Personal Qualms Don't Count

Marnie Ko

"The present mood is...chaotic, helpless, frustrated and highly emotional," Sally wrote. "In the past weeks, I have witnessed tears, breakdowns, illnesses, and stress such as never before...Sick calls have been high and experienced staff nearly impossible to recruit."

Though the tiny infant had been condemned to die, distraught nurses at Calgary's Foothills Hospital spent hours last August caring for it anyway.

"The mother didn't want the baby, so we took turns rocking and holding it for 12 hours until it finally died," says Foothills nurse "Catherine," whose real name has been withheld to protect her job. "Nurses were only allowed to comfort the suffering infant, but this did not even include feedings."

The rejected baby's fate was sealed when it survived a "genetic termination," an abortion performed only five weeks before the mother's due date. Doctors had told her that her baby had lethal genetic defects. But Catherine could see only a baby. "I was sick for weeks," she says.

Catherine, and other maternal care centre nurses who share her views, are destined to get sicker. According to an internal Foothills Hospital memo sent to this magazine, postpartum nurses were told last month that for the first time they would have to begin caring for aborting women, regardless of their own moral qualms. In interviews, nurses say it is unfair for the hospital to force professionals to handle abortions without regard for moral or religious convictions. But a unit caring for healthy mothers and babies is also a questionable environment for genetic termination patients, says Catherine. "Those women don't really want to hear a mother's newborn baby crying next door just after they've had an abortion."

Until March, women seeking late abortions at Foothills had been cared for in an area separated from new mothers and women who aborted before the 24th week of pregnancy. And according to Catherine, late abortions need to be kept separate, partly in order to avoid forcing postpartum nurses from having to do work they oppose morally. "After 23 weeks," she says, "it's pretty dicey because we're getting into viability. Babies can survive."

Late term abortions are done by inserting Cytotec into the woman's vagina; the drug then ripens the cervix and causes powerful uterine contractions which eventually lead to premature birth. Nurses handle the procedure, giving the drug every four to six hours. But Cytotec can take four or five days to cause contractions powerful enough to expel the baby. "Meanwhile, the abortion is tying up a birthing room that's meant for couples who are having a wanted baby," Catherine says. "It's also hoped that the baby dies during labour before coming out. But not all babies do."

In fact, several babies aborted at Foothills have lived for significant periods of time, including the one born last August. "There was even a baby delivered at 23 weeks gestation that briefly survived just a few months ago," Catherine says. "Worse, from 40% to 50% of these terminations are delivered by nurses because the doctors don't make it."

Catherine is concerned that genetic abortions are being done in her unit with increasing frequency. "Six months ago there was only one genetic abortion per month," she says. "But in the last couple of months we've seen one or two a week."

Shirley Popadiuk, Foothills' public affairs manager for acute care, reports that about 40 genetic abortions occurred in 1998. But, she says, labour-inducing medications are administered only by doctors, not nurses. She insists that nurses are not doing abortions.

However, minutes obtained by this magazine from a February staff meeting contradict Ms. Popadiuk. "Staff...will provide the patient with the medication to induce labour and do their vital signs," the minutes state. And when delivery is "imminent" nurses "will be called to do the delivery and the subsequent paper work." The document makes clear that, "No one will be excluded from the care of these patients."

Ms. Popadiuk confirms that a 23-week gestated fetus did survive termination. She describes the baby as "a rare infant, born alive with lethal injuries. It would not survive." Ms. Popadiuk says that according to hospital records, the baby received palliative care, such as fluids, warmth and comfort. She admits, however, that she has no first-hand knowledge of the case. Catherine recalls that the infant had Down's Syndrome, not life-threatening defects. And she reports that the baby lived for two hours without medical support.

Mrs. Popadiuk insisted that abortions are not performed at Foothills after 24 weeks because they are forbidden by a policy adopted by the Alberta College of Physicians and Surgeons. But when asked about the baby aborted last August, only five weeks before term, she ended the interview abruptly. "I can't answer these questions," she said. "I have to go."

Calgary Foothills Hospital senior operating officer Norma Kirkham was also unable to deny nurses' descriptions of late-term abortions and reports of babies living for hours after being aborted. "I have no idea," she said. "I'm not a clinical person and I have no personal knowledge of this at all." Medical spokesmen for the hospital would not make themselves available for comment. Nevertheless, Ms. Kirkham remained confident that, "without a doubt, no terminations are being done after 24 weeks."

"They aren't doing terminations after 24 weeks because then they call it induction," Catherine explains, "But that's just semantics." The hospital's policy is purposely ambiguous, she reports. "They have every intent of letting the child die," she says. "Induction is abortion; the baby still dies no matter what it's called."

Catherine says ambiguous terminology is an attempt to desensitize nurses. In the same way, physicians no longer refer to women seeking abortions as mothers. "I've been told that these women are just patients terminating their pregnancies," Catherine says.

Senior operating officer Kirkham says that Foothills Hospital is aware of the concerns of the nurses, and that other options for both the location of terminations and ways of dealing with the feelings of reluctant postpartum nurses are being discussed. "Every effort is made to allow nurses to get out of [abortions]," maintains Ms. Kirkham. "Hopefully nurses with problems...make choices not to work in these units." But the nurses insist they have no choice but to do abortions if they want to keep their jobs.

Another nursing staff member, "Sally," wrote an anonymous letter to this magazine last week describing the volatile situation currently gripping the postpartum and labour and delivery wards at Foothills. She was outraged by the administrative decision that forced postpartum nurses to care for women aborting "imperfect" babies.

"The present mood is...chaotic, helpless, frustrated and highly emotional," Sally wrote. "In the past weeks, I have witnessed tears, breakdowns, illnesses, and stress such as never before...Sick calls have been high and experienced staff nearly impossible to recruit."

In fact, hospitals everywhere have discovered that recruiting personnel willing to provide abortion services is very difficult. Last year, over 65% of registered nurses in the United States polled by RN magazine said they would refuse to work in an obstetrics unit where abortions were performed. This reverses figures from 10 years ago, when most nurses would help perform abortions, said RN editor Suzanne Wolfe in an interview with Reuters Health.

"As it stands now the union has told us that nurses can't refuse to care for patients," says Catherine. "There are 125 staff on the unit, and no matter what the hospital says about making efforts to accommodate nurses who don't want to do terminations, the head nurse and the charge nurse have told us that we all have to take our turn. I have to shut off a part of me to do this job now. It's bad."

Foothills nurses could get relief from Reform MP Maurice Vellacott's "conscience bill," which, if passed by Parliament, will amend the Criminal Code to give healthcare providers the right to opt out of participation in procedures like abortion or euthanasia without risking their jobs. [See Vellacott's bill on the website.-Ed.] As the situation now stands, some nurses and support staff in Canada have already been fired from hospital positions after refusing to provide such services.

Forcing nurses to participate in pregnancy terminations fits into the pro-abortion agenda, says Joanne Hatton, Alberta Pro-Life president. "This is yet another attempt to pretend that abortion is legitimate medicine." Nevertheless, Ms. Hatton is convinced the public is beginning to sense how resistant nurses are becoming at being forced to assist with procedures they find morally repugnant.

"It's schizophrenic-nurses on the same ward celebrating life and at the same time having to kill life," says a 62-year-old retired nurse who asked that her name be withheld. Selective abortion is really another name for eugenics, she says. "They are trying to make a perfect world by getting rid of babies who are not perfect. It reeks of Naziism. It's horrifying that anyone would kill a life because of an imperfection. If these babies are going to die it should be a natural death. Leave it up to God. Right now the hospitals are killing disabled children."

"Abortions should be illegal," Catherine concludes. "These are not little lima beans with feet. These so-called genetic terminations are babies. If you were holding their head in the palm of your hand, their little feet would reach your elbow... We're crossing the line."