How to Lie with Statistics: Response to Progressive Alaska Part 2

With Sarah Palin's resignation, the direction of this blog has taken a temporary detour. It has been impossible over the last five days to keep the focus on "Babygate," and ignore the larger implications of her resignation and the "hoopla" surrounding it. And I don't think anyone wants me to.

Is Sarah Palin still a viable national entity? I do not believe so. Her history of quitting is quite striking: she quit as mayor of Wasilla to run for Lt. Governor of Alaska (a race she lost.) She quit a major Alaskan appointment, that of chairman of the Alaska Oil and Gas Conservation Commission. Although a great deal has been made of this "protest" resignation, the reasoning is eerily similar to her resignation as governor. She could be more effective from outside of the commission than actually on it. But numerous people in Alaska have put a more mundane spin on this resignation. The job was reportedly a real full-time job with real full-time work. She was expected to produce, not just be a figurehead; she just was not up to it.

And now - with a year and a half left as governor she quit for reasons that she stated as mostly personal: things like adults being mean to Trig. (Whether her stated reasons are all there are is of course open for question, but for now let's take her at her word.)

But that still leaves us with the initial question of this blog, and as I said in the "Sarah Quits; We Won't" post several days ago, I do not intend to let this issue slide. I believe that there still is enough of a chance that Palin might emerge on the national stage that the truth about Trig's birth must come to light, once and for all. I still believe that the elements of the Republican Party that gave us Sarah Palin and kept her on the ticket (while - I strongly suspect - becoming aware at some point in the campaign that she had faked the pregnancy) must be held accountable.

I am continuing now with the multi-part post I began last week, before the resignation, in which I am attempting to consider a very long post written by Lee Tompkins, a labor and delivery nurse, last January, and reprinted several weeks ago by the blog Progressive Alaska.

I have received some criticism for doing this, including a comment from someone I respect, accusing me of doing nothing but "addressing nonsense arguments from a moron first posted months ago." But I disagree. These "nonsense arguments" form the basis of why some very reasonable people, who I do not think ARE morons, and who do not support Gov. Palin in general are still not on board with the idea that she faked a pregnancy, duping both Alaskans and the American people. And the topic of today's post - the Down Syndrome "proof" that Trig must be Sarah's - is one of the cornerstones of this.

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Here's the link to Part 1 in case I have new readers who have not seen it.

This is the second part of my very long post, addressing the points raised in Lee Tompkins' article. In this installment, I intend to (try to) debunk one of the most persistent (and incorrect) assumptions in this whole issue: that Trig's Down Syndrome virtually proves that Sarah is his mother. I do apologize for all the math and numbers here, and realize that at times it's difficult to follow. But the problem is that this statistical proof is cited so often without anyone even understanding the numbers, that they only way to reasonably confront it is with the calculators on the desk.

A couple of Google searches and it's not difficult to figure out that the likelihood of a Down's pregnancy in a 44-year old woman is 25 times greater than that of a teenager. Of course, overall more Down's babies are born in the younger age groups but that is reflective of the greater numbers of pregnancies occurring in younger women than older women. That statistic alone should be convincing enough, but it is probably not.

The writer's opinion here is clear. This statistic (i.e, that Sarah had a 25 times greater chance of having a baby with Down Syndrome) alone should virtually prove to us that Trig must be Sarah's.

This "proof" of Trig's parentage has haunted those of us searching for the truth since day one. Often people who appear to know virtually nothing about the "Who's Your Mommy?" controversy (except perhaps that there is one), all can unfailingly summon this one "fact": Trig MUST be Sarah's because older women have babies with Down Syndrome. I've seen it a thousand times in comments on blogs, gotten hundreds of emails that say the same thing. Trig has Down Syndrome; this proves Trig is Sarah's. Case closed.

What is the reality?

It IS more likely, much more likely in fact, that a woman over 40, on a given pregnancy, will conceive a child with Down Syndrome than a woman less than 20. No dispute. But every year in the U.S. about 300 babies with Down Syndrome are born to women under 20. Not a huge number, but not insignificant either. This is about the same number as babies born deaf to women under 20 (who have no family history of deafness.) Would we disbelieve the story if we are told that a teen mother would have a deaf child?

Furthermore, those who repeat this statistical argument ignore another, equally powerful one in the opposite direction, one that I have never heard confronted head-on, with real numbers, regarding this situation, and that is that Sarah Palin, at 43, had a far FAR lower chance of ever having a baby at all.

Natural fertility drops sharply after age 40, a fact that is now nearly lost in the perception of the general public. Every week, it seems, yet another celebrity well into her forties has a baby. Several in the last few years (Geena Davis and Nancy Grace to name two) have been quite near, even at, fifty. But many - probably the majority - of these women have had these babies with fertility assistance: injections to stimulate ovulation, hormonal support after conception to compensate for a body that is really too old to be having children, and in many (perhaps most) cases where the mother is over 42 or 43, the use of donor eggs. However, these private details are typically not made public, so the public knows only that a baby has been born. They have no realistic clue just how difficult and expensive it was to achieve that.

In addition, women are routinely counseled to stay on contraceptives into their late forties, yet are only rarely advised by their physicians as to how low their actual chances of becoming pregnant are. Because of this, the erroneous perceptions that older mothers conceive often and easily and that pregnancy after forty is likely are firmly ensconced into our national consciousness. (This is much to the dismay and sad disappointment of many women in their late thirties and early forties, who have delayed childbearing and are now discovering that the effects that aging has on fertility often cannot be overcome even with help.)

In reality, what are the chances that a 43 year old woman, who is presumably practicing some sort of contraception and who is not "trying" to get pregnant, in fact will get pregnant at all and then carry that child to near term? The odds are actually extremely poor.

Women who are over 40 face a double whammy: fertility drops every year, and simultaneously rates of miscarriage rise.

Consider the following:
1. At age 40, a woman who is demonstrably fertile still only has a 1 in 20 chance (5%) of getting pregnant in any given cycle. A teen has a 20-30% chance of getting pregnant in a given cycle. And that's age 40. Sarah Palin was 3 1/2 years older than this.
2. At age 40, even using in vitro fertilization, (involving medical assistance with precise timing and hormonal support) the pregnancy rate per cycle is only 10%.
3. The chances of a woman over 40 who is trying to get pregnant via in vitro using her own "old" eggs is one/sixth of that of getting pregnant with younger "donor" eggs. In fact, most clinics will not even use the eggs of women over 40 because the failure rate is so unacceptably high.
4. 50% of pregnancies in women 42-43 years of age end in miscarriage, compared with only 10% for women less than 30.
5. By age 40, 33% of previously fertile couples are infertile, and this rises to 90% by age 45. At age 43 1/2 (the age at which Sarah Palin is alleged to have become pregnant) the chances of her even still being fertile at all were only about 1 in 3. Read that again. Statistics tell us that Sarah Palin had a 66% chance of not being able to get pregnant at all.

Plus - the Palins have been clear that the pregnancy was unexpected, that their baby-having days were over, and that they were not trying to have a child. This can only mean one thing: some sort of family planning method was being used. This would have cut Sarah Palin's already-low chances of becoming pregnant much farther. Oral contraceptives are 95% plus successful in preventing pregnancy. Even condoms are supposedly 85-90% effective in preventing pregnancy if used correctly.

So let's whip out the calculators here. For this little calculation, I am going to ignore the issue of contraception. We can't know what sort of birth control anyone in this equation was using or how consistently and rigorously it was used. So, to simplify things, I am going to, using statistics, attempt to answer the following question. If you have a 43 year old woman and a 17 year old woman who are both "letting nature take its course" (i.e., both sexually active and neither using contraceptives) , what are the relative chances that, in a given single month, each will get pregnant and carry the baby to term?

In a given monthly cycle, at age 40, a fertile woman has a 5% (1 in 20) chance of conceiving. I could not find a comparable statistic for a 43 year old, so we'll use 5% while stipulating that the actual number is certainly lower for a 43 year old. However, don't forget that this is a fertile woman. By age 43, 2/3rds of previously fertile woman are infertile. This reduces that ACTUAL monthly chances of conceiving for a 43 year old to 5% x .33 or 1.66%. A random sexually active 43 year old woman not practicing contraception has only a 1 in 60 chance of getting pregnant each month.

A 17 year old has a 20-30% chance of conceiving per month. For simplicity, let's split that down the middle and say 25%. A random sexually active 17 year old woman not practicing contraception has a 1 in 4 chance of getting pregnant per month.

In other words - the seventeen year old's chances of getting pregnant in a given month are 15 times higher.

But that's not the end of the story because now, the much higher rates of miscarriage come into play.

The 43 year old has at least a 50% of chance of miscarrying the baby. This cuts the success rate in half, to .8%. The chance that a 43 year old woman will get pregnant in a single month and carry the child to term is less than 1 in 100.

The 17 year old, meanwhile, has a 7% chance of miscarriage. (Sources cite numbers any where from 5% to 10% - I am splitting the difference.) This gives us a successful pregnancy rate per month for the 17 year old of 23%. The chance that a 17 year old woman will get pregnant in a single month and carry the child to term is 23 in 100.

.8% for the 43 year old versus 23% for the 17 year old. 29 times more likely. Ironically, quite close to the often quoted statistic that Down Syndrome is 25 times more likely in the older mother. So read that again. Understand what it really says. Yes, Down Syndrome is 25 times more likely in an older mother, but SUCCESSFUL PREGNANCY is 29 times more likely in the younger mother.

And don't forget, this result is for women NOT using contraceptives (Palin almost certainly was) plus this result was obtained using fertility rates for 40 year olds ( Palin was 43.) Both of these factors would reduce this already - low number even farther in this specific case.

Younger women can have babies with Down Syndrome, though it's rare. Older women can have babies with no medical assistance or support, though it's rare. But what the statistics do show is that those who USE Down Syndrome rates to argue that Trig must be Sarah's are totally missing the other bus: We could just as easily use overall fertility rates to argue that Trig must be Bristol's.

So return to the paragraph I quoted from Lee Tompkins article to start this post, now rewritten:

A couple of Google searches and it's not difficult to figure out that the likelihood of a pregnancy carried to term in a 17-year old woman is 29 times greater than that of a 43 year old. That statistic alone should be convincing enough, but it is probably not.

Feels funny when the shoe is on the other foot, doesn't it?

Now, to be explicitly clear: statistics are merely a guideline. Statistics do not prove anything either way. Trig has Down Syndrome. This in no way proves he is Sarah's. Trig exists. This in no way proves he is Bristol's (or any other younger mother's.)

And that's what needs to be taken away from this post.

PART 3 COMING SOON

Pulling A Palin: My Response to Progressive Alaska Part One

Over the week or so, I will post on this blog a multi part series. Today's installment is the first.

In January, Alaskan Blogger Celtic Diva published a "guest post" by a Labor and Delivery nurse named Lee Tompkins entitled The Birth of a Conspiracy; Delivering the Real Issue. Several days ago, a second Alaskan blog, Progressive Alaska, reprinted this post in toto. The theme of this post was simple: both the original writer and Phil at Progressive Alaska believe that the focus on Palin's birth story should be squarely on what they consider the "real issue," which is the very poor judgment she showed in traveling while allegedly in labor with Trig. They believe that Palin's terrible choices so endangered her child that on that basis alone she should be disqualified from any serious consideration for public office.

Both believe Sarah Palin's birth story, specifically that Trig was born to Sarah on April 18, 2008, after a trip back from Texas that I have chosen to call "The Wild Ride." (For those who don't know, I based that moniker on a quaint Disney theme park ride, Mr. Toad's Wild Ride, still operational at Disneyland (and, according to Wikipedia, one of the few remaining attractions that was present at the 1955 opening) but removed from Disney World in 1998. The concept of the ride was based on Kenneth Grahame's children's book The Wind in the Willows, from which Disney had made a cartoon in 1949.)

While Phil at Progressive Alaska obviously continues to take this position (he reprinted this post barely a week ago) i.e., that Trig is Sarah's and was born April 18, 2009, from private conversation with Celtic Diva (again, original source of the post last January though she did not write it), while she may be unsure of the whole truth regarding Trig's birth, she now personally entertains at least some doubts that it occurred as Palin reported. Would she, today, late June 2009, post Ms. Tompkins' guest blog? I don't know but I intend to ask her.

Most of Palin's supporters will not intelligently debate the evidence at all. Their tactics are few - but very consistent - whenever the pregnancy story is discussed. It takes only a moment for a reasonable-sounding authoritative voice, without citing any specifics, to label a theory like ours "irresponsible, incorrect, poorly researched, sensationalistic," or - simply - "bad." It takes much longer to refute these charges. Points, often boring ones, must be made individually. Specific examples, requiring serious research into dates, times, places, and statements, must be discussed. Obstetric minutiae is of little interest to most people, and actually unpleasant to discuss for many.

These are some of the favorite tactics used:
1. Their favorite red herring is Obama's birth certificate. "There's the real story," we are assured solemnly. There may be a story there. I don't know - I haven't looked into it at all. But what I do know is that regardless of where, when, or to whom Barack Obama was born, it's got nothing to do with Sarah Palin.
2. A tactic of "redirection" is employed whenever specific obstetrical facets are considered. Everyone seems to know someone that "never looked pregnant with a fifth child," or whose water broke and she didn't go into labor. All that tells us is that it is "possible" that some aspects of Sarah Palin's story might be true based on others' similar experiences. It does not prove that they are.
3. They simply refuse to believe the evidence in front of their eyes. Shown documented photographs from unimpeachable sources, these folks simply allege (with no proof whatsoever) that the documentation is wrong or suspect and then, because they cannot "verify" the source of the evidence, they will not discuss anything further.
4. The last bastion: Sarah's story is true because Sarah wouldn't lie.

When one (or all) of the four tactics above are employed, it's impossible to have an honest debate with a legitimate exchange of ideas. With Ms. Tompkins post, I can. I can debate her reasoning with my own. What I intend to do here is to go through Ms. Tompkins' post point by point and do my best to, if not refute each one, then at least put forth why I think the real evidence indicates something different: specifically, that Sarah Palin did NOT give birth to Trig Palin on April 18th, 2008. I intend to quote large sections (indicated by blocks) of the original post, though not all of it, just because of length considerations.

Let me say categorically that I think the widely disseminated rumor that Sarah Palin is not the mother of her child Trig is totally false, although I know many well-informed and well-educated people who believe otherwise, and I certainly understand their theory.

I'm going to spend some time discussing the reasons why I think the Palin faked pregnancy story is not true, but first I think it is of interest to comment on why this story has really caught hold of the imagination of many.

... the general public disliked Sarah Palin and when the bizarre circumstances of the birth of her child Trig became generally known, the public wanted to believe that she was capable of faking a pregnancy in order to bolster her standing as a "family values" candidate by avoiding the baggage of a daughter who was about to become an unwed teenage mother. Avoiding that didn't quite work out for Palin as it turned out, but that didn't stop a vocal minority of conspiracy theorists to believe Palin capable of such chicanery earlier. The public wanted to believe the worst of Sarah Palin.

I've stated this before, but I will repeat it for the purposes of this post. I have done more than anyone regarding "Babygate," and while I can't speak for others, I can certainly speak for myself. My initial interest in the story had nothing to do with wanting to "believe the worst" about or discrediting Gov. Palin. I'd never heard of her. I was an Obama supporter and doubt that anything could have made me vote for the Republican ticket but I certainly did not dislike Sarah Palin on any sort of visceral level. In fact when I first heard that a mother of five had been chosen, I was rather thrilled and very very happy for her. I was eager to learn more about her.

In an ironic sense, I set out to defend her, feeling that she specifically and women in general are not well-served when such an unlikely and implausible childbirth story is disseminated. My initial interest stemmed from my desire to set the record straight. Some dim-witted young male reporter who probably barely understood how babies get in much less how they get out, I assumed, had gotten his facts wrong. No experienced mother, having had four prior births, would fly ten hours at 35 weeks while leaking amniotic fluid. Ludicrous. Crazy. Didn't happen.

This was my original premise and it had nothing to do with Sarah Palin at all. It was only after I understood that this WAS her story and she WAS sticking to it, that my B.S. meter went off the chart.

....the evidence very strongly suggests is that Palin was guilty of recklessly endangering the life of her unborn child, which to me is far worse than faking a pregnancy, to protect her political ambition and perhaps the reputation of her daughter. It's just not as sexy of a story, not one the public could latch onto with such fervor. Discussing ruptured membranes ain't exactly something to talk about at the dinner table. And since "life imitates art more than art imitates life" it's highly doubtful the Desperate Housewives' writers will be opening next season with one of the wives flying transcontinentally with preterm premature rupture of membranes.

The public couldn't understand why anyone would do anything other than take the greatest of care and every absolute precaution with the health of a special needs child, whose parent should have been their greatest advocate and protector.

The faked pregnancy theory was easier to believe. And so it was born...

I agree, I think recklessly endangering a child would be worse than faking a pregnancy. Much worse in fact. Where we differ is that I don't think Palin actually did that.

I do not believe that Sarah Palin, under any circumstances, would have risked giving birth on an airplane. Whether she would have been motivated to avoid this by concern for her child (hopefully) or fear of criticism and embarrassment doesn't really matter in the end. What matters is that the consequences of giving birth under such circumstances probably would have been career-ending.

I do not think she would have taken this risk. More to the point, I do not believe she DID take this risk. She was absolutely positive she would not have a baby on the airplane. And how could she be positive? The same way I am positive every time I fly that I will not have a baby on an airplane. I am not pregnant.

We are "working" this story knowing how it ends. We know that Sarah Palin did NOT have a child on an airplane on April 17th 2008. But at 2 PM that afternoon, when Sarah Palin would have been walking down that jetway, she could NOT have known what the next ten hours would hold. If Sarah Palin was 35 weeks pregnant on April 17th, given her obstetric history, not only was it possible she would give birth within ten hours of her membranes rupturing, it was probable. She would had to have guessed, getting on the airplane, that there was a very fair chance she'd have the baby in the air.

She should have known that the odds were against her, and if she did not, any credible doctor would have made it immediately, explicitly, abundantly clear. Several different versions of how much contact she had with her doctor and when that contact occurred on that day have circulated. But if Sarah Palin had been pregnant and had been leaking amniotic fluid, no doctor in the world would have ever told her it was alright even to consider getting on an airplane. Any physician would have made it clear that, if you're leaking amniotic fluid, you have a very high chance of having the baby before you get back to Alaska, certainly BETTER THAN 50/50. That information would have stopped Palin cold. Let's be reasonable. It would stop anyone.

The primary risk she would never take is to her own public image. She cares about what people think - very much. No professional woman - and certainly not the narcissistic governor of Alaska - would have risked for a second the absolutely appalling level of scrutiny and social embarrassment that would have resulted if she had given birth on the airplane... and that is if things came out well. If her preterm baby had been harmed by the choice, she could have been charged with child endangerment and prosecuted!

I have personally seen a baby born after two hours of membrane rupture and one - yes you're reading right - ONE contraction. Palin had boasted, prior to April 18th, about how easy her birth had been with Piper six years earlier, reminding people that after Piper had been born, she'd gone back to work the next day. Sarah Palin may not know the ins and outs of African politics, but she's a practical-minded woman who had given birth four times. She knows where babies come from and just exactly what is involved in getting them out. Do THAT on an airplane? Never. Not in a million years did she chance it.

I have never looked at a map and checked proximity of the hotel where Palin was staying in Texas to a hospital, but in a large urban area, surely she could not have been more than, say, ten minutes away from a good hospital where she could have gone in a hurry. I can accept - and always have - that someone in Palin's position might try to give the speech. MIGHT, though the image of an amniotic fluid "leak" turning into a full-fledged rupture while on stage certainly would have dissuaded me personally. (If you wonder what I'm talking about, dump approximately one and a half quarts of yellowish pinkish kinda funky smelling liquid between YOUR legs all at once. Now picture this happening WHILE giving a speech to other governors. Hmmm. Sort of wrecks the professional aura, doesn't it?)

But no one will ever convince me - ever! - that the image-conscious governor of Alaska risked having to lie down in public, spread her legs, and grunting and panting in a messy puddle of amniotic fluid, mucous, blood, urine and possibly either the baby's excrement, her own, or both, push her baby out on the carpet in the aisle. Risked her own health and her baby's. Risked the public criticism she would have come under for inconveniencing hundreds of other passengers. And taken this chance not once, but twice, on two separate four hour flights.

Would she ever have been able to overcome the eye rolling and snickers? I don't think so. "Oh yeah, Sarah Palin. She's that Governor that had a baby in first class. YUCK YUCK YUCK. Good thing it wasn't coach. HAR HAR HAR." "Didjya hear the one about the Governor that had the baby..." And on and on and on. Millions of people who had never heard of Sarah Palin would have, all at once, and not in a good way. "Pulling a Palin" (or something comparable) probably would have become - for generations - a synonym for: stupidest choice imaginable.

My "comeback" to Ms. Tompkins is that I believe that the faked pregnancy theory (which of course means she was never actually at risk for having a baby on the plane) is in fact far more plausible than suggesting that she risked the incredible level of scrutiny and criticism, possibly career ending, that she would have come under if she'd given birth somewhere over Canada.

And consider this: If you are going to put this forward - that Sarah Palin recklessly endangered the life of her child - you're going to have to be able to offer some plausible explanation for why she did it. That has never happened. Sarah Palin has NEVER offered any credible or even remotely believable explanation as to WHY. WHAT was her utterly compelling reason for getting on the airplane? WHY did she chance this medically risky and humiliating scenario?

So that her child could be born in Alaska.

This is the only reason she has ever offered. So that her child could be born in Alaska. (Or to quote the succinct Todd, "You can't have a fish picker [commercial fisherman] from Texas.") This makes no sense. It is in fact one of the dumbest things I have ever heard.

Having a baby on an airplane would almost certainly have ended Sarah Palin's political career, just due to the embarrassment and the criticism she would have come under for inconveniencing the other passengers. If the baby had come to harm, it would definitely had ended her career and might have opened her up to prosecution. If the events of April 17, 2008 occurred as described, at 2 PM on that day when she got an airplane to return to Alaska, she could not know what would happen during the next eight hours. This is the risk the Sarah Palin would not take. This is the risk she did not take.


PART 2 COMING SOON.

Alaskan Geography 101

One of the concepts I will continue to focus on on this website and this blog is the long series of implausible and inappropriate choices that Gov. Palin made regarding her pregnancy and birth. Although I have mentioned her choice of physician a few times before, it didn't hit home to me how really curious this choice was until I started looking in detail at a map of Alaska, and realizing just how far it really is from Juneau to Anchorage.

Like most folks in the "Lower 48," my sense of Alaskan geography is not very good. (I apologize for this.) I know Alaska is big. Really big. And that's about it. Here's a map to help us in our review.



And here's another that shows the relationship between Anchorage, Wasilla, and Palmer.



Most of us remember (or at least should remember) from grammar school that Alaska's capital is Juneau. This is where the governor's mansion as well as the state capitol buildings are located. This is down on a little "neck," mostly surrounded by Canada, and hell and gone for the bulk of Alaska. Sarah Palin is from Wasilla, a town about sixty miles from Anchorage. Anchorage is about 800 miles by road (a bit less by air) from Juneau. To put this into perspective, this is about the same distance as it is from Richmond VA to Chicago IL, or Philadelphia PA to Atlanta GA. No matter what map you look at, it's flippin' far.

Unlike being a state legislator (where in most cases, the legislators only come to and live in the capital during legislative session) being Governor is a full-time job. Sarah Palin's official residence once she accepted that job was in Juneau. Although she spent a lot of time at her home in Wasilla (and apparently billed the state for a per diem when she did so) at least theoretically, Sarah Palin was supposed to be living in Juneau.

So what did she do when she became pregnant with her fifth child at age 43? Did she seek out prenatal care where she lived - the choice that virtually every pregnant woman in America makes? There's absolutely no evidence that she did. She should have known by October 2007 at the latest that she was pregnant and has stated that she had an amniocentesis in December. But considering the "shock" that her staff expressed at the time of her announcement in early March 2008 (a staff that would, routinely manage her calendar and appointments,) it seems very unlikely she was seeing a doctor in Juneau.

Instead, throughout her entire "pregnancy," even once she allegedly knew that her child had Down's, thus putting her pregnancy into a HIGH RISK status, she apparently continued to consult her family practice doctor in Wasilla / Palmer - an HOUR from Anchorage which is itself two hours by plane (twenty hours by car) from Juneau! Did she intend to commute from Juneau to Palmer bi-weekly beginning at 32 weeks and then weekly at 36?

Who did the amniocentesis? Family practice doctors don't do them; usually they are done by obstetricians though occasionally they might be done by radiologists. Once she knew the baby had Down's, and of course, had made the decision to continue the pregnancy, it would be recommended for her to have at least one - and possibly two - special ultrasounds that are capable of visualizing fetal heart defects. Who did these exams? Where? When? Not a family practice doctor in Palmer Alaska, I can promise you that.

Although a woman who had a good "obstetric" history in the past has every expectation that the current pregnancy will be trouble-free, common sense intervenes. No woman assumes that just because all of her previous experiences were good, that this one will be as well. What was Sarah Palin planning if she'd gone into premature labor in February or March (dead of winter in Alaska) while in Juneau? Did she intend somehow to fly to Anchorage and then drive to Palmer, maybe in the middle of the night? Or was she going to just present herself at an E.R. in Juneau and hope for the best?

Of course, none of these prenatal choices can even compare to the claim that a 44 year old woman, who is supposedly in preterm labor with a Down's baby, bypassed NICU equipped facilities in three cities (Dallas, Seattle, and Anchorage) ultimately to give birth with a family practice doctor at a small community birthing center in Palmer Alaska. (And, according to some websites, (though I personally have not been able to confirm this) Dr. Baldwin Johnson, HAD PRIVILEGES at the hospital in Anchorage that has the NICU, Providence.)

But STILL Gov. Palin landed in Anchorage, 12 hours after her amniotic sac allegedly started leaking, and then bypassed this hospital (six miles from the airport) and drove to Palmer. On some websites her reckless behavior once in labor has been excused with the statement that she's such a staunch Alaskan that she was willing to take risks to make sure her baby was born on Alaskan soil.

But her choice to bypass Anchorage, where her doctor had privileges, in favor of Wasilla shows that "Alaska" was not the issue, nor even a favorite doctor. She was desperate to get to Mat-Su Regional Hosptial in Palmer Alaska. Why? What's there? Are their birthing rooms really THAT nice? Ummm, probably not.

Granted, not all births are likely reported on the Mat-Su Hospital's website. But it looks like on most days, there are only 1 or 2 births... it's a small facility. Could it be that the greatest attraction of the facility was its utter privacy, combined with the fact that Dr. Baldwin-Johnson was a long-time friend and acquaintance, who had Sarah Palin to thank for an appointment to the Alaskan Health Council in May of 2007?

Why Amniocentesis?

As I have stated several other places on the website and blog, I find Gov. Palin's series of inexplicable - even bizarre - choices made during the birth of Trig Palin on April 17th and 18th extremely troubling. At no point from the start of the process until the end did she behave like someone who was in labor (or "maybe" in labor) with a fifth child and one who had allegedly been diagnosed prenatally with Down's Syndrome.

It's been stated in numerous places that she knew through "early testing" that Trig had Down's Syndrome. Immediately after the birth, articles only stated "early testing," but in an article published in May (links to all of these are available in the website proper) she stated that the testing was done in December.

So why did she have an amnio done? No where on the Internet that I can see has this question been addressed. Without getting too long-winded, there are three basic reasons a family would have amniocentesis performed. The first is to obtain a prenatal diagnosis on a couple fairly common birth defects, specifically Down's Syndrome (trisomy-21)and spina bifida. The second is to test for lung maturity in a case where there is premature labor. The third is to test for specific genetic disorders that might be unique to that family, tests that would not be done routinely. Obviously reason two is out as this was supposedly "early testing." No one can know if in the Palin family there is any genetic problem that would require testing but considering the birth of four healthy children prior, it's probably not likely. This leaves the first reason - routine testing for Down's and spina bifida, and it's pretty routinely recommended for all women over 35.

There is a heated debate in the pro-life community regarding this testing. The majority of strongly pro-life women actually chose to skip the test, regardless of age, since it does increase the risk of miscarriage slightly. (About 1 pregnancy in 200 will miscarry - (official medical term: abort) directly because of the amnio.) For a pro-life woman who will not terminate even if she learns that her child does have Down's, any increased risk is considered unacceptable. Obviously, given Palin's stated beliefs, she falls into the group of women who would never have chosen to terminate a pregnancy.

So then, why do the test? The ONLY reason at that point is to diagnose Down's or spina bifida, two conditions that would push the birth into a higher-risk category, thus allowing the mom to PLAN HER BIRTH ACCORDINGLY!

But not Gov. Palin. What we are now expected to believe is that she had a test done, a test that does carry the risk of miscarriage, for the sole purpose of diagnosing certain conditions that would definitely move her pregnancy into a high risk category. Yet, after RECEIVING this diagnosis, she does... well... nothing. She IGNORES the results completely. We are expected to believe that she continues plans to give birth with a family practice doctor (not an OB) who practices in a rural community hospital 800 miles from her official residence. She goes into some sort of pre-term labor in Dallas, Texas a city with two NICUs (one at Baylor, and one at Presbyterian Hospital) flies to Seattle (a city also with two high risk facilities) flies to Anchorage (with a hospital that has Alaska's ONLY level III NICU) then drives an hour out into the country to give birth in Palmer. Oh, and if this is not enough to swallow, we are supposed to believe that the doctor approved of all of this.

So... I repeat my question. Why did she have the test done in the first place?