During the U.S. Supreme Court oral argument for Dobbs v. Jackson Women’s Health, Justice Amy Coney Barrett, the mother of seven biological and adopted children, wondered why adoption does not obviate the need for abortion. One answer, provided by the attorney for Mississippi abortion providers, is that pregnancies can be deadly for the people who bear them. Attorney Julie Rikelman cited Mississippi’s exceedingly high maternal mortality rate, which poses 75 times the risk of death as a pre-viability abortion. Mississippi’s infant mortality rate is equally deplorable and is the highest in the United States. No matter what happens after the pregnancy, requiring people to remain pregnant when they cannot, should not, or will not is a violation of their right to liberty — and it also can violate the pregnant person’s own right to life.
My story is one of many. While still nursing another baby, I got pregnant with almost-conjoined twins who were sick with a very rare condition called twin-to-twin transfusion syndrome. My pregnancy was a disaster, imperiling my life and the fetuses I carried. Although I tried mightily to save the pregnancy and both fetuses, anti-abortion politics hidden in technical and regulatory barriers prevented willing doctors from being able to help me. Anti-abortion politics determined the procedures, tools, and medicines doctors could use to maintain my pregnancy. Anti-abortion politics dictated where I could give birth and which hospitals were willing to treat me. Anti-abortion politics even muzzled my doctors, controlling what words they could say to advise me on my own health.
I describe the effect of abortion stigma on my pregnancy in my book, Challenging Pregnancy: A Journey through the Politics and Science of Healthcare in America, which was released for presale in time for the Dobbs argument. Because abortion is a challenging topic, I draw readers in with my twins’ story and then walk them through the anti-abortion insanity that is a high-risk pregnancy and birth in America.
Fearing that saving one twin would abort the other, two hospitals denied my surgeons’ requests to perform intrauterine laser surgery to separate my twins. I was discharged to another doctor whose office was at a Catholic hospital. According to my doctor, there was little chance the pregnancy would end with healthy children and a healthy me; the best course of action would be to terminate the pregnancy. But given the location of his office, my doctor could only whisper this advice to me and slip me an address of an abortion clinic. I kept searching for another surgeon — anywhere in the world — who could operate to save at least one twin. By the time my pregnancy advanced beyond when surgery would have been possible, I had found no one willing to operate. Having no other choice, I ran the clock out until the end, wondering if my pregnancy would result in one, two, or three live people. I went into preterm labor, hemorrhaged, and gave birth to dangerously underweight twins with holes in their hearts.
Adoption will not resolve the dangers of maternity to the pregnant person, and prohibiting abortion has a perverse effect on those with wanted pregnancies. An abortion doctor saved my life and those of my twins. A former Planned Parenthood medical director, my doctor was able to salvage my pregnancy because of his skill in providing abortions. Creation is the flip side of destruction, and my doctor used his education and experience in terminating pregnancies to make the careful calibrations necessary to save mine. Six years later, my twins and I are completely fine.
By prohibiting abortions, Americans do themselves a great disservice: they drain the pool of physicians with the knowledge, skills, experience, and techniques to preserve a wanted pregnancy. Due to anti-abortion politics, abortion training is increasingly scarce in U.S. medical schools. New doctors therefore may not have the necessary skills or knowledge to resolve a miscarriage or a high-risk pregnancy. When she is in need and her pregnancy has been struck with a bolt from the blue, the anti-abortion voter or justice will face the consequences of her single-mindedness. No one will be left to save her.
Genevieve Grabman is the author of the forthcoming book, Challenging Pregnancy, which tells the story of her harrowing pregnancy with twins facing a rare and deadly syndrome while examining the politics of maternal healthcare in the US.
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