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Ethics, pregnancy, prematurity

The Duggar’s Russian roulette with prematurity

Michelle Duggar is pregnant again. Number 20.

Perhaps ratings were slumping for their “reality” show? I use the term reality loosely, because a family with 19 children is not reality for anyone. While TLC likes to call themselves the ‘Family, Home, Style, Cooking network,” (you know, crock pots and crafts), TLC is really code for The Desperate for Attention and Whoring Myself and/or My Kids Out channel. TLC just rolls off the tongue a little bit easier.

While being a grand multipara (5 or more deliveries) increases the risks of some specific obstetrical complications, Michelle Duggar is also assuming a special kind of risk. A woman who delivers prematurely due to severe preeclampsia at 25 weeks (as she did in her last pregnancy) has a 60% chance of developing severe preeclampisa before 28 weeks in her next pregnancy. That means Michelle Duggar has a 60% chance of having another extremely premature baby (because the treatment for severe preeclampsia is delivery). Babies born before 28 weeks have a 30% risk of a moderate or severe disability.

There is also a 60% chance that her baby will have a NICU bill of over $500,000, a good portion of which will be covered by Medicaid (never mind all the post-NICU care). And here I thought not lying was one of those Commandments (see #9, “Do not bear false witness”). Michelle and Jim Bob love to say they don’t take government money, but they clearly have (why does no one call them out in this?). Every baby who weighs less than 1,200 g at birth gets Medicaid. So, any portion of the estimated $500,000 NICU bill incurred by Josie that was not covered by her private insurance was paid by great the State of Arkansas.

But Michelle is not only playing Russian roulette with her new baby. Preeclampsia is the third most common cause of maternal death in this country. For every 100,000 babies born alive in the United States,  790 women die from preeclampsia. And Michelle Duggar has a 60% chance of developing this condition before 28 weeks.

Of course, she has a 40% chance that she’ll make it to the 3rd trimester and if she does there will be the implication that it’s a “miracle” and “God’s will.” Which irks me to no end, because 40% isn’t a miracle and the whole “God’s will” thing implies some higher power thinks it’s just fun and games for everyone else who had a bad outcome with their pregnancy.

I know many preemie moms who delivered before 28 weeks due to preeclampsia. Most with their first pregnancy and most have decided that they won’t have another baby because they simply couldn’t go through it again. Not only because of the risks to their own health and the thought they could leave their baby motherless, but because they just couldn’t put another baby though 10 or more weeks of the NICU and then the years of uncertainty that follow.

To me, the Duggar’s decision to have another baby can only be a desperate attempt to improve ratings and by extension income, because who in their right mind would have a 20th child knowing there is a 60% risk of a terrible outcome?

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Discussion

24 thoughts on “The Duggar’s Russian roulette with prematurity

  1. First of all, can I just say that Michelle Duggar is CLEARLY delusional, and that her husband must not give a rats ass about her. They are idiots for reproducing. Again. Do they not think their other 18 children suffered during their baby’s 6 month hospital stay? Someone give this woman a hysterectomy. Or a tubal. Good Lord, she doesn’t have a clue. Or doesn’t care. Maybe she would be good with the 19 coming to visit her at the nursing home after she strokes out. Having a uterus doesn’t imply that one needs to use it every year they are withing childbearing years. Mmmkay.

    Posted by Kristin | November 9, 2011, 1:35 pm
  2. Totally agree with your entire article. I just want to point out one thing. All babies under 1200 g do not get Medicaid. Our son born at 29w was between 900-1000 g and we did not get one cent of Medicaid. Why? Because our hospital realized what great insurance we had at the time and they never told us we were eligible for it. Why? Because as I later found out, Medicaid only pays maybe 30% on a good day of what the NICU charges. They got him pre-approved with our insurance for an 8 week stay and even though he did really well and probably could have gone home after 6 weeks, they kept him a full 8 weeks but were pushing us out the door that last day!

    I had mild pre-e with him. I was diagnosed with a clotting disorder after that. We were told with treatment that our chances were very good for a term baby and so we chanced it and went to 38w, 4d with a scheduled repeat c/section. We decided to chance it one more time, but despite being on a triple dose of blood thinner, I developed HELLP with the 3rd one but thankfully not until 38w. The baby was fine but I ended up having to go back to the ER a week after she was born for severely high blood pressure. After my experience with HELLP, we will not purposely go through that again and for one of the reasons you mentioned, leaving my children motherless.

    Thank you for all you do to promote Preemie Awareness.

    Posted by Cassie Brown | November 9, 2011, 6:58 am
    • All babies under 1,200 g do get medicaid. It ist he Lantzman act I believe. Medicaid is the insurer of last resort, so if your private insurance picked up your entire tab, then there would be nothing left to bill Medicaid. It you are even Medicaid eligible (haven’t applied, but low birth weight) the hospiatl still can’t bill you. How long you have Medicaid after delivery varies by state, but every baby under 1,200 g has it while they are hospiatlized. Itis sad more social workers do not help with this. Because thsi is such an issue I included a chapter on government programs in my book, The Preemie Primer.

      When a hospital tried to bill us outside of Medicaid, I filed a complaint with Medicaid (Colorado) and thehosptal got audited. It was a very persuasive compaint with ample documentation.

      Posted by Dr. Jen Gunter | November 9, 2011, 6:50 pm
  3. “…the whole “God’s will” thing implies some higher power thinks it’s just fun and games for everyone else who had a bad outcome with their pregnancy.”

    It seems you said this as someone who doesn’t have a relationship with God. As someone who does, (and who had a preemie at 24 weeks) I can assure you that the whole “God’s will” thing confirms there is a higher power who knows better than we do, even if we humans – in our infinite wisdom – think otherwise.

    Posted by Marissa Skipper | November 9, 2011, 9:34 am
    • I do not belive in a God who helps one famiy have 20 babies, yet allows millions to go hungry.

      Posted by Dr. Jen Gunter | November 9, 2011, 6:46 pm
      • I know this is not a theology blog, and am grateful for the preemie awareness that you promote. I just wanted to be clear about who God is, and he is not someone who thinks suffering is fun and games. Things in this world aren’t perfect or always happy, and as long as we are here that’s how it will be. It doesn’t mean God is wrong or bad. Many of the people who are suffering still believe in him and trust him. I hope you come to know THAT God.

        Posted by Marissa Skipper | November 10, 2011, 3:18 pm
      • Dr. Gunter, this is the same argument I’ve had with my fundamentalist evangelical mother and sister … and I’m with you.

        Posted by Gleemonex | February 14, 2012, 9:18 am
  4. Jen, do you have a source for this: “Preeclampsia is the third most common cause of maternal death in this country. For every 100,000 babies born alive in the United States, 790 women die from preeclampsia.” It seems high to me, but I am most certainly not in the medical field.

    I hope it all goes well, because 20 kids and the dad alone, would be just sad.

    Posted by fleetssara | November 9, 2011, 6:43 pm
  5. I got a lot of opposition when I rolled my eyes at her God’s will comments at a meeting at my church this week. Whoops. But the reality is she has NINETEEN other kids who need their mom, and putting your life and the life of your child on the line is foolish.

    God gave us modern medicine to use when we need it. If she dies they’ll say it was God’s will, but I see it more like the guy who drowned in the big flood and asked God why he didn’t save him. God said I sent a bus, a boat, and a helicopter, what more did you want?

    I gave you the option of birth control, a tubal, a vasectomy, what more do you want?

    We won’t get into my personal feelings on the whole buddy system thing and the fact that you can’t actually PARENT 19 kids, there aren’t enough hours in the day.

    Posted by Katy Linda, IBCLC (@Stylin_Momma) | November 9, 2011, 6:48 pm
    • I have thought of that joke about God & the boat, bus,helicopter. I’ve heard it many times before & it relates to many issues in our lives when we just do not want to see the light. I agree that Jim Bob & Michelle are extremely selfish for continuing to reproduce. But, I believe they are actually trying to get pregnant, which to me, is not the same as just leaving it up to God as they so often say. Michelle used to have a calendar on the fridge which tracked her cycles & ovulation weeks. Why on earth would they need one if they weren’t trying for another baby again & again? I believe in God as well, but I also believe that He helps those who help themselves and they clearly are rolling the dice with this risky pregnancy. Not just for the baby but for Michelle & her remaining children should they be minus a Mom in the end. Tragic & unnecessary if that should happen.

      Posted by Mitsy | November 16, 2011, 11:29 am
  6. Bitter much…

    Why is it anyone’s business if they have 30 children? Get a life and maybe worry about the drug addict that has one child that she can’t even parent…from what I hear, the US has enough of them floating around that you would never have to concern yourselves with the Duggars ever again…

    Written by a Canadian mom who could care less, because I have a life…

    Posted by Donna | November 9, 2011, 7:47 pm
    • Yes, I do worry about the child of a drug addict. However, the big difference here between a Druggie child and a Duggar child is that usually the Druggie child is unplanned. The new Duggar child was obviously planned. I hope and pray for the best for it.

      Posted by Cassie Brown | November 11, 2011, 5:08 am
    • If they put themselves on TV, then they are subject to whatever ANYONE MIGHT SAY good or bad. This forum is about the Duggars (not a drug addict who has a child). If you couldn’t care less, then WHY post here?

      Posted by Mitsy | November 16, 2011, 11:32 am
    • “Why is it anyone’s business if they have 30 children?”

      Because it is a really bad idea for the reasons Dr. Gunter has described and many other reasons. Frankly, Mrs. Duggar is being treated worse than a female dog in a puppy mill.

      Posted by jlxn | April 2, 2012, 11:57 am
  7. Hello Dr. Gunter,

    I’m convinced that Michelle is a pregnancy/birth junkie. I remember her standing over little Josie’s incubator saying she was possibly pregnant again. My jaw dropped. This woman has barely survived a bout of pre-e, she has a critically ill micropreemie who’s future is a best uncertain, and she’s fantasizing about another pregnancy!? Lady, how about focusing on your critically ill newborn instead.
    Its obvious this woman has had a fixation on another pregnancy since Josie arrived and the media and fans treat her like they do the daredevil who has just announced a new death defying stunt. And like the adrenalin junkie she eats up the adulation and attention.
    Michelle has said she would willingly risk another premature birth. Oh isn’t that big of her. No problem about what this child will endure? I’ve had to tell Michelle worshippers that the NICU scenes on TV were highly sanitized. They didn’t see little Josie endure needles, tubes, surgery, noise, light, restraints, pain and discomfort. Oh and Michelle you do have other children, one with possible special needs. Any thought as to what could happen to them if you are debilitated or die this time? Do you have a problem disrupting their lives again and moving them closer to the hospital?
    However Dr. Gunter the real clincher for me was when JimBob and Michelle left for El Salvador on some mission and seem to have left Josie in the care of her sister who is barely out of her teens. This is a child who was a micropreemie with an extensive medical history, months in the hospital, had one emergency return to the hospital when she nearly arrested, and her parents leave her in the care of her sister while they leave the country!
    Well guess what, little Josie developed a fever and seizured. Thankfully she recovered after an overnite stay in the hospital. You can see the video on google. It enraged me. By all appearances Jill was handling this crisis alone. She is seen rocking her very ill sister, who is on oxygen, while mom prays over the phone and dad and mom snivel about how helpless they feel. Well if you were home with your medically fragile child like you should be you wouldn’t be so helpless! Their indifference and appallingly bad judgment enraged me.
    Excuse me folks, but children like your daughter require constant vigilance. They cannot be foisted onto older siblings like the rest of your young children.

    I’ve gotten many Michelle fans irate with me but I stand my ground. This woman is a self absorbed pregnancy /birth junkie who gives no thought to her own safety or that of her unborn child. She also seems to give little consideration to her 19 children and what effect this has on their lives. Its about her.
    Sorry, not my idea of a nuturing Christian mother.

    Posted by Mary | November 10, 2011, 2:02 pm
    • Excellent post. I had forgotten about Josie being in the hospital while they were away on their little “trip”. I also think Michelle gets some kind of bizarre “high” out of churning out baby after baby and gives little thought to her existing children. She has no amount of time to spend with ANY of them yet she procreates more. Perhaps LESS time with Jim Bob? These people truly make me ill.

      Posted by Mitsy | November 16, 2011, 2:03 pm
    • Totally agree with you Mary–100%

      Posted by lorrie | December 13, 2011, 5:35 pm
  8. Why aren’t Social Services involved? These children are neglected.

    Posted by Catherine Voutier | November 13, 2011, 9:50 pm
    • I have to wonder where social services is when a child like Josie is not being properly cared for by adults and instead by kids just out of their teens while mom and dad are out of the country. Did the hospital or medical professionals who have cared for Josie have some issues with this? I didn’t see grandparents. I didn’t see parents. I only saw Jill who seemed to be handling this crisis alone. I was willing to give JimBob and Michelle the benefit of the doubt until now, but this incident enraged me.
      Under what other circumstance would this be considered responsible parenting?

      Posted by Mary | November 22, 2011, 6:40 pm
  9. They are entitled to live their lives the way they want. They support their children and are good parents. The whole deal with them is that they expect all their children to help out. That is how it works and it works for them. They take no state aid and clearly none of their kids have rebelled so who are we to say their way doesn’t work for them. They are debt free and how many of you posting can claim the same. As I said, it works for them. I am more concerned about our planet and over population and for that their total number of kids bothers me.

    Posted by Madge | December 13, 2011, 6:28 pm
    • Madge,

      I think you are missing the point here. Dr. Gunter is pointing out the serious risks to Michelle and her unborn child. This isn’t about their lifestyle but rather a serious medical risk. Both Dr.Gunter and I have seen women die of this disorder and we take the possibility of a recurrence in Michelle very seriously.
      Believe me I’ve gotten flack from people when I raise this risk issue and it enrages me. This woman’s pregnancy wasn’t a spectator sport that folks cheer like they’re are at a horse race. This is something that can kill a woman and drastically effect many lives.
      I have become incensed at JimBob and his smiling like a cheshire cat upon announcing his wife’s pregnancy. I don’t know about you Madge, but I firmly believe a man has an obligation to protect his wife and children. I absolutely cannot fathom any man, especially one of religious conviction, being so anxious to impregnate a wife after she has nearly lost her life and their child in a previous pregnancy, and being so oblivious and indifferent to the danger his wife is in. I don’t care what “precautions” you take, you cannot guarantee to prevent pre eclampsia, just as taking precaution is no guarantee against cancer. I equate JimBob with Rusty Yates, who I hold personally responsible for the deaths of those 5 children drowned by their psychotic mother. Both are fathers and husbands who have failed miserably in their responsiblities to their wives and children.

      Also Madge, have you not noticed its the older daughters who have been relegated to being housemaids and nannies? Incredibly beautiful and intelligent young women who should at the very least have the option to go to college. There ARE Christian colleges. They should be either entering or finishing their advanced educations. Why aren’t they? What kind of parents relegate their daughters to this kind of life? I wonder if they would enjoy interaction and friendship with other young men and women like themselves instead of lives that are isolated and controlled in every aspect by their parents. I have no problem with children “helping out”. I have a problem with parents foisting parental responsiblities on their chidren and totally controlling every aspect of their lives.
      BTW, have you ever seen Jim Bob hauling diaper bags, carrying his children, giving baths, rocking children, etc.? Isn’t that part of parenting or is that just for the women to do? Maybe he should once in a while and give his older daughters a break.

      Posted by Mary | December 14, 2011, 8:09 pm
  10. I realize that this is an old conversation, but I had my son this summer at 32 weeks, and there is no way our family could have made it through that time without God. He gives strength and peace in the most challenging circumstances, and he has sure done that for us. I also am thankful to read in the bible that God hates injustice even more than we do (Proverbs 17:15 is one of many places that talk about it), and he promises to one day make all things right (Revelation 21).

    Posted by carla | September 22, 2013, 5:15 pm

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