeks with ruptured membranes. This fetus was not viable, and could not be saved. From the moment Savita stepped foot into the hospital, her fetus was not viable. But there WAS a chance of saving Savita, a chance that grew smaller and smaller each moment hospital staff waited, as first infection, then sepsis, then septic shock set in.

Unsurprisingly, the investigative body agrees with this assessment.  Their investigation of the circumstances surrounding Savita’s death led them to state that another “key causal factor” in Savita’s death was the, “Failure to offer all management options to a patient experiencing inevitable miscarriage of an early second trimester pregnancy where the risk to the mother increased with time from the time that membranes were ruptured,” and that:

International best practice includes expediting delivery in this clinical situation of an inevitable miscarriage at 17 week with prolonged rupture of the membranes and infection in the uterus because of the risk to the mother if the pregnancy is allowed to continue.  Expediting delivery (either medically or surgically as appropriate or feasible, and within the law) at the earliest signs of infection in the uterus is a critical part of management to reduce the risk of progression to sepsis, severe sepsis and septic shock and maternal morbidity and death.

Additionally, the team stated that:

Different management options needed to be considered – including termination of the pregnancy – as removal of the source of infection reduces the potential risk of sepsis thereby potentially avoiding rapid deterioration in the patient’s clinical condition due to progression to severe sepsis and septic shock with an associated high mortality rate.

That? All of that above, antiabortion gang (and other antis), is experts clarifying that the fact that termination of Savita’s pregnancy was NOT expedited even though she was miscarrying a nonviable fetus, had prolonged premature rupture of membranes, and an infection in her uterus, increased the risk of, if not directly caused, her death.

So antis, STFU about there not being a need for access to abortion services to save the lives of women. This case proves otherwise, as do many, many, MANY other cases around the world.

Finally, though this post has focused on the need for abortion care in situations where a woman’s life is at risk, I want to be careful to iterate that when it comes to abortion care, it SHOULD NOT MATTER whether a woman’s life or health is at risk from the pregnancy. What matters, ALL that should matter, is whether or not a woman wants to continue with her pregnancy. The reasons a woman wishes to access abortion care are of concern to her, and to her alone.

While Savita Halappanavar represents the ultimate tragedy of death that can befall a woman denied access to care, women who are denied access to abortions suffer many other consequences. Some turn to butchers like Gosnell when they cannot access safe and legal care, other attempt to perform abortions on themselves, and many others are coerced into carrying their pregnancies to term with devastating consequences. Focusing solely on life and health exceptions creates a false dichotomy between “good” and “bad” abortions. There are no “good” and “bad” abortions; only abortions which are safe and healthy for women, and those that are not.

Rest in peace, Savita Halappanavar. I hope that your family is finding peace, as well.

Till next time,

– H

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© Heather Parker and Antigone Awakens, 2012-2013.