I think back to an old advice column in which (drat — was it Dear Abby or Ann Landers?) responded to a busybody whose letter wondered about a woman who had a 7-pound baby only six months after the wedding: “The baby was on time, the marriage was a little late. Forget about it.” Dumb kids do dumb things. Daughter Bristol has enough difficulty ahead of her. Let it go.

PS- to any and all who are second-guessing Sarah Palin’s choice of doctor, his treatment of her condition, how qualified he was to handle this pregnancy, etc: It’s none of your business. She gets to make her own health care decisions based on what she and her doctor and her family think is best. You have not been appointed to analyze her medical choices. Your opinions, however sincere and well-intentioned they may be, are totally irrelevant. You handle your health care with your doctor, she handles her health care with her doctor. Enough said.

I accept your concession of every point I made with the exception of the term one should use to refer to physicians. You might want to look at the origin of the word “doctor.”

Also, you’re the one who claimed that I had no shame, that what I am saying is despicable and vicious. IOW, you haven’t tried to keep it reasonable and impersonal at all. Most of your attempted rebuttals have involved misrepresentations of my words and positions.

Where’s your evidence that she was misquoted, Trish? After all, she lied about opposing the “bridge to nowhere” and about whether anyone on her staff had tried to get her ex-brother-in-law trooper fired, didn’t she?

“What it should have said was that this was not true labor.”

What evidence do you have? According to Palin herself, it wasn’t like false labor. If it wasn’t false, what was it?

“As to the claims that there is “no evidence” that Palin was under a doctor’s care or took the advice of her doctor, how about the word of the doctor?”

Trish, you’re being ridiculous. Here are my specific claims:
1) There’s no evidence that she sought medical permission before going.
2) There’s no evidence that she consulted any physician before going.

Those are very specific points. I take it from your gross misrepresentation of them as far more general that you agree with them.

“http://www.adn.com/626/story/382864.html
Oh, wait, according to you nobody calls a physician a doctor.”

Educated people generally don’t.

“As to the statement that “knowing her medical history and condition” implies that she wasn’t pregnant–”

I made no such statement. The total story makes no sense.

“…are you mad?”

Can you read?

“Leaking amniotic fluid is a cause for concern, but it does not necessarily demand immediate hospitalization.”

Straw man, as I pointed out that it demands immediate attention. Did you even read the ADN story, Trish?

—-
Still, a Sacramento, Calif., obstetrician who is active in the American College of Obstetricians and Gynecologists, said when a pregnant woman’s water breaks, she should go right to the hospital because of the risk of infection. That’s true even if the amniotic fluid simply leaks out, said Dr. Laurie Gregg.

“To us, leaking and broken, we are talking the same thing. We are talking doctor-speak,” Gregg said.
—-

Now I know from experience that even “going right to the hospital” is not the same as “hospitalization” because they do tests at the hospital and often, particularly for primiparous women, send them home to wait and be tested again.

“Her doctor said it was not unreasonable for her to fly back to Alaska.”

That’s the story, yup. It looks like malpractice to me, IF it’s true.

“She did keep in touch with her doctor, and says she would not have traveled if she had been in labor.”

If you knew much about pregnancy and childbirth, you’d know that there’s no bright white line separating being in vs. out of labor.

“What evidence do you have that, if there had been a medical reason for her to check into a hospital with an NICU, what evidence do you have that she would not have done so?”

There was a crystal-clear medical reason. She had a prenatal DS diagnosis and was a month early. Here’s an excerpt from a friend of mine, pediatric geneticist Golder Wilson:
Down syndrome: Perinatal complications and counseling experiences in 216 patients
Joanna K. Spahis, Golder N. Wilson *
Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75235-9063

Joanna Spahis is an advanced nurse practitioner interested in health promotion for children with genetic disease.
Golder Wilson is a clinical geneticist interested in syndrome delineation, mechanisms of congenital malformation, and design of preventive management strategies for children with genetic/congenital disease.

Two hundred and sixteen infant evaluations were selected for analysis from those of 669 outpatients (930 total visits) at a weekly Down syndrome clinic. Each record contained perinatal history and physical examination results, and 191 of the 216 included a systematic interview regarding parental experiences with diagnosis and counseling. Gastrointestinal problems (77% of neonates), cardiac anomalies (38%), and hematologic problems (11%) were the most common complications;…

“Palin used this physician because she delivered Palin’s last child, Piper, and Palin trusted her.”

No, Trish, that’s what she SAID. Palin has very little credibility. My point–which you keep missing–is that even if we take what she SAID to be true, it makes no sense.

“I have yet to see even a shred of evidence that that trust was misplaced.”

You haven’t looked. You conflate what Palin says with fact, and you consistently misrepresent my words and positions.

“I repeat: NO reputable physician of any kind would ever comment on another physician’s treatment of a patient without examining that patient and her medical history. That is completely unethical.”

Then you better contact the American College of Obstetricians and Gynecologists and file an ethics complaint against Dr. Laurie Gregg, because she was crystal clear, not to mention correct:
—
“…when a pregnant woman’s water breaks, she should go right to the hospital because of the risk of infection. That’s true even if the amniotic fluid simply leaks out, said Dr. Laurie Gregg.

“To us, leaking and broken, we are talking the same thing. We are talking doctor-speak,” Gregg said.”
—

Let me know how it goes, OK?

“It is fine to make general recommendations, but that is all. If you truly do know something about pregnancy and childbirth, then you know that every pregnancy is different. To say that one size fits all or that there is “nothing patient-specific” is patent nonsense. Sarah Palin did what she and her doctor decided was right.”

Only according to what they SAID. Palin has been caught contradicting herself many times in the last few days, correct?

First of all, I fabricated nothing. I read a news story which misquoted Palin as saying she did not have contractions. What it should have said was that this was not true labor. As to the claims that there is “no evidence” that Palin was under a doctor’s care or took the advice of her doctor, how about the word of the doctor?
http://www.adn.com/626/story/382864.html
Oh, wait, according to you nobody calls a physician a doctor.

As to the statement that “knowing her medical history and condition” implies that she wasn’t pregnant–are you mad? A woman’s medical condition involves far more than the simple question of whether or not she is pregnant. I’m sure outdoorswoman Palin is in much better condition than I am.

Leaking amniotic fluid is a cause for concern, but it does not necessarily demand immediate hospitalization. Her doctor said it was not unreasonable for her to fly back to Alaska. She did keep in touch with her doctor, and says she would not have traveled if she had been in labor. What evidence do you have that, if there had been a medical reason for her to check into a hospital with an NICU, what evidence do you have that she would not have done so? Palin used this physician because she delivered Palin’s last child, Piper, and Palin trusted her. I have yet to see even a shred of evidence that that trust was misplaced. Incidentally, my pregnancy was also considered “high-risk,” and I delivered my baby at a hospital that did not have an NICU. I guess that must mean I was trying to lose my baby.

I did not say that Downs Syndrome was the major reason that older women are considered “high-risk,” but that it was a “large part.” And while the cause of Downs Syndrome exists before conception, the fetus does not. A condition cannot exist in a being that does not exist.

I repeat: NO reputable physician of any kind would ever comment on another physician’s treatment of a patient without examining that patient and her medical history. That is completely unethical. It is fine to make general recommendations, but that is all. If you truly do know something about pregnancy and childbirth, then you know that every pregnancy is different. To say that one size fits all or that there is “nothing patient-specific” is patent nonsense. Sarah Palin did what she and her doctor decided was right.

It’s interesting that now that you’ve made all these hostile accusations, you say primly, “I don’t believe they’re true.” Yes, you should be ashamed, but I guess you just aren’t capable of it.

There’s no evidence that she sought medical permission before going, Trish.

“Because she consulted with her doctor and it was determined that it was safe to do so.”

There’s no evidence that she consulted any physician before going.

“She was not having contractions;…”

This is utterly false, according to Palin herself:
“Palin said she felt fine but had leaked amniotic fluid and also felt some contractions that seemed different from the false labor she had been having for months.”

This was reported back in April:
http://www.adn.com/front/story/382864.html

Now, what’s your source for your claim that she wasn’t having any contractions?

” a woman who has been pregnant four times knows when birth is imminent.”

Women who have given birth four times know that barring complications, the later ones come out very quickly. Palin herself said that she didn’t view her contractions as false labor, while you fabricate and claim that there were no contractions at all.

“Because there was no medical reason for her to go there [to a hospital with an NICU].”

Now you’re claiming that DS babies aren’t at high risk for life-threatening neonatal problems, Trish?

“Because this was the doctor who had been caring for her throughout her pregnancy,…”

There’s no evidence of that.

“… and knew her medical history and condition.”

You mean that she wasn’t pregnant at all?

“A family practice physician is a full-fledged doctor…”

What? “Doctor” is a title used to address those with doctoral degrees. It’s not an occupation.

“… who is fully qualified to deliver a baby.”

A typical baby, yes. This was a high-risk mother and a high-risk baby combined.

“An obstetrician is a doctor who focuses on pregnancy to the exclusion of other conditions.”

Yes, and is far more qualified in high-risk situations like these.

“John, it’s clear you don’t know much about pregnancy and childbirth.”

How do you figure, Trish? I’ve caught you in two outright falsehoods and every claim you’ve made isn’t supported by evidence, just supposition and spin.

“A so-called “high-risk” pregnancy is not the constant medical emergency you seem to think it is.”

Straw man. Leaking amniotic fluid requires prompt medical attention, which she did not seek. She risked a medical emergency when she flew, assuming that she really was pregnant.

“In fact, a large reason the pregnancy of an older woman is “high-risk” is the increased incidence of Downs Syndrome, which is genetic and occurs at conception.”

It’s not the main reason (complications surrounding childbirth is), and btw, the genetic event (nondisjunction) that causes DS occurs BEFORE conception. But hey, I’m just a geneticist–you obviously know much more about medicine and genetics than I do.

“As to the claim that “not a single OB has agreed with the alleged advice,” no reputable physician of any kind would comment about another doctor’s treatment of a patient he himself had never met.”

Many already have commented, and there’s nothing patient-specific about this. It makes no sense at all.

“Yet even in the face of the facts you pretend Sarah Palin was trying to kill her baby.”

No, I wrote that IF all of those things are true, it’s as though she wanted to lose this baby. I don’t believe that they are true–everything is too fishy.

“That is utterly despicable. You should be ashamed.”

I’m not, but then unlike you, I’m not contradicting Palin’s very own story by claiming that she had no contractions.

Q: Why did she fly home while leaking amniotic fluid? A: Because she consulted with her doctor and it was determined that it was safe to do so. She was not having contractions; a woman who has been pregnant four times knows when birth is imminent.

Q: Why did she bypass Dallas, Seattle, and Anchorage hospitals with NCIUs? A: Because there was no medical reason for her to go there.

Q: Why was her “high-risk” baby delivered by a family practice physician instead of an OB? A: Because this was the doctor who had been caring for her throughout her pregnancy, and knew her medical history and condition. A family practice physician is a full-fledged doctor who is fully qualified to deliver a baby. An obstetrician is a doctor who focuses on pregnancy to the exclusion of other conditions.

John, it’s clear you don’t know much about pregnancy and childbirth. A so-called “high-risk” pregnancy is not the constant medical emergency you seem to think it is. In fact, a large reason the pregnancy of an older woman is “high-risk” is the increased incidence of Downs Syndrome, which is genetic and occurs at conception.

As to the claim that “not a single OB has agreed with the alleged advice,” no reputable physician of any kind would comment about another doctor’s treatment of a patient he himself had never met. And in fact, the “alleged advice” proved the correct advice: no harm came to Trig or Palin during labor and birth.

Yet even in the face of the facts you pretend Sarah Palin was trying to kill her baby. That is utterly despicable. You should be ashamed.

No, Trish, those are just claims, not facts, and besides, you’re ignoring the problem of her alleged use of a family practice physician instead of an OB and neonatologist for a high-risk pregnancy and high-risk baby.

“If anything was wrong it is the doctor, not Palin, who is to blame.”

So where is she in all this? Not a single OB has agreed with the alleged advice.

“She did not put the baby at risk, or try to lose him. That is a vicious thing to say, and you ought to be ashamed of yourself.”

If that’s true, you, Palin, or her physician should easily be able to answer these simple questions:

Why did she fly to a political function in her third trimester?
Why did she fly home during contractions while leaking amniotic fluid?
Why did she bypass Dallas, Seattle, and Anchorage hospitals with NICUs?
Why was her high-risk baby delivered by a family practice physician (who also is on staff at the Anchorage hospital) instead of an OB?

Certainly Bristol is a sinner. We are all sinners. No one can meet God’s standard of perfection. That’s what Christianity is about–confession, repentance and forgiveness. Bristol has repented, and is going to do the right thing. If I’m not mistaken, her future husband is already out of high school.

My angel mother, who is now in heaven, was never graduated from high school, but she was a lovely human being, who volunteered to help with recreation at a mental health facility once a week well into her 70s, until she became incapacitated.

I think a little decency is in order now.