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A New Perspective

April 2009
By: Teresa Cook
I sat deep in thought at the nurse's station as monitors beeped softly from the darkened rooms of the four-bed intensive care unit. "Your patients are all stable," my head nurse had said earlier when she made assignments. "It should be an uneventful night."

Since taking the report from Connie, the evening nurse, I felt a growing suspicion that I would disagree with my supervisor.

"Williams in 431 is still on the ventilator," Connie said. "She's not doing any better, and the doctors have decided she doesn't have a chance while the baby is putting such a strain on her body. They talked to her husband this afternoon, and he signed a release. We started a Pitocin drip at five o'clock. Her contractions have been weak and irregular so far."

Linda Williams was just 25 and desperately wanted to be a mother. A severe asthmatic, she became pregnant against her doctor's advice. Initially, she fared well, but as the baby grew, her body rebelled against the additional burden. At five months' gestation, Linda suffered an unremitting asthma attack. Brought into the emergency room wheezing and gasping for air, her skin a grayish-blue, Linda was frightened for herself and her baby. When medications failed to bring the attack under control, doctors had no choice but to put her on a ventilator and admit her to intensive care.

In order to keep Linda from fighting the ventilator, her pulmonary doctor ordered round-the-clock sedatives and doses of Pavulon, a curare-like drug used to completely paralyze her muscles. Chest x-rays were done several times a day, and Linda's body was bombarded with powerful drugs in an attempt to halt the attack. Her condition remained unchanged. No one talked about the effect the radiation and medications might have on Linda's unborn child.

"I called labor and delivery and asked if someone could bring up a Doppler to check on the baby's status," Connie whispered conspiratorially during report. "I'd just like to know . . . " she said, her voice trailing off.

The word Doppler took me back to my rotation through labor and delivery in nursing school. I remembered the expectant mother I was assigned to follow through pregnancy and childbirth and the look of wonder on her face when the doctor used a fetal Doppler to locate and amplify her baby's heartbeat. That sound offered her concrete evidence that her baby was alive and well.

After the report, I walked into room 431 and watched my patient's chest rise and fall rhythmically at the insistence of the ventilator. I glanced at the IV that steadily infused Pitocin into her vein to induce labor. As I stood there, I pictured the fetus implanted inside Linda's uterus. At this stage it would be about 10 inches long with distinct fingers and toes already growing tissue-paper-thin fingernails and toenails. Its sex would be apparent, and its face would be taking on characteristics different from anyone else in the world. I wondered if Linda had felt its fluttering movements that typically begin during the fifth month.

I shook myself. What was I doing? The Supreme Court had ruled on Roe versus Wade five years earlier, and I considered myself pro-choice. I can handle this, I thought. After all, I'm a modern woman. Then I remembered how badly Linda wanted this baby.

Jill's voice interrupted my contemplation. "Hi, Tracy," she said. "Things are slow in labor and delivery right now so I thought this would be a good time to come by. Is this the patient Connie called about?"

"This is the one," I replied. "We'd like to see if you can find a fetal heartbeat."

I uncovered Linda's abdomen while Jill pulled out the Doppler and lubricated it with K-Y jelly. As Jill moved the Doppler around and adjusted the volume, I imagined what it would be like when the Pitocin had its desired effect and Linda's body expelled the tiny baby it now held. I'm not a labor and delivery nurse, I thought. I never dreamed I would have to face something like this in ICU.

"I'm not finding anything," said Jill, still searching with the Doppler. "I think the baby must be . . ."

Suddenly we heard it—the rapid whoosh, whoosh, whoosh of a strong fetal heartbeat. Our eyes met over Linda's distended abdomen.

"Teresa, Dr. Hanson is on line two for you." The floor secretary's voice coming over the intercom made me jump, breaking the deadlock.

I walked out to the desk and answered the phone. "Stop the Pitocin drip on Williams," said the OB/GYN intern. "I don't want to be disturbed tonight. We'll resume it in the morning."

"All right," I said and breathed a silent thank you.

For the rest of the night, I worked mechanically as I reflected on Linda and her baby. I've been trained to save lives. How could I participate in the taking of a life—any life? I pondered. I thought I believed in a woman's right to terminate a pregnancy until I was confronted with what that really meant. Even when the mother's life was at risk, did we as the medical profession have the right to decide who should live and who should die, to trade one life for another? How many times had I seen doctors proven wrong about a patient's prognosis? Wasn't God still in control of what happened?

By the end of the shift, I knew the answers to these questions. A living heartbeat sounded in my mind, and I knew I would refuse to ever again be a part of ending a new life, no matter how bleak the alternatives seemed.

My head nurse was wrong about it being an uneventful night. I walked out of that hospital a different person than when I walked in. I now had on the issue of abortion.

Retired from nursing, Teresa Cook writes, speaks, and conducts workshops to train other writers in tackling tough topics such as abortion. Visit her at

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