There are countless health issues that arise during a pregnancy that constitute medically necessary grounds for terminating a pregnancy
I was 33 when I first became pregnant and at my 20-week anatomy scan my husband and I received the gut-wrenching news that the fetus had a congenital heart defect that would result in a very short, painful life. After consulting with numerous experts at renowned facilities, we made the crushing decision to terminate the pregnancy. It was without question the darkest chapter of our lives.
The weeks between receiving the news at the anatomy scan and the procedure referred to as a dilation and evacuation, were marked with dizzying uncertainty as we waited for the heart to increase in size just enough to be able to make as black and white of a decision as humanly possible under the confounding circumstances.
I had four echocardiograms in this short timeframe and each time I would crane my neck in an attempt to zero in on the digital images on the screen, as if my untrained eye would know what to look for, or what the pixelated splatters of color indicating cardiac blood flow really meant. If there’s red in the upper left section, and blue in the lower right, is that good? Does that look like a fully formed heart? It sounds like a strong, functioning heart, so it must be okay, right? The images were as foreign to me as an ancient Egyptian scroll but I could not, would not look away. It was the last scan at Stanford’s fetal cardiology unit that provided us the information we needed to make an informed and brutally painful decision.
As agonizing as the news was to hear at this last scan, it was delivered gently and compassionately, with clear options and next steps laid out in front of us. The doctors we encountered along the way never once made me/us feel like there was a wrong decision. They treated me/us with respect and dignity every single step of the soul-scorching journey. They never doubted our decision or made us question our faith in ourselves as parents staring down an impossible crossroads. In this sense, I was lucky. I was lucky to have had this experience with medical experts whom I trusted and who trusted me, and I was lucky to have a strong sense of knowing what to do, and a partner who shared that sense of knowing with me. I do not doubt the decision we made, and am grateful to the doctors who helped us arrive at our decision through their compassion and steadfast professionalism.
This is not the reality women now face since the Supreme Court has overturned Roe v. Wade, leaving the states to decide how to proceed. In the states with the strictest abortion laws, many women are facing impossible situations with doctors who don’t know if they can legally provide proper medical care for them. Abortion is far from a black and white issue. There are countless health issues that arise during a pregnancy that constitute medically necessary grounds for terminating a pregnancy and performing abortive care.
To the doctors in the states with the most restrictive access to healthcare for women, I do not envy you. You know what your patient needs and you are in an impossible situation, having to weigh the legislative realities that affect the kind of care you can provide against the healthcare needs of your patients. Please, choose your patients. I know that is far easier said than done, and I know you are afraid, but so are your patients. They are terrified and don’t know where to turn. Their lives and health are in your hands. Please, don’t turn your back on them.
Call your elected officials and share your stories. They are not doctors. They do not understand the consequences of their moral jurisdiction over the women you treat. These women are your patients and they need your expertise and care. Be brave. Be one of the ones who says, fuck these draconian laws that make no sense – my patient could die, or her health and reproductive future could be in danger and my duty is to help her, period.
I know you did not choose to be in this impossible predicament, caught in the crosshairs between being a “law-abiding” citizen, and preserving the health and life of your patients. I beg you, choose your patients. Do the hard thing that you know in the deepest recesses of your conscience as a physician is the right thing. Trust in your knowing.
In the wake of receiving the unbearable news at that anatomy scan I couldn’t even decide what shoes to wear each day. Making the simplest decisions under the weight of my grief was nearly impossible. I cannot fathom being told by my physician, “sorry I can’t help you, good luck.” To imagine what it would have been like to then have to determine where to go for my healthcare needs, how to get there, where to stay and for how long is incomprehensible. What is impossible for me to imagine, is far too many women’s reality right now. To layer on the logistics and financial burden of seeking out-of-state medically necessary healthcare on top of immeasurable grief and physical impairment is unreasonable, cruel and flat out wrong.
To the legislators who implemented strict abortion bans with narrow exceptions, you do not understand what you have done to countless women, girls and physicians. You do not understand what abortion is and is not. You are mercilessly penalizing women and girls; compromising their health and stripping them of their dignity. And for what? To save a life at the expense of another? How does this make sense? How do you look in the eyes of a 10-year old and tell her it’s God’s will to carry the baby of her rapist? How do you deny an expectant mother the care she needs when she receives the devastating news that she is going to have a miscarriage? How do you tell experienced physicians to deny their patients potentially life-saving care? Do you believe that what you’re doing is actually moral? Do you believe you are reserving your place in Heaven by expecting rape and incest victims to carry their perpetrators babies? Is this what you would want your daughter, granddaughter or niece to do? I know with every ounce of my being it is not.
My wish for all those in need of abortive care is that they are able to seek it out safely, humanely and with their dignity top of mind for their health care providers.
