Unexpected Pregnancies and Hard Choices

I am standing in the exam room, in the Women’s Health Center,
listening to the rapid heartbeat of a four-month-old fetus on a
Doppler. The patient, Carey McDonald, 17, a slim blond cheerleader, is
alone today. Sometimes her mother, a single waitress, comes with her.
The father of the baby, a star football player on the hometown team,
denies paternity. "But it’s his!" Carey told me. "It is! He’s the only
boy I’ve ever been with and even that was only two times." Carey and
her mom will raise this baby together.

I don’t ask the young woman if she thought of using a condom.
I don’t ask her if she had access to a birth control clinic. I don’t
ask if her mother ever talked to her about sex or if she had sex
education classes at school. It’s too late for that now.

Natalie Lopez is a 29-year-old travel agent. She’s seven weeks
pregnant and accompanied, at this first exam, by her lover of three
years. "I can’t take birth control pills because of the other
medications I’m on, but we used protection every time." Her eyes water
over and she hands me a folded white paper on which are printed the
names of two antidepressants and a mood stabilizer. "We want to be
parents. I’ve always wanted a baby. But I can’t have this one. The
medications I’m on are toxic and there’s a high chance the child will
be born with a congenital defect."

If Natalie had come to me sooner, to get a more effective
method of birth control, this might not have happened. But Natalie
doesn’t have health insurance. There are over 17 million women in the United States that don’t have health insurance.

Diane Boggs is only twelve. Her eighteen-year-old cousin sexually
assaulted her. Afraid people would say it was her fault, Diane didn’t
tell. Sitting on the exam table, she hangs her head low so her long red
hair covers her face and the tears fall into her lap. She is, by
ultrasound, sixteen weeks pregnant. Her grandmother, Mrs. Boggs, a
widow, who’s raising Diane alone, clutches her pocket book and takes a
deep breath. "I never believed in abortion, but I can’t raise another
child. I’m already seventy-three."

Diane is too far along for a simple termination. A second
trimester abortion is difficult to find. In some states they’re
illegal. The pressure of the pro-life movement has closed abortion
centers. Older physicians in private practice, skilled in the
procedure, are afraid to help, even in cases of incest, for fear of
reprisals by anti-abortion activists. Ninety percent of counties in the United States don’t have access to reproductive termination.

Ruth is a forty-five year old, married mother of three who had
a tubal ligation after her last delivery. She is ten weeks pregnant.
"The doctor told me there was only a 2 in 1000 failure rate for the
sterilization, but I never thought it would happen to me. My husband
has been laid off his job and I was trying to make him feel better."
She smiles a half smile and looks up at me from the corner of her
eye… then her expression changes.
VIDEO: Helping Women Find Repro Health ServicesVIDEO: Helping Women Find Repro Health Services

"I love my children more than anything. I just never thought
I would be in this spot, but you see, it’s all we can do to keep up
with the ones we have. My youngest is autistic. Ron lost his health
insurance along with his job. I’m one payment behind on the house and
can barely afford the heat. I don’t know where to turn; none of my
conservative family would understand or help me get a termination. What
am I going to do?"

I’m thinking of lending Ruth the money to drive to Maryland. The cost would be $400 dollars.

We live—if you are a health care provider, a female, a parent,
or someone who cherishes a woman—in dangerous times. The Health and
Human Services Department of the U.S. is cutting funding to
reproductive health centers and birth control education programs in
schools. Right-to-lifers, who picket on the sidewalks in front of
abortion centers, still heckle and humiliate vulnerable patients
seeking services. The pro-life movement has energized around their new
calendar girl, Sarah Palin.

I am a nurse-midwife, not an ethicist, but I know Diane,
Natalie, Carey, Ruth, and Mrs. Boggs. I don’t even ask myself what I
would do in their shoes.

This is their very private decision. I give them a handout on
reproductive centers, all of them two hours away. I tell them how many
weeks they have until they must make the appointment and not to make a
decision in haste. I provide prenatal vitamins and prenatal care,
should they decide to keep the pregnancy. I talk to them about giving
the baby up for adoption. I give them birth control afterward and try
to prevent another unwanted pregnancy.

In thirty years, I have never met a woman who made the
decision to terminate with a dry eye. I hold them in my arms while they

Maybe, if those who judge could sit in the exam room with Diane
and her grandma, they would understand that, as a society, we must do
all we can to avert such unintended pregnancies… and sometimes we must
weigh one life against another.

In the interest of privacy, the names and some identifying details of the women discussed in this post have been changed. 

You may also want to listen to this radio interview with Patricia Harman or read this excerpt of The Blue Cotton Gown.

This post was first published at the Beacon Broadside.

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  • marysia


    Please don’t assume that people who disagree with you on abortion "sit in judgment" of women faced with difficult pregnancies.  I for one have been doing my damnedest for years to help women with choices other than abortion. 


    It’s because I care for women with such grave problems, not because I sit high above them in lofty judgment about who they are and how they conduct their sex lives.  In fact, I myself conceived and bore and raised an unplanned child before I was married, in conditions of hardship.   And now I am doing everything I can to help my own beleagured college student daughter with her own unplanned and congenitally disabled child.  How could I have complicity in any callousness and hostility towards women like us and still sleep at night?


    I also mourn the fact that so many women, like your client, who fear their fetuses might turn out disabled, have abortions…not because I sit in judgment, but because I am disabled myself and have to question why this society as a whole does not extend a hospitable, comprehensive, lifetime welcome to people like me, before or after birth.


    Prolife to me is not about stern, unforgiving impositions of judgment…it is about the daily work of making life bearable and happy as possible, for all humans, born and unborn (and for other-than-human lives as well).



  • invalid-0

    it is about the daily work of making life bearable and happy as possible, for all humans, born and unborn (and for other-than-human lives as well).

    So, how do you propose to make life ‘happy’ for a raped 12 year old who is being forced to carry the product of that rape to term? Hospice?

  • marysia

    It would depend on the particular situation of the particular 12 year old and her unborn child.  I cannot tell you what that means without knowing their circumstances.

     I do know that human beings, even so young, have survived and even thrived despite rape and/or non-aborted unplanned pregnancy–to have these things happen is not necessarily a death sentence, horrific as they are. People can be remarkably resilient.  I would never condemn anyone to perpetual "victimhood" no matter what horrors they have endured, but encourage along their strengths.–and not in any blithe, uncomprehending, pollyannish manner, either!


     I do not say this lightly, but from a position of knowing myself what it is like to be utterly shattered this way, and witnessing and helping along the lives of others who have dealt with such things themselves.

    And otherwise, I advocate and work for rape prevention, child abuse prevention, male responsibility, access to emergency contraception, healing services for those who have been raped….you have gotten me wrong, I do not think just passing a legal ban on abortion is going to help, there have got to be real, substantive alternatives to it and that’s the most important thing.


  • http://www.michellesteele.com invalid-0

    I think if people are pro-life then fine, they don’t have to have abortions. They should really leave the decisions of other women to be made on their own. A baby should not be brought into this world just because it was conceived. The person carrying the child should be able to make the ultimate decision of whether they are going to have the child or not. It is their body, they are the life support while that child is in the womb. A woman should not be forced to have a child just because pro-lifers want to save a life. What about a thinking, breathing, aware woman? Should she not have as much rights to her own body. The twelve year old girl should not be forced to carry a child because she was raped. It was not her decision to be raped but it should be her decision whether she carries the child to term or not. Her body is her business, not the pro-lifers. And Sarah Palin, well don’t even let me get started on her, I could go on for days.

    By the way, I do not condone abortion as a birth control method. I think if we educate women about their bodies and cycles we could reduce the amount of abortions.

  • invalid-0

    It just amazes me that people would wish to force a 12 year old child who’s already been raped to carry on with the pregnancy. It’d be like carrying around a piece of the person who’d raped you, and being violated by him for nine months. Most adults would find that traumatic, but I can barely imagine the suffering it would cause a child. It would just be unspeakably cruel to force her to stay pregnant. To me, alleviating the suffering of those who are already in the world is so much more important than bringing new lives into the world.

  • invalid-0

    And add to that the dangers of a child that young delivering a baby. though a 12 yr old can conceive their bodies are not mature enough to handle the dangers of pregnancy. But that is really not the issue-as others have said: If you don’t beleive in abortion don’t have one but don’t take away other women/girl’s rights over their own bodies!

  • http://www.dcabortionfund.org invalid-0

    This was an incredibly touching post that reminds us that the best arguments for being pro-choice are built upon hearing stories of women — who like 1 in 3 American women of child-bearing age — who have decided to terminate a pregnancy.

    For those facing similar circumstances who may need clinic referrals and/or financial assistance, here are a few resources:

    The DC Abortion Fund (http://www.dcabortionfund.org) is an all-volunteer non-profit organization to offers grants to women in the DC metropolitan area. They offer clinic referrals and financial assistance to women who have decided to terminate a pregnancy but still face financial obstacles that prevent them from getting the care they need.

    The National Network of Abortion Funds (http://www.nnaf.org) is an umbrella organization made up of local groups (like the DC Abortion Fund listed above) throughout the country who may be able to make a donation to a clinic on a woman’s behalf. Use the website’s clickable map to find a local abortion fund near you.

    The National Abortion Federation Hotline (1-800-772-9100; http://www.prochoice.org) offers referrals to its member clinics as well as funding assistance for those who qualify. It is a nationwide, toll-free hotline and its hours are M-F 8-11, Sat and Sun 9-5.