I followed a link from Andrew Sullivan’s site to Laura’s blog and have found myself fascinated by the analyses here of the Palin pregnancy mysteries. I read quite a bit about it during the ’08 campaign, but just off and on since then, so some of my memories might be a little clouded. Andrew’s fascination is with the aspects of lying and exercising bad judgment; mine, too, but I have always been interested in the pregnancy part, which, of course, doesn’t interest him in the least. :-) It appeals to my clinical and management experience as a registered nurse in Labor and Delivery early in my career and I contemplate the logistics of how it happened. I agree with the neonatologist’s assessments of the “hallway” photo. BTW, when the baby is not in the nursery, it is in the mother’s room, and the idea that a grandparent would carry a baby outside of that room wandering around in a hallway unattended is outside of my experience. A couple of other observations about the baby’s face: several hours after a vaginal birth and the nose is straight, not smashed sideways, plus there are almost always what might be called skin blemishes, usually reddened, from the bony birth canal. And the presence of milia is almost universal. Those were not obvious here.
Trying to come up with an explanation for why or how Sarah Palin would have been in a hospital with a 6-8 week old baby passing it off as a newborn is pretty hard to grasp. She announced a pregnancy March 5, 2008, so she had to have an outcome, either a living child or a credible story about its loss. The photos of her pregnancy are pathetic, especially compared to the one of her first pregnancy when she was as big as a house. I didn’t think she looked pregnant in any of them except the Gusty photo on 4/13 and the photo of her at that governors’ conference 4/17. But, here is something to think about…the amniocentesis/near abortion story she told in Indiana, among other places.
Trying to come up with an explanation for why or how Sarah Palin would have been in a hospital with a 6-8 week old baby passing it off as a newborn is pretty hard to grasp. She announced a pregnancy March 5, 2008, so she had to have an outcome, either a living child or a credible story about its loss. The photos of her pregnancy are pathetic, especially compared to the one of her first pregnancy when she was as big as a house. I didn’t think she looked pregnant in any of them except the Gusty photo on 4/13 and the photo of her at that governors’ conference 4/17. But, here is something to think about…the amniocentesis/near abortion story she told in Indiana, among other places.
As a pregnant woman in her forties, an amnio would be recommended. Here is what has always bothered me. Remember that in Sarah’s telling of her story to pro-life audiences, she indicated she knew ahead of time she was going to have a “special needs child,” and by default, this meant she had had an amnio, which meant she was around 20 weeks when it was done. Amnios are typically done around 20 weeks. In none of her photos does she even look big enough to safely have an amnio except for the Gusty photo. Due to some conflation of the sequence of events and my memory, I think she then talked about how she was out of town by herself and intimated she got the Down syndrome amnio results and could have terminated the pregnancy and “no one would ever know.” Nevermind the fact that she is obviously clueless about how unavailable (second trimester) abortion is in this country to think that she could arrange one practically on the spur of the moment. I think that something like over 85% of the counties in this country have no abortion services whatsoever. That was playing into stereotypes and fears right there, but I digress. Sarah has never specified to my knowledge what the out of town circumstances were. She was governor at the time and does not seem to ever travel alone. It is conceivable she might have concocted the out of town story after she hit the national scene, but assuming for a minute she was OOT by herself, I can think of an alternative explanation and it comes from something Levi said in his own moment in the spotlight.
Levi said that Palin would come home and go immediately to her bedroom and stay there and that Todd would crash in the recliner all night. That was his way of suggesting they didn’t have sex, like hint, hint, how did Trig even get conceived? Or maybe he was suggesting that they didn’t have sex with each other. In another interview he told the story about a family vacation to Hawaii and Levi went with them. But, Todd and Sarah had a big fight and Sarah left and went home alone to AK. This was the “summer” of ’07. (This trip may have been in November 2007 for a wedding; I’ve seen conflicting reports. I haven’t found any reference in the emails, yet.) Well, I used to calculate due dates for a living, and you can just never really get away from it after you’ve done it for 10 years. So I started doing a little math. As you know, a pregnancy is 40 weeks. The general rule is you use the date of the woman’s last menstrual period (LMP) and subtract 3 months and add 7 days for an estimated due date. Well, when someone is due on May 25th and delivers on April 18th, her LMP was around the previous August 19th, you know, summer. (The Internet has date calculators, which I used.) Of course, we will never know the actual due date, but I sure wish I knew when that vacation was. BTW, fetuses grow at a pretty predictable rate until the last month of pregnancy, when they begin to gain one-half pound per week. For example, a 32-weeker usually weighs 3-2, 3 pounds, 2 ounces. At 37 weeks, the baby is usually around 5 pounds. For a 35-week baby to weigh 6 pounds, that would mean it would have to gain one pound a week from 32 weeks to 35 weeks. Not likely, except for diabetes. Since Palin didn’t announce the pregnancy until March, the due date could have been manipulated to fit whatever timeframe she wanted it to.
That “no one would ever know” moment is unintentionally revealing, because maybe it meant Todd would never know. Just ask yourself why one might want to keep the knowledge of a pregnancy from one’s husband, especially if one has had a tubal ligation after your last child seven years earlier.
Texas. Here are the perinatal problems with her Wild Ride story, which is basically that she started leaking 5 weeks early and left a few hours later and didn’t get home for 10 hours after that, had to then be induced and delivered in the early morning hours. Sarah was described as not being in active labor by many witnesses during the flights home. Why? She had ruptured membranes, didn’t she? We know that leaking amniotic fluid doesn’t equal labor. Usually the rupture of the membranes stimulates prostaglandins which stimulate oxytocin which produces contractions. Not always, however, particularly if it’s just a small leak or has sealed over. The danger with the leaking is that it breaks the sterile barrier of the uterus and offers the opportunity for vaginal organisms to enter the uterus and become pathogenic and over time produce an infection, which is life-threatening to the fetus. So you can’t ignore any rupture of the membranes, which protects the fetus from the outside world. Her story is that she ignored the leak. What is the standard of care? IF she called her doctor and told her she thought she was leaking, the standard is to find out. Go to Labor and Delivery and be checked. In my day, we used Nitrazine paper to check for amniotic fluid in the vagina. It is pretty reliable and turns a distinctive purple in the presence of amniotic fluid (it is yellow paper so the change is not subtle.) But, you’ve got a problem if you’re out of town. I am not a physicist, but I think one of the reasons why late pregnant women aren’t allowed on airplanes is not just because of not having a doctor to deliver a baby on board. It is also because I imagine that there are changes in atmospheric pressure that can induce labor. More deliveries during a full moon is real, regardless of the claimed statistics. So, Sarah’s doctor would have no way of knowing if she got on a plane whether the changes in atmospheric pressure would induce her labor to begin. Plus, the fetus may not be as well oxygenated at 35,000 feet. There was absolutely no way to know and no way to test. That is a dicey, risky call, I think.
I didn’t know her doctor had changed her privilege status around June 2008 until I read it here. At the next committee meeting after 4/18, I can imagine her peers asking her if her patient called her from TX and what her medical advice was. They would have had the chart to review. If she advised Palin to come home to the hospital without verifying the status of her membranes, I don’t think her peers would have agreed with that advice. If she advised Palin to go to a hospital and she refused, her peers would agree that the doctor couldn’t have done anything about any advice that Palin refused to follow. If she was truly ruptured (and I include just leaking), then the medically safe way to get her home would have been some sort of medical ambulance type arrangement. If her doctor did not advise that, then I think her peers would criticize her for that. Traveling to TX in late pregnancy was risky (did she have her doctor’s consent?), but traveling home with leaking membranes is the central point. Everything revolves around whether she was leaking, which either would have been really obvious to her, or she should have had verified by a nurse and/or MD. The more obvious her leaking was, the higher her chances of going into labor. Once she got into active labor, she would deliver quickly after 4 previous deliveries and no one can predict when she would get active in this scenario. When she did get active in the hospital, chances are she did deliver rather quickly. That was the risk she took, because all she has to ask herself is would she have been able to get to any hospital fast enough enroute in the plane after she got into active labor. My guess would be no.
Going back to Dr. Baldwin Johnson’s privileges, please be aware that a physician’s medical practice is viewed legally as his or her chattel – property - and restriction of the practice by any governing or regulatory body, including changes in hospital privileges, is grounds for a lawsuit if the reasons are not airtight. I’ve read that she voluntarily restricted her own privileges. That signals to me one of two things: either her peers had substantial evidence to yank her privileges and this was a negotiated settlement or that the focus of her practice had changed, such as if she had so few deliveries that it just wasn’t worth maintaining hospital privileges for them.
Another problem with Sarah Palin’s Wild Ride story is a basic physiological one: one must be fertile to become pregnant. There are hearsay reports that she had a tubal ligation sometime after Piper’s birth in 2001. Hmmmm, pregnancy following a tubal ligation. Veddy interesting. The ligation failure rate is 2-10/1000 procedures and is affected by how it was done, when it was done, the surgeon’s skill and the healing process. Tubals are done during a cesarean section, after a vaginal delivery or at a time not surrounding a pregnancy, and since we know that the tubes are not in the same place or condition at all those times, which could lead to the known complications I noted, a pregnancy after a tubal ligation is certainly possible.
We have also seen a report that indicates Sarah Palin had a procedure around 2002 that made it medically impossible to conceive and carry a pregnancy. For this procedure, in addition to the usual surgical team, a perfusionist was asked to be on standby. A perfusionist is a specialized individual who operates the heart-lung machine for heart surgery. They are also used for cases with a lot of blood loss or if a patient wanted to reduce the possibility of having a blood replacement transfusion (e.g. to avoid contracting HIV) because they use a technique to save the blood lost during surgery, wash it and administer it back to the patient. This sounds like a hysterectomy to me, which can be a bloody procedure, and which would absolutely eliminate the possibility that she faced a diagnosis of Down syndrome found in an amniocentesis report, or ‘chose life’, or delivered Trig.
So is there another candidate for Trig’s birth mother?
Allie, RN, is a former L & D nurse, and 25-year OR nurse. She is working on Part II on how back-to-back pregnancies could have occurred. Many thanks, Allie, for taking the time to share your skill, and thoughts, with us. Allie will check the comments and be available to readers as much as she can.
Levi said that Palin would come home and go immediately to her bedroom and stay there and that Todd would crash in the recliner all night. That was his way of suggesting they didn’t have sex, like hint, hint, how did Trig even get conceived? Or maybe he was suggesting that they didn’t have sex with each other. In another interview he told the story about a family vacation to Hawaii and Levi went with them. But, Todd and Sarah had a big fight and Sarah left and went home alone to AK. This was the “summer” of ’07. (This trip may have been in November 2007 for a wedding; I’ve seen conflicting reports. I haven’t found any reference in the emails, yet.) Well, I used to calculate due dates for a living, and you can just never really get away from it after you’ve done it for 10 years. So I started doing a little math. As you know, a pregnancy is 40 weeks. The general rule is you use the date of the woman’s last menstrual period (LMP) and subtract 3 months and add 7 days for an estimated due date. Well, when someone is due on May 25th and delivers on April 18th, her LMP was around the previous August 19th, you know, summer. (The Internet has date calculators, which I used.) Of course, we will never know the actual due date, but I sure wish I knew when that vacation was. BTW, fetuses grow at a pretty predictable rate until the last month of pregnancy, when they begin to gain one-half pound per week. For example, a 32-weeker usually weighs 3-2, 3 pounds, 2 ounces. At 37 weeks, the baby is usually around 5 pounds. For a 35-week baby to weigh 6 pounds, that would mean it would have to gain one pound a week from 32 weeks to 35 weeks. Not likely, except for diabetes. Since Palin didn’t announce the pregnancy until March, the due date could have been manipulated to fit whatever timeframe she wanted it to.
That “no one would ever know” moment is unintentionally revealing, because maybe it meant Todd would never know. Just ask yourself why one might want to keep the knowledge of a pregnancy from one’s husband, especially if one has had a tubal ligation after your last child seven years earlier.
Texas. Here are the perinatal problems with her Wild Ride story, which is basically that she started leaking 5 weeks early and left a few hours later and didn’t get home for 10 hours after that, had to then be induced and delivered in the early morning hours. Sarah was described as not being in active labor by many witnesses during the flights home. Why? She had ruptured membranes, didn’t she? We know that leaking amniotic fluid doesn’t equal labor. Usually the rupture of the membranes stimulates prostaglandins which stimulate oxytocin which produces contractions. Not always, however, particularly if it’s just a small leak or has sealed over. The danger with the leaking is that it breaks the sterile barrier of the uterus and offers the opportunity for vaginal organisms to enter the uterus and become pathogenic and over time produce an infection, which is life-threatening to the fetus. So you can’t ignore any rupture of the membranes, which protects the fetus from the outside world. Her story is that she ignored the leak. What is the standard of care? IF she called her doctor and told her she thought she was leaking, the standard is to find out. Go to Labor and Delivery and be checked. In my day, we used Nitrazine paper to check for amniotic fluid in the vagina. It is pretty reliable and turns a distinctive purple in the presence of amniotic fluid (it is yellow paper so the change is not subtle.) But, you’ve got a problem if you’re out of town. I am not a physicist, but I think one of the reasons why late pregnant women aren’t allowed on airplanes is not just because of not having a doctor to deliver a baby on board. It is also because I imagine that there are changes in atmospheric pressure that can induce labor. More deliveries during a full moon is real, regardless of the claimed statistics. So, Sarah’s doctor would have no way of knowing if she got on a plane whether the changes in atmospheric pressure would induce her labor to begin. Plus, the fetus may not be as well oxygenated at 35,000 feet. There was absolutely no way to know and no way to test. That is a dicey, risky call, I think.
I didn’t know her doctor had changed her privilege status around June 2008 until I read it here. At the next committee meeting after 4/18, I can imagine her peers asking her if her patient called her from TX and what her medical advice was. They would have had the chart to review. If she advised Palin to come home to the hospital without verifying the status of her membranes, I don’t think her peers would have agreed with that advice. If she advised Palin to go to a hospital and she refused, her peers would agree that the doctor couldn’t have done anything about any advice that Palin refused to follow. If she was truly ruptured (and I include just leaking), then the medically safe way to get her home would have been some sort of medical ambulance type arrangement. If her doctor did not advise that, then I think her peers would criticize her for that. Traveling to TX in late pregnancy was risky (did she have her doctor’s consent?), but traveling home with leaking membranes is the central point. Everything revolves around whether she was leaking, which either would have been really obvious to her, or she should have had verified by a nurse and/or MD. The more obvious her leaking was, the higher her chances of going into labor. Once she got into active labor, she would deliver quickly after 4 previous deliveries and no one can predict when she would get active in this scenario. When she did get active in the hospital, chances are she did deliver rather quickly. That was the risk she took, because all she has to ask herself is would she have been able to get to any hospital fast enough enroute in the plane after she got into active labor. My guess would be no.
Going back to Dr. Baldwin Johnson’s privileges, please be aware that a physician’s medical practice is viewed legally as his or her chattel – property - and restriction of the practice by any governing or regulatory body, including changes in hospital privileges, is grounds for a lawsuit if the reasons are not airtight. I’ve read that she voluntarily restricted her own privileges. That signals to me one of two things: either her peers had substantial evidence to yank her privileges and this was a negotiated settlement or that the focus of her practice had changed, such as if she had so few deliveries that it just wasn’t worth maintaining hospital privileges for them.
Another problem with Sarah Palin’s Wild Ride story is a basic physiological one: one must be fertile to become pregnant. There are hearsay reports that she had a tubal ligation sometime after Piper’s birth in 2001. Hmmmm, pregnancy following a tubal ligation. Veddy interesting. The ligation failure rate is 2-10/1000 procedures and is affected by how it was done, when it was done, the surgeon’s skill and the healing process. Tubals are done during a cesarean section, after a vaginal delivery or at a time not surrounding a pregnancy, and since we know that the tubes are not in the same place or condition at all those times, which could lead to the known complications I noted, a pregnancy after a tubal ligation is certainly possible.
We have also seen a report that indicates Sarah Palin had a procedure around 2002 that made it medically impossible to conceive and carry a pregnancy. For this procedure, in addition to the usual surgical team, a perfusionist was asked to be on standby. A perfusionist is a specialized individual who operates the heart-lung machine for heart surgery. They are also used for cases with a lot of blood loss or if a patient wanted to reduce the possibility of having a blood replacement transfusion (e.g. to avoid contracting HIV) because they use a technique to save the blood lost during surgery, wash it and administer it back to the patient. This sounds like a hysterectomy to me, which can be a bloody procedure, and which would absolutely eliminate the possibility that she faced a diagnosis of Down syndrome found in an amniocentesis report, or ‘chose life’, or delivered Trig.
So is there another candidate for Trig’s birth mother?
Allie, RN, is a former L & D nurse, and 25-year OR nurse. She is working on Part II on how back-to-back pregnancies could have occurred. Many thanks, Allie, for taking the time to share your skill, and thoughts, with us. Allie will check the comments and be available to readers as much as she can.
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