Wanted babies: Assumptions and the illusion of choice in abortion legislation

I’ve had two abortions. Both in my thirties, both considered elective, both while happily married, and both pregnancies were very much wanted.

Until now I’ve called these miscarriages. Or just referred to them as “the babies I’ve lost.” But that’s not the whole story.

I’ve always pined myself mostly in the pro-choice camp, but the side of that camp that thought, “Three months is enough to know if you want to keep the baby or not.” Assuming, as most people do, that abortion is for people who are reckless, get pregnant and don’t want the baby.

In my teens and 20s I said I could never see myself ending a pregnancy, though I was never 100% against it, especially in situations of rape or incest. If asked to vote for a second trimester abortion ban before last year I likely would have.

Today I’m eternally grateful I did not have that choice. I’m even more grateful that I live in a state that offers me a choice (albeit in a restricted timeframe), and doesn’t treat abortion as something that’s technically legal, but requires you to drive hundreds of miles to find a doctor who will do the procedure.

Our legislation and the conversation around abortion generally ignore scenarios beyond the simplistic ‘wanted or not’ debate. Contrary to general assumptions and portrayals in media abortion is rarely a simple yes/no black/white situation.

Round 1

The first time I got a positive pregnancy test in December 2014 my husband and I were ecstatic. We’d decided to start trying that month and voila. Excited for our first appointment, we went in and expected to see a little bean and a heartbeat on the ultrasound.

What we saw was nothing. We had an empty sac. But it was early, about 8 weeks. The doctor said that it might be hiding. I went home, did a lot of internet research and it confirmed what my doctor said, this sometimes happened — ultrasounds sometimes don’t see babies until a little later because of their position in the uterus. Holding out hope we went back two weeks later, and still nothing.

We were disappointed, sad and confused. My blood tests showed a progressing pregnancy. I had morning sickness. There was no visible embryo. My doctor said this was called a “missed miscarriage.” My options were to have a dilation and curettage (aka abortion procedure) to clean out my uterus, to take the abortion pill and hope it works (it doesn’t always and is somewhat unpredictable), or wait for it to evacuate on its own. Since my body was full-on progressing as if I were pregnant, waiting for my body to handle it may have taken months. I chose the expedient and safest option: an abortion.

I’ll pause here: Definitions of abortion differ, and since there wasn’t an embryo involved here some people may disagree with my classification. But the procedure is the same, and not something anyone is eager to undergo.

I laid there, my husband holding my hand and sad, disappointed, but knowing we were making the right choice.

Round 2

In comparison to my next story, round 1 was a piece of cake.

A couple months later, after the recommended recovery time, my husband and I decided to give this baby-making thing another go. After two months of trying in May 2015, another plus sign on the pregnancy test. We were excited, but cautiously optimistic, as we now understood that things can and do go wrong.

We had our first ultrasound early, at about 7 weeks (they were kind to accommodate us) and we saw an embryo and a heart beat. Color us ecstatic. We did it! My internet searches assured me that the chances of miscarriage after seeing a heartbeat was very low, so we were incredibly confident that we’re going to be parents for real this time. We mostly kept the news to ourselves, but after passing our genetic tests and a clear 12-week ultrasound we started telling co-workers and most of our close friends and family. We planned a vacation during week 19, just before our 20-week check-in. We had nothing but confidence it would go smoothly.

As you might expect at this point in the story, the 20 week appointment did not go smoothly. The first ultrasound was inconclusive. We learned that he was a he, but also that there might be something wrong with his heart. The second ultrasound a few days later confirmed there was a problem with his heart. How bad, we didn’t know. We did an amniocentesis to rule out any genetic disorders the previous tests may have missed and scheduled an appointment ASAP with a pre-natal cardiologist.

At this point, I was 22 weeks. My husband and I were shocked. We discussed the range of scenarios and decisions we might make depending on the severity of any genetic issue, how bad his heart was, what surgical options we had, and on and on. We were still confident that we were having this baby.

We went to our appointment and learned that the heart problem was bad. Pretty much the worst.

In plain terms, our baby did not develop a pulmonary artery, which connects the heart to the lungs and is essential for oxygenating blood. As long as he was in me and not breathing, he was just fine and perfectly healthy. I was doing the work for him. The problem would come when he needed to breathe on his own. He’d survive for awhile. There are some veins that could compensate for a short time to sustain life, probably for a matter of days, maybe weeks. But the prognosis was grim. Once he was born, he was destined for a short painful life. Were there surgical alternatives? Yes, but since our baby’s condition was severe, the prenatal cardiologist didn’t think they’d be successful, and surgery would only prolong the inevitable.

Our options were A) cary the baby to full term, watch him suffer a painful short life (and if you’ll allow me a moment of practicality, incur significant medical expenses) or B) end the pregnancy and have another abortion. This time, a full on, late term bloody-baby picture abortion.

After extensive conversations with multiple doctors, questioning every possible scenario, it was clear that the prognosis was not going to change. This is what these professionals look at every day. They’ve seen hundreds of this rare condition, and they know the outcomes. Maybe it was selfish, and maybe we should have waited it out. I don’t know, and we will never be 100% confident we made the right decision. I hope it’s the hardest decision we’ll ever have to make. But the answer was B. We couldn’t justify putting the little guy through that. And, we couldn’t justify putting ourselves through that.

What made it worse is that a decision needed to be made immediately. In California you have a choice until 24 weeks. We had less than a day to make an appointment, with a week wait for the procedure. If we didn’t choose by then, I’d have to carry to full term. In other states, like Wisconsin (my former home), the cut off is 20 weeks. I wouldn’t have had option B.

A close friend in Wisconsin had a similar situation at 16 weeks. Her baby girl was diagnosed with the chromosomal abnormality 45,X, was in heart failure and had no chance for survival. If they’d caught this a couple weeks later, she would have had to carry the baby to full-term, only to lose her at birth, or wait for her body to have a late-term miscarriage. She chose to help nature on its way.

The illusion of choice

In these situations, we were “lucky” that our timing allowed us to have a choice at all. A week here or there, a day extra to get an appointment, and our options, our “choice,” would be gone.

Our abortion laws and regulations are not made for these scenarios — where an abortion is the last thing you want to do, but it’s the best option out of a bunch of crappy options, and it’s the only choice that won’t cause more long term pain and suffering for everyone, including the unborn baby. Our laws, and most pro-life advocates, assume that abortions are for women to get rid of unwanted pregnancies. An assumption I was guilty of until last year. They assume that all embryos and fetuses will be perfectly healthy, and carry minimal risk to itself and the mother. As I’ve learned the hard way, twice, that is definitely not the case.

My husband and I cried a lot. I cried on the operating table. The doctor who performed my procedure cried with me. This wasn’t an outcome anyone wanted. But we got “lucky,” we had a choice.

I’m now expecting again, and I’m thrilled to report everything looks good. I hope I will never again have to make a hard decision to have an abortion. But if I do, I hope time will again be on my side.

In some ways, I’m grateful to have gone through this process. It’s opened my eyes to this issue. I’m grateful to live in a state and have an insurance provider that allows me a real option. I’m grateful for the doctors that continue to learn and perform the procedure. No longer naive to the many different fates of a pregnancy, I’m also angry that under just slightly different circumstances, I would not have had a choice. Our legislation is a one-size-fits-all solution and ensures the right to choose is often only an illusion. I am now and will in the future continue to lobby for and support causes that allow for more flexible abortion laws that accommodate these, and other, special circumstances.