I am a physician. I live in a very conservative area.

In fact, just down the street from my office, there is an anti-abortion advocacy group that labels itself as a crisis pregnancy center but offers primarily anti-abortion information scare tactics, ultrasounds of “heart beats” with incorrectly drawn pictures and has zealous members who have threatened the lives of my colleagues in this town who do abortions and even the lives of their children.

When I have someone willing to listen even with even a bit of openness regarding the need for choice, I tell them about 3 women I have known. Only one was a patient, and she gave permission, as did the others to tell their stories, but because of the shaming and honestly the fear of violence toward these women, I keep them anonymous.

The first was a patient of mine. She was in her early 30’s. She had one daughter who was about 4 and ever since that child was about one, she and her husband had been trying to have another, including infertility evaluation, and had been told it was unlikely. She was brought to the ER having had a first severe grand mal seizure at home. They lived out on a farm a ways from town and the seizure had lasted a long time, and the rescue crew under the guidance of the ER MDs had given her IV anti-seizure meds en route to the ER. She required further different IV seizure meds in the ER as she was still seizing when she arrived. As routine course lab including a pregnancy test was drawn and she was whisked to CT scan. The pregnancy test result came back positive at the same time the CT report was read to say she had a “bad looking” tumor in her brain.

As the high dose powerful (and teratogenic) intravenous medications controlled her seizure, she awoke for me to tell her the reports. She had expert consultations with an excellent neurosurgeon, neurologist and oncologist, and high risk pregnancy expert. (All of whom were men, and to their credit and /or not, including her “right to life” neurosurgeon, independently said they did not feel right to give her advice with regard to her pregnancy.) It was up to me who had the long term doctor relationship with her to order extensive literature searches about all know information about her tumor type / prognosis re pregnancy etc and give her the known knowledge for that time that if she carried the pregnancy to term, she could not receive the most effective and potent treatments for the tumor until after delivery and most likely would die late in the pregnancy, or soon after.

That treatment might prolong her life, but we could not guarantee cure but it would be a long shot. That pregnancy hormones tend to accelerate the growth of the tumor. Or we could risk the fetus and give her some treatment (not to mention that the seizure medications she would continue to need and the x-rays she had might also cause harm to the developing fetus/baby she carried.) I also could hold her hand and let her know that this was her decision to make, not her families, her doctors, etc. and that she could take some (short, days) time to reflect if she needed and that I would be there to support her decisions in any way. She told me soon after that she wanted to fight that tumor with every chance she had, that she wanted to live for her daughter, and wanted to terminate the pregnancy. We found a GYN who was willing to terminate the pregnancy in hospital (due to her health risks) and she had the surgery on the tumor soon after and aggressive treatment. (At surgery it was found that the tumor type was even worse than expected.) She lived another quality 5 years and thanked me more than once for giving her the fairness and support to make the decision that she never regretted to live as long a she could and have time for and with her family.

The other 2 stories are shorter:
Jill was a young woman with schizo-affective disorder. Her life was tumultuous and she would have psychiatric admissions almost once a year as her psychiatrist tried to find medications that would work. During one downslide she was manic and went off some of her meds including her birth control pills. She was admitted to the hospital in a psychotic state and required some potent (and birth defect causing) meds to bring back her sanity. She was also pregnant, didn’t know who she might have slept with, and as she gained her rationality back, knew she was in no condition mentally, financially, etc to be a fit parent. She chose to have an abortion. She went on to get stabilized through the right meds and counseling , and had the chance to have an education, a good career and marriage. (She also became emotionally stable enough to have the shaming of anti-abortion friends not throw her into relapse.)

The third story is of a woman who also is married, professional, and in her first pregnancy had a scare with abnormal alpha-fetoprotein levels leading to amniocentesis to rule out Downs. The little boy turned out to be fine. It took her about 5 years to finally get pregnant again and so by then chorionic villus sampling was available and that unfortunately was abnormal, but not for Down’s but for a rare chromosomal abnormality that was incompatible with life beyond a year or 2 at most, but that she would be able to carry to term. This too was a much wanted pregnancy. She underwent a second procedure with amniocentesis, then 2 different MD genetic counselors to confirm this grim news. The decision was long and arduous for her and her husband and they also sought advise from their religious leaders. Finally she decided that she could not prolong the inevitable suffering of this essentially terminally ill at conception child and that she would discontinue “life support” not carry the pregnancy to term. Because she was in the second trimester she had to travel more than a 100 miles to the only MD who would do a late termination procedure. She had already named the child and she arranged a memorial serving for it. She grieved as one would a stillborn child, but never regrets ending the pregnancy at that point.

These are the stories I tell. And I ask, who dares tell any of these women that they have the right to take away the choice that these woman, with care and facts and advise from those best able to give them that counseling, made? And who would dare to make that process any more difficult than they already had to endure? Shame on you if you think you have any right to decide for them!