Madeleine Albright, Pregnancy Complications, SCOTUS, and Me

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My admiration for Madeleine Albright began when she was confirmed as the first female US secretary of state, and chapter four of Albright’s memoir, Madam Secretary, confirmed my love for her. Albright describes her pregnancy’s complication from hydramnios, a condition in which too much amniotic fluid causes brain and heart damage to the fetus and an allergic reaction in the mother. Despite being a devout Catholic, Albright inquired about having an abortion; but in 1966, terminating pregnancies was illegal. Albright had to wait for three months to discover the outcome of her pregnancy. She wrote, “These months were silent, scary, crushing, horrible.” She gave birth to a stillborn baby.

Albright published in 2003, a decade before I began my own childbearing. But my experience bound me ever closer to Secretary Albright. When I was nine weeks pregnant, my doctors diagnosed my fetuses with twin-to-twin transfusion syndrome (TTTS). TTTS is a leading cause of handicap and death in identical twin pregnancies. Untreated TTTS results in virtually certain death of at least one fetus, likely brain and heart damage of the surviving fetus, and potential hemorrhaging of the mother. The smaller of my fetuses also suffered selective intrauterine growth restriction (sIGUR) and a compromised umbilical cord and placenta.

The doctors tracking my pregnancy told me that I was at the very edge of science. No one knew what the interplay of TTTS and sIUGR, along with the cord and placental share issues faced by the smaller twin, could mean for the pregnancy or for long-term neurological outcomes of any babies born. I tried to obtain fetal laser surgery after the nineteenth week of pregnancy, but several hospitals denied my requests. My surgeon offered me a coagulation of the smaller fetus’ umbilical cord to try to save the larger twin, but a good outcome for the larger twin was uncertain. When I was 21 weeks pregnant, my doctor suggested I find a provider who would terminate the pregnancy. 

Like Albright, I am Catholic. I had to buck my family and my religion to consider terminating a presumably nonviable pregnancy. Like Albright, my entreaties for medical intervention in my pregnancy were denied. My hospital did not permit terminations, and few medical providers in the US are trained to terminate pregnancies after 20 weeks. Albright and I both had to wait until we gave birth to find out who would survive the pregnancy. That waiting was a torture. As Albright wrote, “[T]he experience made it clear to me that a woman should have the right to choose,… whether the reason relates to the health of the fetus, or the woman’s own health, or other sad circumstances.” 

I agree. The Supreme Court now is deciding Dobbs v. Jackson Women’s Health Organization. The court’s ruling in Dobbs likely will return the United States to 1966, permitting all states to outlaw abortions. I hope, before it requires pregnant people to suffer the silent, scary, crushing, and horrible months of carrying dying fetuses, the Supreme Court will listen to women like Secretary Albright and me.

Read my book about twins (and healthcare access.

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Genevieve Grabman is a policy and communications lead at the United Nations High Commissioner for Refugees. She previously served as director of Government Relations for Physicians for Reproductive Health. An attorney, she has worked for the World Health Organization and the Pan American Health Organization. Grabman is author of The Technology Takers: Leading Change in the Digital Era. She lives in Washington, DC.

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