If your doctor doesn’t perform the procedure you want, ask to be referred to someone who does.

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Q:

My unborn child has been diagnosed with severe spina bifida with hydrocephalus at week 19 gestation. My husband and I have decided to terminate the pregnancy. The  D&E seems cruel to me. I would like to have early induction and delivery abortion (L&D) but I don’t think they will offer it to me.

I think that I would cope and grieve more effectively with this termination method. I want to see my child and say goodbye. Do you have any suggestions?

A:

I am very sorry that you are having to go through all of this. I agree that having a say in the type of procedure you will undergo can make a big difference in coping with all of this.

Please let your doctor know that having an L&D (early induction) is very important to you. He or she should be able to find a hospital that will let you have an L&D termination. Some doctors assume their patients would prefer the D&E because it doesn’t involve going through labor.  Sometimes doctors won’t offer the option of an L&D unless you ask. So please, just ask. If your doctor doesn’t perform the procedure you want, ask to be referred to someone who does. At 19 weeks, you still have time to find another doctor and schedule the procedure you’ll be most comfortable with.

If for some reason an L&D is not an option that’s available for you, rest assured that a D&E is not at all “cruel.” These days, standard protocol in most medical facilities includes administering an injection which stops the fetal heart before any procedure to end a second or third trimester pregnancy. This step is to prevent futile pediatric department interventions that can be a matter of hospital policy pertaining to any live birth. Doctors who don’t administer the injection typically cut the cord first in a D&E procedure, but even if they did not, the anesthesia that puts the mother under for the procedure will do the same for the baby.

Medical science says it’s highly unlikely that a fetus can register pain before 24 weeks gestation. However, if it turns out you don’t have a choice to get the L&D, for your own peace of mind be sure to ask your doctor about any concerns you have.