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In a hard delivery we tell the mother “the baby is fine” before we know. Does keeping her calm make it right?

Its coordinates: 3.3.1 Bioethics and Medical Ethics

On our ward, when a labour goes badly, someone always says it: the baby is fine, keep pushing. Often nobody knows that yet. The heartbeat has dropped, the doctor is coming, and the mother is frightened. A frightened mother tightens, pushes badly and sometimes makes things worse. A calm one helps herself and the baby.

I have said it too, many times. Most of the time the baby is fine and nobody remembers the sentence.

But I have also sat with a woman two days later whose baby was not fine, and she said to me: "You all knew and you told me something else." She did not say it angrily. She said it as if a door had closed between us.

So my question is not whether it works. It usually works. My question is whether working is enough. Is a lie that helps the person who hears it still a lie in the bad sense? And does it matter that she cannot agree to it, because asking would undo it?

I come from the Baul songs, not from books, so I would welcome answers in plain words.

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3 answers

  1. Tsion Bekele

    Fellow

    In interpreting we have a rule that helps me here: you may choose what to say, but not say what is false. "The baby is fine" is false when nobody knows. "Everyone is looking after your baby, and the best thing you can do is push now" is true, and it still calms.

    Your woman two days later felt the difference between being protected and being managed. I think the true sentence would have protected her without closing the door.

  2. Nadia Haddad

    Fellow

    What you describe has a name in palliative care too: we call it the gap between the comfort of the moment and the trust of the whole relationship. A lie can buy the first and spend the second.

    Care ethics would ask what the relationship needs, not only what this minute needs. You will be in that room with her for hours more, and perhaps for her next birth. That is a consequence too, but one that the "it usually works" calculation forgets to count.

  3. Farhana Akter

    Fellow

    Tsion, I like your sentence and I will try it. The problem is that in the worst minutes nobody is choosing words carefully, the words just come. Maybe the answer is to have the true sentence ready before, the way we have the instruments ready.