Without modern obstetrics, both Jessa and Jill Dugger would probably be dead


Trust birth?

You must be joking!

Jessa Duggar Seewald and Jill Duggar Dillard are two, young healthy women who planned homebirths. They were about as low risk as low risk can be, yet, in an object lesson for homebirth advocates, both had to be rescued by obstetricians.

Jill, in direct contrast to the prattling of homebirth advocates that “your body won’t grow a baby too big to birth” grew a baby too big to birth.

[pullquote align=”right” color=”#86273F”]They trusted birth and birth nearly killed them.[/pullquote]

Jessa apparently had an uncomplicated spontaneous vaginal delivery … and then began to bleed heavily, so heavily that she had to be transferred to the hospital.

What would have happened to the Duggar sisters had they lived 200 years ago instead of today?

Jill would have been one of the hundreds, perhaps thousands, of American women who died of obstructed labor each and every year.

What is obstructed labor? It’s the technical term for a baby too big or too poorly positioned to fit through the pelvis. Prior to the advent of safe cesareans Jill would have labored in agony for days, struggling to push the baby through her pelvis with no chance of success. The baby’s head would have molded and elongated, the plates of the his skull sliding over each other in a desperate effort to decrease the diameter of the his head so it could be forced through.

A uterine infection might have developed to which baby and mother would have succumbed. Alternatively, Jill’s uterus might have ruptured and they could have bled to death. If the situation became desperate, her providers might have attempted to save her life by passing instruments through the cervix and dismembering the baby.

Jessa, in contrast, might have bled to death after the successful birth of a healthy boy. Why did she bleed so much? There are a number of possible reasons:

  • Uterine atony: the uterus was simply exhausted after pushing a very large baby and simply refused to contract. Since the only way uterine bleeding can be stopped is by the uterine muscles contracting around the blood vessels and closing them off, massive bleeding will occur if the uterus fails to contract.
  • A retained remnant of placenta: The uterus can only contract completely if it is completely empty. Even a small piece that has torn away from the placenta can keep the uterus from contracting and heavy bleeding may be the result.
  • A cervical laceration: These tears in the cervix can bleed profusely and can only be stopped by clamping and stitching them. Cervical lacerations are not common but they are more likely if the mother begins to push before she is fully dilated.
  • Major vaginal lacerations: These tears can extend through the back of the vagina right through to the rectum. Although they need to be carefully repaired by an obstetrician they usually don’t bleed a great deal.
  • Jessa could have developed pre-eclampsia with HELLP syndrome. HELLP stands for hemolysis, elevated liver enzymes and low platelets. It is a life threatening condition that, in the absence of treatment, can easily result in death.

What would have happened if Jessa had give birth at the hospital? That’s hard to say since we don’t know exactly what had happened. Uterine atony could be treated with a variety of medications. A piece of retained placenta could have been removed immediately. A cervical laceration or vaginal lacerations could have been repaired immediately. All of these things would have reduced or prevented heavy blood loss.

Instead, Jessa lost so much blood that she had to be admitted to the hospital, probably for blood transfusions at the least. The fact that she remains in the hospital suggests that there was a bigger problem than blood loss or lacerations alone.

Ironically, Jessa gave birth at home almost certainly so she could spend the first hour skin to skin and breastfeeding her newborn. Instead, she probably wasn’t even in the same zip code.

It’s hard not to feel sorry for Jessa. She was probably contractually bound to news outlets to provide pictures of the baby, but she wasn’t there to be in them. She was probably contractually bound to provide a family photo as soon as possible so her husband brought the baby to the hospital and it appears that they hung a sheet behind her hospital bed; she was probably sitting in the bed (too weak to stand?) and husband was standing beside her.

She’s given birth, she’s suffered a serious complication and she’s required to be on display in order to earn money. So much for the intimacy of homebirth.

So both Jill and Jessa trusted birth and birth nearly killed them. Obstetricians, in contrast, saved them. They’ve given us an object lesson in why homebirth can be dangerous and even deadly.

Thinking about homebirth? Think about Jessa and Jill and think again.