My Late-Term Abortion

President Bush’s attempt to ban partial-birth abortions
threatens all late-term procedures. But in my case,
everyone said it was the right thing to do—even my
Catholic father and Republican father-in-law.

By Gretchen Voss

The Boston Globe
http://www.boston.com/news/globe/magazine/articles/2004/01/25/my_late_term_abortion?mode=PF

1/25/2004

Way too excited to sleep on that frigid April morning,
I snuggled my bloated belly up to my husband, Dave.
Eighteen weeks pregnant, today we would finally have
our full-fetal ultrasound and find out whether our baby
was a boy or a girl. I had no reason to be nervous, I
thought. I was young (if 31 is the new 21), healthy,
and had not had so much as a twinge of nausea. Well
into my second trimester, I was past the point of
worrying about a miscarriage.

The past 3 1/2 months had been a time of pure bliss —
dreaming about our future family, squirreling away any
extra money that we could, and cleaning out a room for
a nursery in our cozy, suburban home, then borrowing
unholy amounts of stuff to fill it back up. From the
day that we found out we were expecting a baby — on
New Year’s Eve 2002 — we thought of ourselves as
parents, and finding out whether the "it" was a he or
she would cap the months of scattershot emotions and
frenetic information-gathering. I just couldn’t sleep.
I invited our 105-pound yellow Labrador "puppy" into
bed with us and snuggled even closer to Dave.

Later that morning, at quarter past 9, Dave held my
hand as I lay on the cushy examining table at the Beth
Israel Deaconess Medical Center office in Lexington. As
images of our baby filled the black screen, we oohed
and aahed like the goofy expectant parents that we
were. "Can you tell if it’s a boy or a girl?" I must
have asked a million stupid times. The technician was
noncommittal, stoic, and I started feeling
uncomfortable. Where I was all bubbly chitchat, she was
all furrow-browed concentration. She told us that she
had a child with Down syndrome, and that none of her
prenatal tests had picked it up. I thought that was
odd.

Then, using an excuse about finishing something on her
previous ultrasound, she left the room. Seconds passed
into minutes while we waited for her to return. Staring
at the pictures of fuzzy kittens and kissing dolphins
on the ceiling, I knew something was wrong. Dave tried
to reassure me, but when the ultrasound technician told
us that our doctor wanted to see us, I started to
shake. "But she doesn’t even know we’re here," I said
to her, and then to Dave, over and over. That’s when I
started crying. I could barely get my clothes back on.

The waiting room upstairs, usually full of happy
pregnant women devouring parenting magazines, was
empty. Our doctor, who usually wears a smile below her
chestnut hair, met us at the front desk. She was not
smiling that day as she led us back to her cramped
office, full of framed photos of her own children.

As we sat there, she said that the ultrasound indicated
that the fetus had an open neural tube defect, meaning
that the spinal column had not closed properly. It was
a term I remembered skipping right over in my pregnancy
book, along with all the other fetal anomalies and
birth defects that I thought referred to other people’s
babies, not mine. She couldn’t tell us much more. We
would have to go to the main hospital in Boston, which
had a more high-tech machine and a more highly trained
technician. She tried to be hopeful — there was a wide
range of severity with these defects, she said. And
then she left us to cry.

We drove into Boston in near silence, tears rolling
down my cheeks. There was no joking or chatting at the
hospital in Boston. No fuzzy kittens and kissing
dolphins on the ceiling of that chilly, clinical room.
Dave held my hand more tightly than before. I couldn’t
bear to look at this screen. Instead, I studied the
technician’s face, like a nervous flier taking her cues
from the expression a stewardess wears. Her face
revealed nothing.

She squirted cold jelly on my belly and then slid an
even colder probe back and forth around my belly
button, punching it down every so often to make the
baby move for a better view. She didn’t say one word in
45 minutes. When she finished, she looked at us and
confirmed our worst fears.

Instead of cinnamon and spice, our child came with
technical terms like hydrocephalus and spina bifida.
The spine, she said, had not closed properly, and
because of the location of the opening, it was as bad
as it got. What they knew — that the baby would
certainly be paralyzed and incontinent, that the baby’s
brain was being tugged against the opening in the base
of the skull and the cranium was full of fluid — was
awful. What they didn’t know — whether the baby would
live at all, and if so, with what sort of mental and
developmental defects — was devastating. Countless
surgeries would be required if the baby did live. None
of them would repair the damage that was already done.

I collapsed into Dave. It sounds so utterly naive now,
but nobody told me that pregnancy was a gamble, not a
guarantee. Nobody told me that what was rooting around
inside me was a hope, not a promise. I remember
thinking what a cruel joke those last months had been.

We met with a genetic counselor, but given the known as
well as the unknown, we both knew what we needed to do.
Though the baby might live, it was not a life that we
would choose for our child, a child that we already
loved. We decided to terminate the pregnancy. It was
our last parental decision.

So this is our story — mine, my husband’s, and our
baby’s. It’s not a story I ever thought I’d share with
a mass audience, because, frankly, it’s nobody’s
business. But now it is.

n November 5, George W. Bush signed the first federal
ban on any abortion procedure in the 30 years since Roe
v. Wade, and the first ban of a surgical technique in
the history of this country.

"I’m pleased that all of you have joined us as the
Partial-Birth Abortion Ban Act of 2003 becomes the law
of the land," Bush said. After singling out 11
political supporters of the bill — all of them men —
the president whipped the 400-strong, antiabortion
crowd into a frenzy. "For years a terrible form of
violence has been directed against children who are
inches from birth, while the law looked the other way,"
he said to cheers and whoops and hollers.

The signing ceremony staged by the White House was part
evangelical tent revival, part good ol’ boy pep rally,
ending with the audience muttering "Amen." The
president stoked the crowd’s moral indignation with
emotional platitudes like "affirming a basic standard
of humanity" and "compassion and the power of
conscience" and "defending the life of the innocent."

But on that Wednesday afternoon, President Bush never
addressed what, exactly, the ramifications of the bill
would be. His administration portrayed it as a bill
aimed solely at stopping a "gruesome and barbaric"
procedure used by healthy mothers to kill healthy
babies. That portrayal served to spark a national,
emotional knee-jerk reaction, which precluded any
understanding of the practical outcome of the
legislation. But it was those very real practicalities
that immediately prompted three lawsuits and got three
federal courts to prevent the bill from actually
becoming law, starting a fight that will probably drag
on for years.

At the heart of the debate is a term that legislators
concocted. They created a nonexistent procedure —
partial-birth abortion — and then banned it. They then
gave it such a purposely vague definition that,
according to abortion providers as well as the Supreme
Court, which ruled a similar law in Nebraska
unconstitutional, it could apply to all abortions after
the first trimester.

Though some proponents of the bill say that they merely
want to ban a specific medical procedure — properly
called intact dilation and extraction, which accounts
for fewer than one-fifth of 1 percent of all abortions
in this country, according to a 2000 survey by the Alan
Guttmacher Institute — they never specifically called
it that. Instead, the bill is written in such a way
that the much more common procedure — dilation and
evacuation, which accounts for 96 percent of second-
trimester abortions, including my own — would also be
banned.

Supporters of the ban have argued that this procedure
is used on babies that are "inches from life." But in
the bill, there is no mention of fetal viability (the
point at which a fetus could live independently of its
mother for a sustained period of time). Nor is there
any mention of gestational age. Thus, the ban would
cover terminations at any point during pregnancy. (In
fact, Roe v. Wade already protects the rights of a
fetus after the point of viability, which occurs
sometime after the 24th week of gestation, in the third
trimester of pregnancy. Massachusetts bans all
abortions at and beyond the 24th week, except to
protect the life or health of the mother. Indeed,
according to the Massachusetts Department of Public
Health, in 2001 there were only 24 abortions after the
24th week, out of a total of 26,293 abortions.) By not
mentioning viability, critics say, this ban would
overturn Roe v. Wade, which clearly states that women
have the right to abortion before fetal viability.

So what does it all really mean? It means that all
abortions after the first trimester could be outlawed.
No matter if the fetus has severe birth defects,
including those incompatible with life (many of which
cannot be detected until well into the second
trimester). No matter if the mother would be forced to
have, for example, a kidney transplant or a
hysterectomy if she continued with the pregnancy.
(Legislators did not provide a health exception for the
woman, arguing that it would provide too big a
loophole.)

In the aftermath of the signing of the bill, its
supporters spoke about having outlawed a medical
procedure and protecting the nation’s children. "We
have just outlawed a procedure that is barbaric, that
is brutal, that is offensive to our moral
sensibilities," said Bill Frist, the Senate majority
leader. Its opponents bemoaned an unconstitutional
attack on legal rights. "This ban is yet another
instance of the federal government inappropriately
interfering in the private lives of Americans,
dangerously undermining . . . the very foundation of a
woman’s right to privacy," said Gregory T. Nojeim, an
associate director and chief legislative counsel for
the American Civil Liberties Union.

But lost in the political slugfest have been the very
real experiences of women — and their families — who
face this heartbreaking decision every day.

don’t know what was worse, those three days leading up
to the procedure (I have never called it an abortion)
or every day since. I clung to Dave. He was always the
rock in our relationship, but I now became completely
dependent on him for my own sanity. Though abortion had
never been part of his consciousness, he was resolved
in a way that my hormones or female nature or whatever
wouldn’t let me be. But I worried about him, too. The
only time I saw him crack was after his brother — his
best friend — left a tearful message on our answering
machine. Then I found Dave kneeling on the floor in our
bathroom, doubled over and bawling, his body quaking.
That nearly killed me.

I don’t remember much from those three days. Walking
around with a belly full of broken dreams, it felt like
what I would imagine drowning feels like — flailing
and suffocating and desperate. Semiconscious.
Surrounded by our family, I found myself tortured by
our decision, asking over and over, are we doing the
right thing? That was the hardest part. Even though I
finally understood that pregnancy wasn’t a Gerber
commercial, that bringing forth life was intimately
wrapped up in death — what with miscarriage and
stillbirth — this was actually a choice. Everyone
said, of course it’s the right thing to do — even my
Catholic father and my Republican father-in-law,
neither of whom was ever "pro-choice." Because
suddenly, for them, it wasn’t about religious doctrine
or political platforms. It was personal — their son,
their daughter, their grandchild. It was flesh and
blood, as opposed to abstract ideology, and that
changed everything.

I was surprised to find out that I would no longer be
in the care of my obstetrician, the woman who had been
my doctor throughout my pregnancy. It turned out that
she dealt only with healthy pregnancies. Now that mine
had gone horribly wrong, she set up an appointment for
me with someone else, the only person who was willing
to take care of me now. I felt like an outcast.

As we drove to his private office in Brookline that
Monday, April 7, 2003, I couldn’t shake the feeling
that we were going to meet my executioner. I had never
met this doctor, but I did look him up online. With
thick, mad-scientistlike glasses, he looked scary. In
person, though, he reminded me in both looks and manner
of Dr. Larch in The Cider House Rules. He had the
kindest, saddest eyes I had ever seen, and he sat with
us for at least an hour, speaking to us with a
heartfelt compassion and understanding that I had never
encountered from any doctor before. His own eyes teared
as Dave and I cried.

He explained the procedure to us, at least the parts we
needed to understand. Unlike a simple first-trimester
abortion, which can be completed in one quick office
visit, a second-trimester termination is much more
complicated, a two-day minimum process. He started it
that day by inserting four laminaria sticks made of
dried seaweed into my cervix. It was excruciating, and
he apologized over and over as I cried out in pain.
When I left the examining room, my mom and my husband
were shocked — I was shaking and ghostly white. The
pain lasted throughout the night as the sticks
collected my body’s fluids and expanded, dilating my
cervix just like the beginning stages of labor.

The next morning, Dave and my mother took me to the
hospital in Boston. I was petrified. I had never had
any sort of surgery, and I fought the anesthesia —
clinging to the final moments of being pregnant — as I
lay in that stark white room. As I started to drift
off, my doctor held one of my hands, and an older,
female nurse held my other, whispering in my ear,
"You’re going to be OK, I’ve been here before, lean on
your husband." It was my last memory. When I woke up,
it was all over.

Dave had to return to work the next day. He didn’t want
to leave me, and he certainly didn’t want to return to
the furtive stares of his co-workers, all of whom knew
that we had "lost the baby." I really don’t know how he
did it. My mother stayed with me at home for the next
week, trying to glue my shattered pieces back together
with grilled cheese sandwiches and chicken noodle soup.
I had no control over my emotions. I felt like a freak
in a world full of capable women having babies, and I
couldn’t stop whimpering: Why did my body betray me?

For months, I hid from the world, avoiding social
outings and weddings. I just couldn’t bear well-meaning
friends saying, "I’m so sorry." So I quarantined
myself, and would try to go about my day — but then,
bam, heartbreak would come screaming out of the
shadows, blindsiding me and leaving me crumpled on the
floor of our house. It wasn’t that I was questioning
our decision. I knew we did it out of love, out of all
the feeling in the world. But I still hated it. Hated
it.

I wrote my doctor a long thank-you note on my good,
wedding stationery. I thanked him for his compassion
and his kindness. I wrote that it must be hard, what he
does, but that I hoped he found consolation in the fact
that he was helping vulnerable women in their most
vulnerable of times. He keeps my note, along with all
the others he’s received, in a large bundle. And he
keeps that bundle right next to his stack of hate mail.
They are about the same size.

he trio of lawsuits that has been filed points to the
Supreme Court’s decision three years ago that
overturned a similar so-called partial-birth abortion
ban in Nebraska. The court, in Stemberg v. Carhart,
ruled in a narrow, 5-4 decision that the ban was
unconstitutional on two grounds: the lack of an
exception to protect a woman’s health; and the fact
that the ban would prohibit even the most commonly used
and medically safe abortion procedures throughout the
second trimester of pregnancy. Many legal scholars
think that this federal ban will also be ruled
unconstitutional on those same grounds.

Because of the lawsuits, the Partial-Birth Abortion Ban
Act of 2003 cannot be enforced, though it could be
years before the abortion debate winds its way through
the system and heads back to the Supreme Court. By that
time, the composition of the court could be entirely
different. "We are looking for a permanent restraining
order," says Petra Langer, the director of public
relations and government affairs for the Planned
Parenthood League of Massachusetts. "Who knows what the
long-term situation will be? If George Bush is
reelected, all bets are off, unfortunately."

But even the short-term situation is bleak. The doctor
who performed my termination has stopped doing the
procedure, worried that he might get caught up in a
lawsuit. He is not a lawyer or a politician, and he
doesn’t know what this law means for him right now. "I
may go to jail for two years," he tells me. "They can
suspend my medical license. It would cost me a fortune
to have a lawyer to defend me."

His fears are justified. "There are bunches of doctors
out there who could be prosecuted today under this
legislation," says Roger Evans, a lawyer for the
Planned Parenthood Federation of America. The three
injunctions cover only doctors who are affiliated with
Planned Parenthood clinics, who are members of the
National Abortion Federation, or who are one of the
individual plaintiffs in the Nebraska suit. This leaves
"scores of doctors who, if they perform an abortion
that falls under the very broad definition of the
banned procedure, could be prosecuted," he says.

The doctor who performed my termination talks about the
women he has helped through the years — the pregnant
woman who was diagnosed with metastic melanoma and
needed immediate chemotherapy, the woman who was
carrying conjoined twins that had only one set of lungs
and one heart, the woman whose baby had a three-
chambered heart and would never live. Now, he is
turning these women away. "Now, today, I can say no,
but what is she going to do?" he says sadly. "What is
she going to do?"

ay too nervous to sleep on that frigid morning this
past November, I snuggled my bloated belly up to my
husband and curled into a little question mark. Sixteen
weeks pregnant, today we would finally have our full-
fetal ultrasound, finding out whether our baby was
developing normally. Given what happened the last time,
I had every reason to be nervous.

The last four months had been a sort of emotional no
man’s land where the baby was concerned. While we were
elated to be pregnant again, we were also terrified. It
was hard to become fully attached to this pregnancy,
knowing that it could be taken away from us. Instead of
shopping for layettes, we were consulting genetic
counselors. We now knew all too well that pregnancy was
a hope, not a promise.

In the lobby at Beth Israel, I shoved my face into a
tattered Redbook, waiting for Dave. As soon as he
walked in, I started crying. "I’m so scared," I said.
"I know, but everything is going to be OK," he
answered, and gave me a hug.

Dave held my hand tightly as I lay down on the
examining table. This time, the technician was chatty
and jokey, while I was silent and concentrating. She
pointed out the kidneys and the stomach, the two
hemispheres of the brain, and the four chambers of the
heart. I started to feel more optimistic. Everything
looked fine, she said. She printed out pictures for us.
She asked us if we wanted to know if it was a boy or a
girl. She never left the room.

My doctor said the ultrasound was completely normal.
Completely normal. They were the words I craved to
hear, but at the same time seemed almost impossible to
believe.

As the rest of our prenatal testing results started to
pile up, all of them completely normal, we began to let
hope back into our hearts. Of course, we know that
anything can happen at any time. We’ll never forget
that. There will be many more months of worry — and
then, I guess, a lifetime more. At least for now,
though, things look hopeful for our son. But I worry
about my friends who are planning to have children now
and in the near future, friends who are as naive as I
once was. It’s a different world these days. "Now, it’s
like the Stone Age, it’s like a Muslim country here,"
says the doctor who performed my procedure. "This is
the most backward law, it is not for a civilized
country. If this was Iran, Iraq, I wouldn’t be
surprised. But to pass this law in the United States,
what is this government doing?"

Gretchen Voss is a freelance writer.