|01-01-2007 - Traces, n. 1
A mother in coma, and a medical team that decided to compensate for the vital functions in order to permit her to give birth, without aggressive treatment, accepting reality as it is
edited by Paola Bergamini
The news hit the headlines in the Italian newspapers last spring: a 37-year-old woman in coma gave birth to a child, at the 27th week, and the child was born healthy. An almost unique clinical case in the annals of medicine. We spoke with Dr Claudio Betto, the head of Neuro-reanimation in Niguarda hospital Milan, where the woman was treated, and who followed the whole story of baby Cristina.
Can you tell us what happened?
On 24th March a woman arrived in our ward with a cerebral hemorrhage in course. Once we had run the tests we realized that there was nothing more we could do. I spoke with the husband who told me his wife was pregnant, and asked me to do what was possible for the child. We had a scan done and found that the child was alive. It was not possible to remove it as it was too small, only at the 17th week, it would not have survived. On the other hand if we stopped the respirator after the six hours that Italian law prescribes in these cases it would have died along with the mother. The father’s will was clear, and the child was alive. We decided to support all the vital functions of the woman to allow the creature to reach a fetal maturity sufficient for it to survive outside the womb. We embarked on this adventure with much hope, without any certainty of the outcome. We did an ultrasound scan every day and the child was sucking its thumb; it had no deformities and was alive. We went ahead like this day by day, and I was sure that if something is not meant to be–you can use all the technology and knowledge you want–then it will not happen. It is the threshold of the kind Mystery that makes everything. In that period, I had asked a lot of friends to pray for that child, and since I was in Rome I entrusted it to John Paul II and prayed for her in the Church of the Divine Mercy, that after the birth she would not be alone.
After two months Cristina was born…
Yes, on June 10 since the mother’s blood pressure fell causing the child’s heartbeat to slow down, we decided on a caesarean section. We couldn’t risk any more. So Cristina was born and stayed in hospital for a few weeks. I remember that the evening before I said to myself on my way home, “Lord, You do it, it is in your hands after all, we can do no more.” After the birth, after six hours of observation we asked the relatives if they wanted to donate the mother’s organs. At that time there was a young woman in coma with fulminating hepatitis. No compatible donor had been found, and she had only a few hours left. Christina’s mother saved her.
There is a lot of talk of “aggressive treatment.” Was there no aggression towards this woman? After all, the chances of the child’s survival were minimal…
Aggressive treatment is when the person is still alive, and the treatment proves to be of no use. This woman was dead, but the child was alive. The only evidence that the clinical reality suggested was to take care of the child’s life, compensating for the functions of the mother. Aggressive treatment is when you use resources in a way disproportionate to the outcome. On this point the Church is very clear: we must guarantee the person’s dignity; and I would add, not only in the hospital, but outside, too.
In what sense?
In our ward we “readjust” the pieces, but often the final outcome for some patients is at the limits of survival. They leave here and they need everything, and the family need to be accompanied if they are not to be squashed by pain and, often, by that lack of adequate structures. For every patient I think of a journey that doesn’t end in our ward. It’s not enough for me to know that they are alive, At times I wish the hospital walls were transparent, so that people could see that there is something more that Big Brother. This work teaches you to see what is really useful in life and what is not. At the start you think that science and technology have all the answers, then you realize that life is something complex, and cannot be classified; that the category of the possible must always be left open. You have to learn to look, even at a tiny baby a few inches long!