If Purvi Patel delivered in hospital she could have declined neonatal care, but she delivered at home so faces jail

Purvi Patel faces 70 years in jail for delivering a premature baby at home and believing her fetus was stillborn. She was found guilty of feticide and neglect.

I want to put these frightening abuses of her legal rights aside for a moment…

The fact that she was questioned immediately after an anesthetic. We don’t let people drive a car after an anesthetic, yet her medical team thought nothing of allowing the police full access.

The fact that Ms. Patel’s hematocrit was 22.1 just 30 minutes after she was questioned, indicating that she had lost a significant amount of blood. This might also affect one’s ability to answer intricate questions, especially after an anesthetic.

The fact that she was not read her Miranda rights.

The fact that the judge refused to exclude this testimony that was obtained without Ms. Patel being read her Miranda rights.

The fact that no evidence was found that she purchased or took an abortifacient.

The fact that there was no evidence that the fetus was born alive.

The fact that had the fetus were born alive the odds of survival, even if Ms. Patel called 911 immediately, were negligible. The fetal length and weight indicate a gestational age of 23-24 weeks. At 24 weeks the only chance of survival is being born in a hospital with immediate tertiary care resuscitation. Paramedics are not equipped or trained for that scenario. While there are neonatal transport teams, they can’t be mobilized and on site in 10-15 minutes.  Even if the paramedics were theoretically equipped to do that kind of resuscitation a 7 minutes response time (which is very fast) would likely be be too late.

So let’s put all that aside and focus on one fact that was never addressed in court. but matters so much I want it to be front page of every newspaper – the gestational age and what would have happened had Ms. Patel delivered in a hospital. 

In pre-trial motions the state was allowed to claim the fetus was 30 weeks based on a guess by an OB/GYN. The OB/GYN was Dr. Kelly McGuire who was called as a second opinion to assess Ms. Patel. He then left the hospital and thus Ms. Patel’s care to join the hunt for the fetus. Dr. McGuire is a member of the American Association of Pro-Life OB/GYNs.

But courts should use facts not guesses by OB/GYNs who are not experts in assigning gestational age at birth, OB/GYNs are experts in assigning gestational age before birth by ultrasound. After delivery it’s all up to the pediatrics team.

The fetus was male and was 12.2 inches (30.99 cm) long and weighed 1.46 pounds (662 g). The body had exsanguinated so we should add about 100 ml/kg of blood, or 70.17 g (the weight of 66.2 ml of blood) to achieve a birth weight of 732.17 grams.

Using average fetal growth curves for a male fetus (these are well known) the length is equivalent to 23 weeks gestation and 1 or 2 days and weight of 24 weeks and 3 or 4 days gestation.  This is not disputable at all yet the prosecutor was allowed to claim 25 weeks. The expert for Ms. Patel stated 23-24 weeks, which as you can see is accurate based on the forensic data and growth curves. 

If Ms. Patel had presented to the hospital in labor an ultrasound would have been performed and an estimated gestational age of 23-24 weeks would have been assigned. Prosecutors aren’t involved with that aspect of obstetrical care just yet, but who knows what’s around the  bend in Indiana!

At 23-24 weeks a woman is allowed to decline resuscitation. This is because the odds of intact neurological survival are quite low.  This is important, so I will restate it, we do not force women to resuscitate extremelypremature infants on the threshold of viability. For now anyway. Perhaps that might change soon in Indiana?

So to be clear, had Ms. Patel delivered in a hospital she could have declined neonatal care had her baby been born alive. But because she delivered at home she is a criminal.

Now tell me this wasn’t a reproductive witch hunt designed to both test the limits of Indiana law in curtailing reproductive rights and score points with pro-life donors and voters.