self-performed caesarean section?
Hi, I'm an aspiring fantasy author! I don't know if you'd know the answer to this question, but I thought id ask anyways. I have a woman whos death I'm writing that is very tragic and sad, long story short, there is a war, she is poisoned by a villain, as the poison is slowly coursing through her veins, she knows she will die. She is pregnant , so she decides to cut her baby out of her stomach in hopes that it will survive and not be poisoned. No one else is around to help her in the middle of a battlefield. ( the child is supposed to survive in the story) How far along would she have to be for the baby to survive? How much blood loss would occur? and how quickly would she die, or how long could she live before dying? What would be symptoms of cutting a baby out of your body? (for example would you cough up blood or pass out or something)? I know its crazy but I'm trying to keep it as realistic as possible. any info would help :)
So my first thought upon reading this is…. She better we performing that cesarean very very quickly. Mom and baby share a blood supply so if she has a poison in her blood stream that’s going to kill her, it’s going to kill baby that much faster.
So then that leads to: how was she poisoned exactly? If it’s entering her system via blood stream, or even intramuscularly, she has very little time before she’s just straight up poisoned. When it comes to anything “coursing through veins” there’s really no “slowly” about it y’know what I mean?
If it’s something she ingested, she has more time as then she needs to absorb it through her stomach or intestines, but then you also have to ask why she wouldn’t just make herself vomit (not that that will be 100% protective, but it will certainly help).
To get down to your actual questions:
Fetuses are considered viable at 24 weeks. That is, their lungs are juuust developed enough that they can actually use them. There have been cases of babies even more premie than that surviving, but that’s a baby that is gonna have a loooot of problems. Even at 24 weeks you’re really pushing it. If you’re talking about a battlefield, blood and grit type of situation where you’re really not going to have access to supportive devices, pulmonary support, temperature control, resuscitative measures, etc. 24 weeks is pretty unrealistic. 24 weeks is going to be a pretty sick baby that’s going to require a lot of medical support.
So that’s a thing that possible I guess. Is in necessary to the story that the baby MUST be preterm? Viability and infant health decrease, and complications increase with every week you fall short of full gestation. I would assume in the type of situation that you’re talking about, in order for the infant to survive, they would need to be pretty close to full term. So while OB and peds are definitely not my specialty, based on what education I do have, I’d say you probably couldn’t go much lower than 34 weeks and have it be realistic.
A lot of blood loss would occur. The uterus is highly vascular, it’s under a lot of pressure (as you could imagine), there’s gonna be bleeding; and that doesn’t even get into shit that can happen with the placenta. C-sections have been performed outside of a hospital setting and people have lived through them… but there’s a lot that can go wrong, particularly if you’re doing it to yourself fueled by necessity and panic. She’s not gonna be careful. She’s not expected to survive either way right? That’s all pretty straight forward. She’s gonna bleed to death either way, but she’ll have at least enough time to get it done. It’s not like we’re talking about an aortic rupture, this is not a situation that she’s going to bleed out in seconds. As long as she’s not just hanging bleeding out of her uterus for a prolonged period of time, I’ll buy it. Everyone’s different, there’s no universal rule on how long it’s going to take someone to bleed out, or to start getting symptomatic from blood loss, etc. so just be reasonable. She’s not going to be high functioning for thirty minutes, however, she might be with it enough to perform complex tasks for 10-15.
I’m more concerned, actually, with what’s gonna happen with the kid. There is a blood-placenta barrier and MAYBE you could make an argument that whatever the poison is can’t cross the barrier…. But idk that’s a stretch. I think shit like arsenic and lead exposure to mom are able to affect the fetus. So I would think that cutting that umbilical cord (the source of poison) is going to be the number one priority. Make sure she has something to clamp that sucker with or else baby’s gonna hemorrhage and die too.
SYMPTOMS: nah you’re not gonna cough up blood since your uterus is not connected to either your stomach or your lungs.
But- she’s going to be in excruciating pain. I’m not sure what kind of poison you’re using in this case, so can’t speak to that. But if we’re just talking blood loss here: she’s going to start getting dizzy, nauseated, sweaty, and shaky. She could be vomiting. Her heart rate is gonna sky rocket. As things progress she’s going to start having mental changes, confusion, anxiety, and eventually unconsciousness. That progresses to death obviously. Again depending on the type of poison, it’s debatable whether the poisoning would like, shut down her respiratory system, or she’d die of blood loss first.
Hope that helps and good luck!
