I could see my baby’s amazing and perfect spine, a precise, pebbled curl of vertebrae. His little round skull. The curve of his nose. I could even see his small leg floating slowly through my uterus.
My doctor came in a moment later, slid the ultrasound sensor around my growing, round belly and put her hand on my shoulder. “It’s not alive,” she said.
She turned her back to me and started taking notes. I looked at the wall, breathing deeply, trying not to cry.
I can make it through this, I thought. I can handle this.
I didn’t know I was about to become a pariah.
I was 19 weeks pregnant, strong, fit and happy, imagining our fourth child, the newest member of our family. He would have dark hair and bright eyes. He’d be intelligent and strong — really strong, judging by his early kicks.
And now this. Not alive?
I didn’t realize that pressures well beyond my uterus, beyond the too bright, too-loud, too-small ultrasound room, extending all the way to boardrooms of hospitals, administrative sessions at medical schools and committee hearings in Congress, were going to deepen and expand my sorrow and pain.
On November 6, 2003, President Bush signed what he called a “partial birth abortion ban,” prohibiting doctors from committing an “overt act” designed to kill a partially delivered fetus. The law, which faces vigorous challenges, is the most significant change to the nation’s abortion laws since the U.S. Supreme Court ruled abortion legal in Roe v. Wade in 1973. One of the unintended consequences of this new law is that it put people in my position, with a fetus that is already dead, in a technical limbo.
Legally, a doctor can still surgically take a dead body out of a pregnant woman. But in reality, the years of angry debate that led to the law’s passage, restrictive state laws and the violence targeting physicians have reduced the number of hospitals and doctors willing to do dilations and evacuations (D&Es) and dilations and extractions (intact D&Es), which involve removing a larger fetus, sometimes in pieces, from the womb.
At the same time, fewer medical schools are training doctors to do these procedures. After all, why spend time training for a surgery that’s likely to be made illegal?
At this point, 74 percent of obstetrics and gynecology residency programs do not train all residents in abortion procedures, according to reproductive health researchers at the National Abortion Federation. Those that do usually teach only the more routine dilation and curettage — D&C, the 15-minute uterine scraping used for abortions of fetuses under 13 weeks old.
Fewer than 7 percent of obstetricians are trained to do D&Es, the procedure used on fetuses from about 13 to 19 weeks. Almost all the doctors doing them are over 50 years old.
“Finding a doctor who will do a D&E is getting very tough,” says Ron Fitzsimmons, executive director of the National Coalition of Abortion Providers.
My doctor turned around and faced me. She told me that because dilation and evacuation is rarely offered in my community, I could opt instead to chemically induce labor over several days and then deliver the little body at my local maternity ward. “It’s up to you,” she said.
I’d been through labor and delivery three times before, with great joy as well as pain, and the notion of going through that profound experience only to deliver a dead fetus (whose skin was already starting to slough off, whose skull might be collapsing) was horrifying.
I also did some research, spoke with friends who were obstetricians and gynecologists, and quickly learned this: Study after study shows D&Es are safer than labor and delivery. Women who had D&Es were far less likely to have bleeding requiring transfusion, infection requiring intravenous antibiotics, organ injuries requiring additional surgery or cervical laceration requiring repair and hospital readmission.
A review of 300 second- trimester abortions published in 2002 in the American Journal of Obstetrics & Gynecology found that 29 percent of women who went through labor and delivery had complications, compared with just 4 percent of those who had D&Es.
The American Medical Association said D&Es, compared to labor and delivery, “may minimize trauma to the woman’s uterus, cervix and other vital organs.”
There was this fact, too: The intact D&E surgery makes less use of “grasping instruments,” which could damage the body of the fetus. If the body were intact, doctors might be able to more easily figure out why my baby died in the womb.
I’m a healthy person. I run, swim and bike. I’m 37 years old and optimistic. Good things happen to me. I didn’t want to rule out having more kids, but I did want to know what went wrong before I tried again.
We told our doctor we had chosen a dilation and evacuation.
“I can’t do these myself,” said my doctor. “I trained at a Catholic hospital.”
omg. trying not to cry, guys…