I looked forward to the birth of my third child. I had decided on a surgical birth (my third cesarean). Since each subsequent cesarean is more likely to become complicated, I would be at a higher risk of blood loss during and after the operation, and as an active Jehovah’s Witness, this made my doctors worry. There were additional complications: gestational diabetes, and my blood iron levels were low. Then, towards the last trimester of pregnancy, I learned that I had a prothrombin gene mutation which increases the danger of bleeding. My upcoming birth was deemed high risk.
My obstetrician and I went over my birth plan, upon which I had written “NO BLOOD! See Healthcare Power of Attorney (POA)”. I explained my beliefs and my refusal of blood transfusion. I informed her that I could agree to a cell-salvage system during the operation but she didn’t think that would be a good option. She asked me to double check with my elders or leaders about my alternative options for treatment since I really had trouble explaining myself. In the meantime she asked me to speak to a hematologist since my blood count (hemoglobin) started to drop and she felt a specialist would offer better options for alternatives to a blood transfusion.
I contacted my elders. They had never dealt with a situation like mine before, so they contacted the Hospital Liaison Committee (HLC). The HLC provided me with a link to a document on JW.org for Witnesses to share with their doctors, with a section on pregnancy and childbirth. I planned on discussing this information with my obstetrician and hematologist.
At my hematology appointment, I asked the doctor about the options listed in the JW.org document like Erythropoiesis-stimulating agents* (ESA) – drugs such as Epo, Epogen, Procrit, Aranesp – and a cell-salvage system. (The other options found in the document were not available in the hospital where I would be delivering.) Because I was just a few weeks away from my cesarean birth, he was undecided about recommending ESA injections since it takes time to work. He suggested I do iron infusions which they offered in his office. As he explained how ESAs worked he did mention that the treatment might benefit me in the days following my delivery, and affirmed that it was my right to decide whether I want the treatment or not. He wanted to discuss it with my obstetrician first. Should we get the green light, he would need to know my blood type. This made me very confused. “Why does it matter what my blood type is with EPO? Isn’t EPO a bloodless product?” He paused and said, “Yes, it is technically a bloodless product but they make it from whole blood and they prefer to use blood that matches the patients.” I didn’t know what to say or what to think. I realized that I knew nothing about blood, how it works and its components. Being a curious person, I had to find out.
I was just a few weeks away from having my baby and I was terrified. Could I be putting myself in unnecessary danger? I felt like I was handing over my life to the JW.org organization without any true or valid reasons. I just started to wonder if maybe the blood transfusion policy might be based on an incorrect assumption. Yet I felt so ignorant about the physiology and anatomy of blood. And this was all triggered by just a simple question from my hematologist that made me stop and think.
Even though I had doubts I decided to modify my birth plan and my alternatives for blood transfusions. My OB didn’t recommend EPO because I was close to my due date, but the iron infusions and supplements helped somewhat. When it came time for my cesarean my OB didn’t recommend the cell-salvage system because of the risk of maternal blood mixing with embryonic fluid which can lead to death. The hospital did not have the tools to perform acute hemodilution so my surgical team just prayed for the best and proceeded.
Everything went well. I recovered quickly to my surprise.
I was able to review some information about blood and learned little by little. With everything that I have read I really don’t see any justification to the Watchtower’s No-Blood policy. My small doubt led me to read about blood components and fractions. ALL components pass through the placenta, mother’s own milk contains white blood cells yet they are banned by the Watchtower organization.
It has now been a year since I had my beautiful baby. I am not an expert but I feel like I can make a better decision about my health and well being. It’s very empowering to do your own research and make an informed decision on your own without anyone else’s ideas or conscience to influence you or make you feel guilty. If you’re pregnant, talk to your doctor openly about the hospital’s procedures for blood transfusions, do some secular research, and if you can, look for a hematologist you can speak to. Get informed! There are risks for EPO (erythropoietin) and since it is a complex hormone, it may not be a better alternative treatment*. There’s a significant risk for death with a cell-salvage system.
Don’t feel guilty about looking for secular information. That’s how I felt, guilty, when I first started to do research on blood transfusions. Some days the guilt was overwhelming especially when I would find information that didn’t support the Watchtower’s teachings. I had to pace myself and pray to Jehovah for understanding. It feels good to finally have my conscience back and be the master of my own faith. My process lasted several months but I knew I had to do it. Doing this research, I feel, has brought me closer to Jehovah since I can see how he values life over the cold application of regulations, especially if it means losing a life. Life is the most valuable thing we have. So please research and ask questions. This can save your life and your baby’s.
* Risks of therapy include death, myocardial infarction, stroke, venous thromboembolism, and tumor recurrence.