A Parent's Loving Decision

We often say in my grief support group that as parents, we make decisions every day on behalf of our children.

Starting with some of the earliest decisions around breastfeeding versus bottle-feeding, to consequences for the stubborn toddler, to how much screen time to allow, to how to pay for college – these decisions are daily, sometimes small, and sometimes life-changing. All are made because the parents are doing what they believe is best.

I cannot begin to describe the level of devastation I felt yesterday upon reading that Ohio had banned a common procedure that occurs in the second trimester of pregnancy called a dilation and evacuation, or D&E. Anti-abortion advocates cheered and I have to wonder if lawmakers didn’t understand why some pregnancies are ended in the second trimester, or didn’t care. Let me be upfront in saying that I believe a woman has a right to choose under any circumstance, but second trimester bans affect me deeply because I know parents are sometimes making the most difficult decision of their lives: to terminate a much-wanted pregnancy.

I know parents who have chosen to end pregnancies due to medical issues with their babies. Doctors who slap on the term “incompatible with life” as though that is supposed to make the diagnosis more clinical and less shattering. Babies who will never take a breath, survive only a few hours, or spend a very short life suffering. Babies who are found through screening to have severe chromosome issues. Parents who head into that 20-week ultrasound ready to find out the gender of their baby, only to be given the worst news of their lives. I can tell you the names that these parents had chosen for their babies.

A D&E procedure was one of the choices I had to deliver Iris, after she had died. But the local hospital would not do the procedure, so instead I would have needed to wait three days (through the weekend) and drive to a hospital in Chicago to have the procedure done by a doctor that I had never met. Or I could stay at the local hospital and have labor induced. A D&E would have been a much shorter procedure, but I couldn’t bear the thought of being pregnant with a baby that had died for three more days. So instead, I chose Labor & Delivery. A fourteen-hour labor, with an epidural, and time spent checking in and time that elapsed before I could be discharged. Overall, a traumatic experience drawn out so much more than a D&E would have been, but at the end I was home, not pregnant any more, a day earlier than I otherwise would have been.

Later, I reflected on how unfair it was that my choices were to either wait three days or have a longer delivery process. I cannot imagine if I were living in Ohio and now the only option would be to travel to another state, instead of another city.

I know a mother who wanted to go through Labor & Delivery, so that she could meet and hold her daughter who had been given a fatal diagnosis. But complications made D&E the much safer option. She is still haunted by that. And if D&E were not available to her, then what? Risk her own health to deliver?

After learning the Nelle was growth restricted, measuring only 16 weeks at the 20 week ultrasound, I did a frantic amount of googling, trying to assure myself that intrauterine growth restriction meant that I could still deliver a healthy baby. Plenty of random forums would say “Oh yeah, my baby was measuring small for gestational age and was born fine!” Most of these had growth restriction much later in the pregnancy, when the baby is viable and could be delivered early. None referred to growth restriction so severe so early as mine. I tried to tell myself that she would be fine, just petite, but the doctor’s words echoed in my ears while we waited for the results of the amniocentesis: “She may never grow or develop normally.”

Ger and I had the difficult conversation: what would we do, depending on the results of the testing, or if the next ultrasound showed no further growth? Hypothetical as it was at that point, we knew the seriousness and having the conversation in advance might mean that we could think more clearly. As if that were possible. I remember sobbing and cradling my pregnant belly and saying “I don’t know if I could, I couldn’t do it, it’s my baby.” But in my head, I knew. I knew that if we were told that nothing could be done for our daughter, what the decision would be.

And when Ger met me at the hospital after Nelle had died, he said “She made a decision, so we didn’t have to.”

Quoted in SELF Magazine, Lauren Streicher, M.D, an associate prodessor of clinical obstetrics and gynecology at Northwestern University Feinburg School of Medicine says “When you look at the reason behind these terminations [after the first trimester], overwhelmingly these are for pregnancies that are problematic—a fetal anomaly, perhaps something that is incompatible with life. For the most part, these are desperately desired pregnancies.”

I met a couple recently that were heartbroken over the decision that they made for their baby, after learning at their 20-week ultrasound that their baby had several severe anomalies. The mother described going back-and-forth to Chicago in order to obtain the procedure to end her pregnancy and I winced, envisioning all too well what that process would have been like.

Our support group leader said gently to them “As parents, you made a decision for your baby, and that decision was made out of love.”