Yeah, childbirth is a biology lesson. It involves a lot of, at times, not particularly appetizing details regarding very private parts of the female anatomy. One reason, I believe, that some of this "deception" has been allowed to go on for so long is that no one will confront Gov. Palin on some of the "private" details, and just how implausible her story is on the specifics.
The single specific piece of information that we have that has caused the most scrutiny of her birth saga is that she traveled back from Texas to Alaska on April 17th leaking amniotic fluid. Yet, she has never once, as far as I can tell, been asked pointed questions about the very real specifics of this. It would be a bit like someone calling in sick at work because he has cut his arm very badly, then never showing any physical signs - like blood, or stitches, or going to the doctor, that it ever happened, yet being defensive about having to "prove" it.
The leaking of amniotic fluid is an indisputable, unmistakable sign of the onset of labor. Flying at eight months of pregnancy is ill-advised. Flying at eight months with leaking amniotic fluid is insane, particularly for a woman who has boasted about her easy (past) births.
According to one obstetric source that I found, a woman with Palin's trouble-free history had about a 66% chance of giving birth within ten hours from the time her membranes ruptured. Although different texts and sources might give slightly different numbers, this is close. I've stated this before, but it bears repeating: It was not possible that Palin would give birth before she got back to Alaska. It was PROBABLE.
First, though, a bit more of our biology lesson. What is amniotic fluid? Most people know it's what surrounds the baby, but where does it come from? It is not something the mother produces, at least later in pregnancy. By the eighth month, the majority of what makes up amniotic fluid is the by-product of the fetus's urinary system; quite bluntly, it's the baby's pee. By 34 weeks, in a normal pregnancy there is about a quart of amniotic fluid. The quantity diminishes a bit by 40 weeks.
Many labors begin with some leaking (or even a large full-blown rupture) of the amniotic sac. For other women, the sac will rupture at some point during labor. If labor is left to progress fully naturally, sometimes the sac never ruptures and the baby is born still encased in it, though most birth attendants now will artificially rupture the sac before this point. (Being born still in the sac (the caul) traditionally was considered good luck, even magical. Here's an article from Wikipedia about it. )
When membranes rupture prior to any other signs of labor, what does this mean? What should be done? I've read some more extreme comments that membrane rupture is an "emergency," and Gov. Palin should have immediately called an ambulance and rushed to the hospital. Most birth attendants would say that that is a bit much. However, it is considered absolutely mandatory that once membranes have ruptured, within a sensible time frame of an hour or two, someone needs to check the baby's heart tones. Why? Because as soon as there is any leakage of fluid, additional compression can be put on the umbilical cord. It's possible in rare cases for the cord to actually slip down between the baby's head and the side of the uterus, at times even coming out through the cervix. This IS a MAJOR EMERGENCY, and the only way to rule out cord problems is to check the baby - fairly promptly. However, it's pretty clear that almost twenty four hours passed from the time that Gov. Palin first has stated that she saw some signs of amniotic fluid until she actually saw a physician.
Where did the story come from that her membranes had ruptured? Interestingly, it seems to have come from her father, Chuck Heath. Let's do a quick review of a timetable.
1. April 17th - 4 AM Texas time, 1 AM Alaska time - Gov. Palin calls her doctor to report, "there was an idea there that he might come early." I am not sure exactly what this means. Did she have a dream that her baby might come early? A vision from above? Did a little bird whisper it into her ear? Or did she have some clear physical indications that she might be in labor?
2. April 17th - Around 11 PM Alaska Time - Palin arrives at Mat-Su after remaining in Texas to give a luncheon speech then taking two separate four hour flights, and having a two hour layover in Seattle.
3. April 18th - 6:30 A.M. Trig is born at Mat-Su Regional Hospital in Palmer.
4. April 18th - Afternoon - KTUU (Anchorage NBC Affiliate) goes to Mat-Su in Palmer and does an interview with Sarah Palin's parents. It was at this interview that apprently Gov. Palin's father states that her water broke in Texas. So while it seems that Gov. Palin might have wished to be a bit more discreet about the details, her father was not so reticent.
5. April 19th - The Palins leave the hospital with Trig.
6. April 21st - The Palins, at Sarah's office in Anchorage, give an interview. (This was not published until the next day, the 22nd.)
It was during this interview, that Palin was asked specifically about her water breaking, and was told that her father had said that. She clearly does not want to discuss it, but she doesn't deny it. Why? Because it's true? Or because it is the story that she gave her parents for why she left Texas early, and now can't backpedal or THEY will get suspicious?
Here's the exact quote from the Palin interview:
Reporter: So did your water break?
Palin: Well, if you must know more of those type of details, but, um…
Reporter: Well, your dad said that and I saw him say it so that’s why I asked.
Palin: Well that was again if, if I must get personal, technical about this at the same time, um, it was one, it was a sign that I knew, um, could lead to uh, labor being uh kind of kicked in there was any kind of, um, amniotic leaking, amniotic fluid leaking, so when, when that happened we decided OK let’s call her.
So, we have it, in Gov. Palin's own (convoluted) words, that her amniotic fluid began leaking at 4 AM in Texas, and they called her doctor. As has been stated so many other places, it is incomprehensible that a doctor would not have told Gov. Palin to go to a hospital immediately and get checked out. And it's also interesting to note that Dr. Cathy Baldwin Johnson has never confirmed that the Palins called her at this time. In fact, she stated that that "things" (a precise medical term if I ever heard one) had already "settled down," (more precision) by the time the Palins called. (Or, as my physician husband has quipped: "I must have missed that day in medical school.")
So... someone is lying.
Amniotic fluid "leaking:" What does this mean to the layperson? What it means is that they probably don't want to think about it. What does it mean to a birth attendant? It means, frankly, a rather untidy mess. When we would attend a home birth, we would set up in the birthing room a full-sized trash can. (Not the kitchen size, your standard outdoor size.) By the time wee-one came along, it was almost always full.)
How did Gov. Palin handle this mess? How did she protect the hotel furniture and bedding, and her business suit during her speech? Did Todd promptly call a cab or the hotel car, rush out to the nearest CVS, and buy hospital grade sanitary pads and/or some Surecare or Chux bed underpads at 4 A.M? When I was still a home birth "helper," we would sit the mom on disposable pads (no panties, and certainly nothing in the vagina like tampons, since that would increase the chances of infection) which were changed scrupulously every half an hour or so. And once membranes rupture, it's not just a drop or two of clear fluid. Women who are going into labor start losing mucous, also known as "the mucous plug" which has sealed up the cervix. What does this look like? For lack of a better description, it looks like bloody snot.
So, morning in Texas, April 17th, we have the Governor of Alaska, with small gushes of fetal urine and bloody snot leaking out of her vagina putting on her business suit (including pantyhose?) preparing to give a speech... which by all reports, she did.
(Good God, does anybody still believe this story?)
(And don't forget, this was a conference! Not only was there a luncheon speech, but I imagine there were panels or discussions or workshops during the "morning session." Never has it been indicated that Palin did not participate... it would have caused comment if she had not. My guess is that she DID participate. We don't have direct proof for that, but we do have the Governor of Hawaii's statement that “Nobody knew a thing. I only found out from my security detail on the way home that she had gone into labor and that she had gone home to Alaska.” Only the Governor of Texas suspected that something was up (probably where the rumors later heard by Lingle's security detail came from), and that was only because the Palins had rushed off so quickly after her speech, refusing to confirm either way whether she was in labor.)
And how would she have handled it if the "leak" had become a full-fledged rupture during the speech or while sitting in some workshop? "OOOPS. Sorry. My bad."
This has personally happened to me. (Not during a speech at a Governors' Converence, of course.) But I had some leaking which all of a sudden turned into a flood. I "popped." And if you don't think a quart of fluid is a lot, I suggest you all get up from your computers right now, take a quart of water, and dump it on the floor between your legs. Now picture that happening up on a podium in front of the other Governors. It would have been the most memorable Republican Governor speech on record, I promise you that.
That anyone would have taken this risk is so implausible it is ludicrous. But no one really wants to "go there" in terms of confronting Palin. (Not that anyone has really been given the chance!) No one really wants to confront her with questions like: How DID you protect your clothing, Gov. Palin? What WOULD you have done had you started leaking a lot of fluid on the floor during the speech? Did you need to call housekeeping and have your bed changed in the middle of the night?
Birth is not a tidy process. Gov. Palin has given, as "proof" of her labor, information that she was in the midst of one of the more untidy parts, yet has given no indication that she behaved in such a way that would support her own contention. And, because it's "private," we're not allowed to ask.
But... of course... the adventure is just beginning, because we are now supposed to believe that she sat on airplane seats for EIGHT additional hours, all the while the flight attendants not noticing anything out of order. People in Alaska knew she was pregnant. The flight attendants certainly should have been aware of it, though they may not have realized the exact due date. If Gov. Palin had been getting up and going to the bathroom every few minutes (clutching her carry-on bag, because of course she would have needed her bag to carry into the restroom the hospital grade sanitary pads she should have been changing), you don't think the flight attendants would have noticed? They would not only have noticed, they would have been worried. But no one observed anything unusual in her behavior during TWO four hour flights. This is completely inconsistent with someone whose "membranes are leaking."
And a note about infection: once it's been determined that there's no compression of the umbillical cord after membrane rupture, the next worry is infection, that because the sterile sac is now compromised, bacteria can enter and begin to grow. It's why most midwives in a home birth setting will not even do an internal exam on a woman whose membranes are leaking until labor is well-established; you do not want to do anything to risk introducing infection. You don't bathe (you shower) and observe very careful hygiene while using the bathroom. You keep everything as clean and dry as possible.
(Now... think about airplane toilets.)
I've read other places that perhaps the logical explanation was that it was not amniotic fluid at all; it was just a bit of urine. We should leave Gov. Palin alone because none of us know for sure. Certainly urine leakage can happen. You sit a six plus pound kicking baby on top of a woman's bladder and, yeah, you betchya, there can be "mishaps." But there are several arguments against this. First, Trig Palin was born at 6:30 a.m. on April 18th . If Gov. Palin had arrived at Mat-Su with no signs of labor (considering that she was just 35-36 weeks) they would have sent her home. There are easy tests that can detect the presence of amniotic fluid in the vagina. The physician would have performed the test and if none had been detected, they would have sent her home. The fact that a baby was born the next morning indicates that someone was in labor that night.
The second thing is that she didn't deny it. She was asked specifically about the "water breaking" on 4/21 and she confirmed her story. She could have told the interviewer on April 21st that her impression in Texas that she was leaking fluid turned out to be wrong; that she'd been mistaken. But she didn't. That she was leaking amniotic fluid in Texas is HER story and she is sticking by it. This is not something "bloggers" have fabricated out of nowhere.
So what do we conclude from all this?
If Palin's story is completely true, if she is Trig's mother, and everything happened the way she has claimed, she took utterly unacceptable medical risks with her infant's life. She did not have him checked when her membranes ruptured, to rule out the possibility of cord prolapse. She would have had to be dressed and to comport herself in a way that would have increased the chances of infection for almost 24 hours. She risked having to give birth with no medical assistance in the aisle of an airplane. She risked disrupting the travel plans of hundreds of other people. And, if Palin's story is completely true, Cathy Baldwin-Johnson should lose her medical license.
If Palin's story is partially true, what parts are a lie? My guess would be that she had no contact at all with Baldwin-Johnson, at least prior to their layover in Seattle. It's a complete fabrication that she called her doctor from Texas. She took utterly reckless chances with her baby's safety as well as the comfort of everyone else on the airplane... and she beat the odds. And THIS is why Cathy Baldwin Johnson has appeared to cut off most contact with Palin and her crazy birth story... because Palin's lies have actually jeopardized Balwin-Johnson's professional reputation. She can't come clean about the birth without telling the world that Palin is a liar. She's reluctant to do that. While I admire loyalty, in this case I would say it's misplaced.
If Palin's story is entirely a lie, and the physical realities of membrane rupture which I have seen and dealt with countless times make me lean very strongly in that direction, then the only answer is she was never pregnant at all.
