Showing posts with label ectopic pregnancy. Show all posts
Showing posts with label ectopic pregnancy. Show all posts

Thursday, July 8, 2010

The American Academy of Pro-Life Obstetricians and Gynecologists Responds to the Ectopic Pregnancy Issue

 9July2010 Addendum:  After very insightful comments on a couple of internet forums, I decided to embellish this post with additional information.

On the advent of Vision Forum's "Baby Conference," AAPLOG offers the following new Position Statement on Ectopic Pregnancy.  I cannot tell you how many truly concerned people have become appalled by Vision Forum's own aberrant position on this matter.  I am so grateful that a Pro Life Organization has responded, and I hope that it will be the first of many more.

The American Association of Pro Life Obstetricians and Gynecologists is a group of some 2,500 members and associates within the American College of Obstetricians and Gynecologists (ACOG), recognized as a special interest group within the College.  (Read more about their organization HERE.)

What is AAPLOG’s Position on Treatment of Ectopic Pregnancy?

Monday, June 21, 2010

How Lawyers Lie With Statistics

Vision Forum willfully distorted statistics related to the true morbidity and mortality associated with ectopic pregnancy.  Ectopic pregnancy still remains the leading cause of death of all pregnant women in the first trimester of pregnancy.  It accounts for 9% of all maternal deaths in all pregnancy-related deaths.  In the case of death of pregnant women which includes non-pregnancy related death (unrelated heart disease or car accidents, for example), ectopic pregnancy still accounts for 6% of deaths of pregnant women.  

Despite these statistics, Vision Forum and Samaritan Ministries insist that ectopic pregnancy does not pose a significant health risk to women.  They have offered that 60-100 cases of live births resulting from ectopic pregnancies have been documented, but I can find no such reference to this rate of frequency.  One rate of frequency of "one in 60 million" has been offered to describe the rate of such births, and many falsely understand this as a probability statement when the probability for such births is actually ZERO.  I believe that the publications produced on this topic also capitalize on frequencies, using them as probability statements.  In the absence of well-rounded data presenting all the statistics, both Vision Forum and Samaritan Ministries manipulate trusting readers to accept a dangerous view of a very serious medical problem experienced by women of childbearing age.  Ectopic pregnancy, a deadly threat to women, should not be viewed as a game of chance.

Note how attorneys alter the way they present information to juries in order to make statistics seem either more or less impressive.  It is my hope that the reader will come away with a greater appreciation for the language of medical statistics and how numbers can be used to deceive the unsuspecting.


Excerpts from


South California Law Review, Vol. 74, p. 1275, 2001
(emphasis mine!)


Friday, June 18, 2010

Why an Average Can Be Misleading and How To Get Number Savvy: Vision Forum Myths About Ectopic Pregnancy as a Prototype

 
 
... Why I take issue with the misleading nature of the “1 in 60 million” rate of ectopic pregnancies that result in live births as quoted by Vision Forum and Samaritan Ministries.  

 Start HERE for some prerequisite ideas about how we can easily fall into "lying with statistics."


Start HERE for an overview of Vision Forum's aberrant stance on Ectopic Pregnancy

Briefly backing up…

Vision Forum and Samaritan Ministries cited a physician who stated that the chance of a live birth from an ectopic pregnancy was “60 million to one.”  I suppose that’s not Vision Forum’s fault for republishing this information, but I do fault Samaritan Ministries for disseminating the related information regarding healthcare statistics.  As an entity involved in the procuring and payment of healthcare, they have a higher burden of responsibility to communicate accurate information to their membership.

Means, Medians, and Modes: Vision Forum Definitely Works the Psychology of Numbers to their Advantage at the Expense of their Followers

... Why I take issue with the misleading nature of the “1 in 60 million” rate of ectopic pregnancies that result in live births as quoted by Vision Forum and Samaritan Ministries. 

Link HERE if you haven't read the previous posts pertaining to Vision Forum, Samaritan Ministries, and their dangerous views on ectopic pregnancy.

I suspect that until I get caught up and do at least a rough chi-square analysis to demonstrate how these calculations work, the probability is actually zero and the actual cases of live births may be more one in some obscene number that’s so big, it has no meaning.  That’s why the probability when calculating these odds is equal to ZERO.

Let’s start with Don Veinot’s blog article which also takes issue with Vision Forum’s position on ectopic pregnancy to demonstrate how such large numbers can become meaningless quickly.

From "The Crux," 17Jun10:

Thursday, June 17, 2010

Hey, Even I Lied With Statistics (By Accident!)

Ignorance, Stupid Error, and Willful Intent:  Vision Forum is still guilty of objectifying women and children

Christians often quote the Apostle Paul when he wrote to the Church at Rome that "God works all things together for good."  Today, I hope that my own error can be used for good, illustrating that statistics can be tough.  Though I am mortified and have sweat through two changes of clothing since I figured out what I did, I think that it illustrates a fine point in the discussion of how we can easily get turned around with statistics.  I hope that it demonstrates that we always have the option to "eat crow," and Winston Churchill once said that it makes for a more than adequate diet.  Where sin (missing the mark) abounds, grace does much more abound.  I hope that this is one instance where God can show His strength through my weakness and show glory through my shame (Ps 4:2).  This verse was of great comfort to me today:
If I must boast, I will boast of the things that show my weakness.
1 Corinthians 11:30-31

I expect that something similar to a portion of this post that now follows will appear on No Longer Quivering sometime in the near future, though I expand a bit more upon the subject here in my own corner of the internet.  If I had intended to be misleading from the start, I would have not included all of the numbers in the post where I first made the error!

Tuesday, June 15, 2010

Surgery for Tubal Pregnancy Deemed an Elective Abortion??? The Discussion of Vision Forum’s Fiat Raises More Questions

A Response to No Longer Quivering's
Vision Forum, Samaritan Ministries Take Extreme “Pro-Life” Position on Ectopic Pregnancies

In the name of “Right to Life” Quiverfull moms could lose their lives

Following the previous post about Vision Forum’s plans to advance their thesis regarding surgical treatment for tubal pregnancy before confirmed death of an unborn baby as the ethical equivalent of elective abortion, several insightful questions have been presented in different areas around the blogosphere including the NLQ Forum.  They are worth noting.

How Vision Forum "Lies with Statistics" to Prove that They are Special to God: Women with Ectopic Pregnancy Consigned to Die

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Please see my post on the No Longer Quivering Blog concerning Samaritan Ministry’s support of the Vision Forum position on ectopic pregnancy, something Vyckie entitled, “Vision Forum, Samaritan Ministries Take Extreme “Pro-Life” Position on Ectopic Pregnancies.”

LATE NOTE:  For math geeks, please see my disclaimer at the bottom of the page.


On the first day of my statistics class in college, the instructor held up a book that was not our assigned text, an old classic from the 1950s entitled “How to Lie with Statistics.”  Whenever he introduced a new topic, the instructor also presented an example of common mistakes made by many people, failing to appreciate the traps one can fall into when trying to prognosticate.  And my own research was good enough to have been the only undergraduate invited to present their research project at the Nursing Honor Society’s regional meeting in 1987.  And I continue to review data and participate in peer review within toxicology, having co-authored published research in this related field.  I’ve won two "Young Scientist" research awards as coauthor from TIAFT.  All that to say that I know a little bit about statistics -- particularly health care statistics after more than 25 years in the field.   I don't know that Vision Forum intends to lie with statistics, but they end up making classic and ignorant errors which results in the manipulation of their followers. (It might be an innocent result of confirmation bias.)   I think that their followers deserve informed consent.

Tuesday, June 8, 2010

Will You Die for a Cause, or Will You Live For One? Ectopic Pregnancy and Honoring Life: Part III of III


My Challenge to the Reader
  
A Response to the Invited Speaker List for Vision Forum’s 2010 Baby Conference

Note:  In the summer of 2008, Vision Form started a campaign to advance their idea that pre-emptive surgery for a woman with a tubal pregnancy constitutes murder of the unborn as an elective abortion.  Individuals who were outspoken or quoted in that discussion have been included as invited speakers at VF’s July Baby Conference (which will also host the famed Duggars of the TLC/Discovery Channel).  I believe that VF will use this vehicle to further advance what I find to be their very dangerous and distorted position concerning tubal pregnancy.

Please start with Part I  and  Part II.

Please note again that I cared for an unusual population of people when I dealt with obstetric (OB) cases in ICU.  I would imagine that only those nurses at that facility have seen the broad population of people in an underserved region of the country with the high acuity that the population that I reference.  It is not typical.   But I must ask myself, according to my causality and my faith, why did I have these experiences and what is my responsibility to the women who suffered and died?  What is my duty to those who lived due to miracles?  What is my responsibility to the husbands of the women I mention here who wept so sadly at their wives’ bedsides over the loss of both spouse and child?   What is my responsibility to the profession of nursing, something that is a holy calling for me?  What is my responsibility to all women?

I believe that I have been put in a very unique place to bear witness to the truth that some women die from peritonitis and sepsis if they don’t first hemorrhage to death following ruptured tubal pregnancies.  The medical profession respects their rights and is sometimes encouraged that people are willing to stand by their convictions, but the profession does not see them as martyrs.  I am here to bear witness about the pregnant women for whom I’ve cared as they struggled against sepsis. 

Monday, June 7, 2010

Will You Die for a Cause, or Will You Live For One? Ectopic Pregnancy and Honoring Life: Part II of III

The Use of Utilitarianism to Prove Special Status before God at a Woman’s Expense

A Response to the Invited Speaker List for Vision Forum’s 2010 Baby Conference

Please start HERE with Part I.

During the Summer of 2008, Vision Forum declared that any pre-emptive surgical intervention for tubal pregnancies constitutes murder, if the surgery takes place before a confirmed fetal death. Tubal pregnancies present a definite problem in this way, because the medical profession does not specifically confirm fetal death --  because there is only one option for a woman with a tubal pregnancy. Life-saving surgery provides the only ethical option for the medical profession. Because no baby from a tubal pregnancy has ever survived, the doctor must save the life of the mother, and it would be drastically unethical to do otherwise. The pathology of the condition ends the pregnancy and risks the mother’s life, not the doctor who acts to rescue the woman. In this case, Vision Forum fails to honor the life of the woman in favor of death. By the time a woman knows that she is pregnant with a tubal pregnancy, the life of the unborn baby has already been critically compromised because of the conditions that have adversely affected its growth. Yet Vision Forum recommends “Watchful Waiting” in ALL cases of ALL ectopic pregnancy types. In cases where the baby stands a chance of survival outside the womb, even with a poor prognosis, I completely agree with “Watchful Waiting.” In cases of tubal pregnancy, however, I believe such behavior dishonors life and makes a mockery of wisdom in the very Name of Wisdom itself.

Sunday, June 6, 2010

Will You Die for a Cause, or Will You Live for It? Ectopic Pregnancy and Ideas about Honoring Life: Part I of III


A Response to the Invited Speaker List for Vision Forum’s 2010 Baby Conference

Note:  In the summer of 2008, Vision Form started a campaign to advance their idea that pre-emptive surgery for a woman with a tubal pregnancy constitutes murder of the unborn as an elective abortion.  Individuals who were outspoken or quoted in that discussion have been included as invited speakers at VF’s July Baby Conference (which will also host the famed Duggars of the TLC/Discovery Channel).  I believe that VF will use this vehicle to further advance what I find to be their very dangerous and distorted position concerning tubal pregnancy.

My Personal Perspective

I no longer work as a nurse in intensive care, but I did so for many years.  While my husband was still in graduate school and on a meager stipend, we lived in a very depressed community with a high indigent population in the heart of the Bible belt.  Even after 25 years of experience as a nurse, I have yet to see such physically sick, fragile people as I did in that town.  The hospital was at a medical school, and the medical director of the ICU where I worked piloted and tested experimental equipment in clinical trials.  Dying people were sent to us for enrollment in these trials as the last possible measures that might save their lives.  Between the poor health of the population we served and the numbers of people that were flown in from outside the state – from places like Baylor and big city hospitals in Dallas – we saw the sickest of the sick.  Doctors who could do no more for their dying patients would send them to us.  So my experiences there at this hospital are not typical, and I saw conditions and did procedures there that many critical care nurses only read about in books.  I saw the worst of the worst of the worst-case scenarios.  That must be noted.  But, regardless, I still saw them.  And we saw many good outcomes that I consider miraculous.  That definitely should also be noted.  But the bad outcomes haunt me still.

I didn’t work in obstetrics (OB), but we received so many OB cases while I worked there, the hospital decided to open their own OB ICU.  I even helped to train those nurses in the care of critical patients.  To some extent, a predictable number of things tend to happen to critically ill pregnant women, just because of the nature of things.  We generally saw hypertensive patients, commonly called toxemia.  And we saw some other more terrible things resulting from sepsis, infection in the blood stream, something that occurs with the peritonitis that follows a ruptured fallopian tube resulting from ectopic pregnancy.  We saw other pregnant women for other critical conditions, and I cared for patients and families as they worked through the decision-making process about what to do and what was ethically right to do.  These decisions do not come as light matters for either patient or doctor, and the outcomes are not always good, even when the most virtuous decisions are made.  Care is often delayed while people try to make the best decisions, and the women often suffer the consequences.  I recall vividly in images that I wish I could wipe from my mind of two different husbands, weeping at the foot of the bed of their wives who were comatose after valiant efforts were made to save their babies.  In both these cases, the babies died and the mothers would likely never regain consciousness.

Sunday, June 15, 2008

The Power of Words to Take Our Pain and Make It Worse


In the prior post and elsewhere, I've mentioned how the death of my godparents' daughter deeply affected me and, in many ways, defined me. If you've heard this story before, it may have a different twist in this telling of it. My godparents walked through the troublesome circumstances of my birth along with my parents, supporting them through what they thought would resolve in my death as a newborn. Their daughter, Anne, would have been six years old at the time I teetered at the threshold of death. I think that it's ironic that when turned six years old that I would be in a similar situation, begging for God to spare Anne's life, even at the expense of my own.

A Mother's Survivor Guilt: A Prelude to the Next Post

I've never met a mother who lost a loved and wanted unborn baby or a child who was in their care who did not ask themselves whether they did something to harm their loved one or whether there was something that they could have done to save their child. Particularly when a pregnant mother loses her unborn baby to a miscarriage, there is a period when she recalls and reviews and scrutinizes all that she did, questioning whether she did something to cause her baby's demise, questioning if there is a punishment due.

I don't know of a nurse or a doctor worth their salt who fought to save a person from death who does not stop at some point and ask themselves if there was more that could have been done. For the best of doctors and nurses, arriving at the place of realization when all has been done to no avail is hard place that is full of grief and bitter disappointment. It is oft disguised in anger or perfectionism or in laughter and jokes. But I assure you that it is there somewhere. For those who live in the realization of this loss, these can be haunting questions. They cover you in the midst of the dark night of one's soul as you struggle to make some sense of tragedy.

Friday, June 6, 2008

Thatmom on the Threat Doug Phillips Poses to the Lives of Homeschooling Moms

Vision Forum has already been drawn into question for threatening homeschooling liberties due to their gender bias and what might yet be viewed as a gender related violation of the Federal Equal Protection Clause as noted by Kimberly Yuracko in an article slated for publication in the California Law Review. Per his reporting of the activities of the 2008 Witherspoon School, Doug Phillips now has extended his misogyny to women with ectopic pregnancies.


Read "thatmom" Karen Campbell's post on Doug Phillips' cold logic and her call to exclude him from homeschooling conferences. Not only does Phillips make the error of mistaking law for ethics, but he also violates the concept that "hard cases make for bad law."

From Karen's post (and link to read the responses there):

I live in the Midwest, smack in the middle of what people around here like to call “tornado alley.” In my town, people often swap stories of the “big one,” the tornado that took out half of the business district and damaged countless homes one lazy July afternoon in 1975. People who survived that day will tell you that now they head for the basement or storm cellar as soon as the sirens sound. They remember the damage, know the personal loss and even the tragedy that came with that twister and they will do all they can to protect themselves and those they love should another one come this direction.

On the other hand, those who have never experienced a tornado often grab an iced tea and sit on the front porch, watching as though they were in a giant screen movie theatre, telling themselves that the destruction might come to someone else but it won’t affect them. Today, I feel as though I am in the homeschooling version of our county’s emergency services. I have been storm spotting for a while and now see the deadly twister coming my direction. It is guaranteed to take lives. It is a an F-5 on the Fujita scale, complete with 300 mile per hour winds and damage akin to “strong frame houses lifted off foundations and carried considerable distances to disintegrate.” This is where the homes of homeschooling families are headed if Doug Phillips from Vision Forum is not held accountable for his most recent rhetoric.

On March 6, 2002, Phillips published a document entitled “A Declaration of Life” where he states the following:
“WHEREAS those theories which justify the killing of the unborn child on the basis of the circumstances of conception (as in the case of rape and incest), or even the life of the mother (ectopic pregnancies) are completely false because they are based on unbiblical and humanistic ethics, unbiblical definitions of “self defense” theory, and a rejection of the personhood of the child; and Continuing Relevance of All of Scripture.”
I am not certain if I read this when it was first published. I probably did not as I most likely assumed that his position would be one that passed genuine pro-life muster. Then, this week (June 5, 2008), Phillips, reporting on the most recent Whitherspoon Law and Public Policy conference, made this statement:
“Some Christians maintain a 100% pro-life, no abortion philosophy. Others believe that it is acceptable to abort a child in the case of rape, incest, or where the life of the mother is threatened. The latter is the position of the Orthodox Jews. And there are many additional questions presented to us by our “brave new world” that raise noodle-cookers of equal emotional challenge and philosophical complexity.”
Since I have been involved with pro-life work for nearly 30 years and have considered myself 100% pro-life, I was puzzled as to what Phillips actually meant. Imagine my shock and horror to read that a woman who faces an ectopic pregnancy, a life-threatening situation and one I have had to face, is considered to be a “murderer” and one who practices “child sacrifice” or “infanticide.” As I read through everything I could find on his website regarding this topic, it quickly became apparent that Phillips is so far out of the mainstream of Christian thought and practice that even stalwart pro-life leaders around this country and pastors who repeatedly speak out against the evils of abortion would also be painted with his defective broad brush.
In contrast to Phillips’ position, Steve Wagner from Stand to Reason makes this statement:
““When the motherʹs life is truly in danger, we must treat both the mother and child as human beings worthy of protection, for that is what they are….In an ectopic pregnancy, the newly conceived human being implants on the wall of the fallopian tube (or some other tissue) instead of on the wall of the uterus. As the embryonic human being grows, the fallopian tube will rupture causing severe blood loss and probably death. In these cases, there is no way to save the child’s life. If we do nothing, both human beings will die. Because we believe it is better to save one life than to lose two, we remove the child (causing his death) and save the mother. The death of the child is an unintended, although foreseen, consequence. So abortion in this instance is the killing of an innocent human being WITH proper justification. Notice though, this is not because the child is not human, but rather because the child is going to die no matter what. The child’s death is unavoidable, so protecting the mother becomes our primary concern.”
After reading this, I contacted Lynn Grandon, who is the director of the Peoria Dioceses Respect Life and Human Dignity office and asked her to give me the most well-reasoned pro-life argument regarding ectopic pregnancies. In the providence of God, she had most recently attended a bio-ethics conference where the topic of ectopic pregnancies was discussed at length by some of the leading Christian bio-ethicists, medical personnel, and pastors around the country. She confirmed to me that saving the life of a mother who is in a genuine life-threatening pregnancy is always considered to be a priority, as the baby would also die in this situation and she said that ectopic pregnancies certainly are in this category. In fact, ectopic pregnancy is the leading cause of death in pregnant women today. And we have to also take into consideration that there are now millions of post-abortive women and as many who have suffered from sexually transmitted diseases, both factors that increase the incidence of ectopic pregnancy.

I mentioned to her the story of the Indian mother that Phillips used as an example of an ectopic pregnancy going to full term and she stated that we should never use the oddest and most extreme cases when looking at issues such as this one. I then read to her the above quotes from Phillips and she sighed and stated that these are unreasoned, irresponsible, and dangerous. She also expressed her sadness that someone with such influence would teach such things. I heartily concurred.
Given the number of homeschooling conferences where Phillips and his supporters speak and promote their militant fecundity message, I believe it will only be a matter of time before someone’s wife or mother dies because of this foolish position on ectopic pregnancy. Phillips, being the man of influence that he is, has irresponsibly taken a position that has now gone beyond his own “declaration of life” and has been entered into the public debate amongst attendees at his 2008 Whitherspoon conferences.

Because of his determination to further this message, I would like to call upon all those who link to his blog or the Vision Forum website to remove that link and to tell him why. I would like to ask those who sell his items to refuse to do so until he has recanted this dangerous position. I would expect those who have been published through Vision Forum to contact him and express their horror at what he is saying. And, most importantly, I would ask any pastors who have supported Phillips’ ministry, including the NCFIC churches associated with him, to publicly assure their congregations that Phillips’ teaching on ectopic pregnancy is outside the orthodox view of Biblical Christianity and the sanctity of human life.

Doug Phillips has become a threat to the very lives of homeschooling mothers and it should be known. Take cover immediately.