Real women, agonizing choices

Lost amid the political and moral posturing over late-term abortions are the actual women who make the painful decision to undergo the procedure.


Stephanie Booth
June 7, 2003 8:23PM (UTC)

For the first time since 1973, when the U.S. Supreme Court legalized abortion, the federal government is poised to restrict women's right to terminate their pregnancies. In early March, the Senate passed a bill to ban late-term, or what abortion opponents call "partial-birth," abortions. On Wednesday, the bill, HR-760, easily won the support of the House, with a vote of 282-139. Former President Clinton vetoed earlier versions of the ban, and the Supreme Court ruled three years ago that similar state bans were unconstitutional. But President Bush has promised he will sign HR-760 into law, making illegal a procedure that he has called "an abhorrent procedure that offends human dignity."

"Partial-birth abortion" is not a medically recognized term -- it's an expression born of politics. It refers to an abortion procedure called an "intact dilation and extraction" (D&X), performed in the second or third trimester, in which a physician partially delivers a fetus, punctures its head while it's still inside the mother, and then delivers it dead. Opponents say the procedure is tantamount to infanticide. Supporters argue that there are a host of reasons, both medical and psychological, why women need to have the right to have late-term abortions.

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One of the key questions surrounding the controversy is why women have late-term abortions. Opponents claim that women, especially young women, often have them simply to get rid of unwanted pregnancies, while defenders argue that most women who have them do so because of health problems, including severe deformities with the unborn baby. The only thing clear is that the procedure is quite rare: According to the Alan Guttmacher Institute (AGI), an estimated 31 providers performed a total of 2,200 such procedures in 2000 (the most recent year statistics are available), a number that represents only 0.17 percent of all abortions performed that year. Beyond that, however, the data is inconclusive. A 1987 AGI study indicated that only 6 percent of women who had abortions after 16 weeks cited concerns for their own or their baby's health as the most important reason they had the procedure. But there is no current data to support that claim, and opponents of the bill -- including AGI -- claim the research is too outdated to have significance. In any case, many defenders of late-term abortions argue that the procedure should be legal whatever the reasons the woman may have, and that the issue has been seized on by abortion opponents as a beachhead to outlaw all abortions.

Easily forgotten amid the political posturing and endless moral arguments over late-term abortion are the real women who make what can be an agonizing decision to go through the procedures that HR-760 outlaws. Following are the stories of two such women, both of whose unborn babies suffered from severe health problems.

Kim, 34, New Orleans

My daughter existed for years before she was even conceived, a dark-curled, green-eyed gamine who spoke early, read early, delighted her parents with her inquisitiveness and intelligence. I saw her holding every stuffed animal, reading every children's book. I could look out a window and see her playing in the yard, tramping down the sidewalk from school, riding a bicycle down the street. My husband and I named her Kate the year we were married. My parents bought into the dream, too, my mother going so far as to buy the not-yet-born Kate books, even getting an autograph for her from Harper Lee. "To Kate," it read, in a fine script. "May you have a long and happy life." My brother framed the slip of paper, and they all gave it to me for our first married Christmas.

My husband at the time, Barry, was still researching his Ph.D. in Birmingham, Ala., and was years away from finishing and getting the job that would enable us to start our family. Those years were difficult ones -- waiting to start our future. But as soon as Barry graduated in 1996 with his computer science degree, we moved to Iowa. We thought it would be the perfect place to raise our family.

At 28, I became pregnant almost immediately, my first trimester a blur of nausea, exhaustion and anticipation. Barry and I were typical Type A parents-to-be: reading every book we could get our hands on, playing Mozart CDs. We considered ourselves well-informed, especially since my mother held a degree in early childhood development. But our routine ultrasound at 20 weeks -- which we hoped would confirm that Kate was indeed a Kate -- revealed shocking news. Our child suffered from anencephaly, a neural tube defect in which the brain doesn't develop past a very rudimentary stage. Essentially, our daughter's brain and skull were not there. We were heartbroken to learn that for all intents and purposes, there was no baby, no reason to continue the pregnancy.

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The doctor's diagnosis came on Friday; on Monday, Barry and I drove to Iowa City, to the University Hospital's special gynecology clinic, to bring my pregnancy to an end. The clinic was in the basement of a building, tucked away on the college campus, and because this was less than a year after the shootings at the Planned Parenthood in Brookline, Mass., I remember we were surrounded by closed-circuit cameras, the reception area cased in bulletproof glass. The doctors did another series of ultrasounds and an amniocentesis to confirm the diagnosis. We wanted to know what was going on and so the doctors explained everything they could, from pointing out what was happening on the monitor to showing me the cloudiness of the amnio fluid.

As for the procedure itself, I don't remember much. I recall the faint sound of a vacuum and feeling some pressure as the doctors worked to extract the fetus, using speculums, curettes, forceps and suction. I don't know how long the fetus was intact; it could have been intact all the way into the birth canal. Unlike the step in the procedure that anti-choice activists like to present in graphic detail, there was no need to compress the skull. It was because my daughter's skull and brain had not developed that we had to have the procedure.

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When I sit here at my desk and close my eyes and think about it, I can see the light on the clinic ceiling and feel Barry holding my hand as I cried. Not because what the doctors were doing frightened me -- the anencephaly had prevented our daughter's brain from developing enough to ever register consciousness so I knew she wasn't in pain -- but because I had just lost my child.

The very week of the procedure, I became an ardent activist for abortion rights, writing letters to politicians, telling the story of our loss, hoping to show the reality behind later abortions. I went from writing those letters to working with Planned Parenthood and the National Abortion Federation, and as that first year without our child went on, I found myself in state capitals all over the country, cornering legislators, giving interviews, making myself heard.

Although my specific procedure wasn't directly referenced in the so-called partial-birth abortion ban being circulated at that time, the broad language of the bill still would have made it a target. If President Clinton hadn't ultimately vetoed the legislation, the procedure I'd undergone would not have been available to me. The language of hr-760 is only slightly less vague.

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Just over a year later, Barry and I discovered we were, thankfully, joyfully, a little scarily, pregnant again. But at 17 weeks, an ultrasound showed that this, too, was an anencephalic pregnancy. Again, I had to end my pregnancy. Again, full of grief, we drove back to the clinic in Iowa City and were ushered behind the bulletproof glass. Last year, Barry asked for a divorce. I don't know if I'll have the chance to try to have children again. I don't know if I can have a healthy baby. And I don't know if I even want to try -- again, it's partly because of the legislation the president has said he'll sign into law. I don't believe people understand the impact of this ban. It will take options away from women like me -- a woman who finds herself 20, 22, 24 weeks pregnant with a fetal anomaly will not have an option.

Michelle, 33, Houston

My husband, Rob, and I had tried so hard to conceive our second child -- I'd even been on Clomid, a fertility drug, for a year -- that when I became pregnant in April of 2001, we felt the difficult part was behind us. Although I knew of things that could go wrong during a pregnancy, I never thought they would happen to me.

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We scheduled an ultrasound at 21 weeks to learn the gender of our child. When the technician suggested I go to the bathroom and release my bladder so they could get a better view of our baby on the monitor, I didn't sense any apprehension in his voice. But when I came back into the exam room, our obstetrician was there. And when he looked at the screen, he told me there was terrible news. My baby had anencephaly -- basically no skullcap from the eyebrows back, and no brain. There is no cure.

My options were to terminate the pregnancy, either through induced labor or through a medical extraction. Or I could continue my pregnancy and deliver a baby that was most likely dead or would die very soon afterwards. It was also quite possible that because I wasn't producing as many hormones as I would during a normal pregnancy, my body wouldn't know when it was time to go into labor. I could carry this child for 42 or 44 weeks, and even then labor might have to be induced. So many other things could happen to put my health at risk: I stood an increased chance of placental abruption and uterine rupture, and future pregnancies might be made much more difficult.

I chose to terminate my pregnancy as soon as possible. It was a very difficult decision for my husband and I to make, but the one we felt was right for us: I have always associated giving birth with life, not with death. My baby had already started kicking and moving. I couldn't imagine wondering for the next 20 or so weeks, "Did she die today? What about today?" And what was I going to tell my 2-year-old daughter? How would I explain that the baby growing inside Mommy's tummy wasn't coming home with us? I think I might have considered carrying my baby to term if I'd been able to donate her organs. Maybe then her dying would have felt like it had a purpose -- if I'd been able to give life to four or five other little babies. But the legal system considers this "harvesting" -- giving birth to a baby just for its organs -- and so it wasn't an available option.

My own doctor couldn't do the procedure because he worked out of a Catholic hospital. That was also an issue for me: I was raised Catholic. And although I've always been staunchly pro-choice, it was unsettling not to have my faith backing me in such a time of need. But although my mom has very strong faith in the Catholic Church and my aunt is a teacher at a Catholic school, they were extremely supportive of me. Everyone in my family was, which surprised me a little. I worried someone might try to talk me out of the procedure, but the attitude I encountered instead was, "What's best for you, is best for you."

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The procedure was scheduled over two days. The first day, my cervix was dilated, and a final ultrasound was done. I turned my head so I wouldn't see the screen. The second day, I went back in to the clinic and had the actual procedure. I did have the option of staying awake (with only my body numbed), but I choose to be asleep.

Physically, I responded fairly well to the procedure. But emotionally, I was devastated. I couldn't sleep or eat. I felt phantom kicks for weeks. I'd taken a month off work, only saying that I'd lost my child, but as soon as I got back, co-workers were constantly asking how I was. I know they meant to be kind, but I just couldn't handle talking about it. I decided to resign. I needed time to mourn the loss of my baby.

If I'd been forced to carry my baby to term, I can't imagine what my state of mind would have been. I would have gone crazy. I look and listen to protesters and think, "They've never been in our shoes." If they actually have, and are still protesting, then I respect that. And I know a lot of women do discover their baby has a problem and still decide to carry to term. I completely respect that, too. Each woman knows what is best for herself, what she can and cannot handle or endure. We're the ones who have to be at peace with our decision.


Stephanie Booth

Stephanie Booth is a freelance writer who lives in New Jersey.

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