On Choice

 On this day of a historic election, with a newly seated Supreme Court justice who is likely to limit reproductive choice, I feel the need to share this. Go. Vote. Your vote matters. It matters to you and it certainly matters to me. As you vote, think of the real impact of your choices. And appreciate the fact that you do have choices. In the days to come, choices may become more limited for many women, if things trend as they seem to be trending today.

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Some years ago, we decided that we wanted to have a child. It was a decision made after years of preparation and a great deal of care.

We found ourselves pregnant quickly, but there was no heartbeat at 10 weeks. Based on the size of the embryo, development had stopped about a month earlier, before a heartbeat ever formed. The fact that I hadn’t miscarried or bled, or had any issues, made this what’s called a “Missed Miscarriage.” We were both devastated, despite being told that “this happens.”

Because the baby failed to miscarry naturally, we had to seek medical intervention. I had surgery and we were cleared to try again as soon as we were ready.

Our next two attempts both resulted in positive pregnancy tests that faded away by 6 weeks. Testing determined that our 10 week loss had done damage to my uterus, which was preventing new embryos from implanting. The solution was surgery, followed by hormones to rebuild my uterine lining. 

We implemented the solution and were overjoyed that our first attempt resulted in twins. Although I had only ever wanted one child, nothing in my life has felt as right as seeing those two heartbeats on the screen. I loved them with a fierceness I didn’t know I was capable of.

Testing showed that they were both healthy girls. I don’t think I have felt as happy in my life, before or since, than the weeks that I knew I was expecting two healthy girls. 

Our happiness came crashing down when Baby B, Zoe’s, water broke at only 17 weeks. In Europe, the standard of care for pre-viable premature rupture of membranes (PPROM) is to give antibiotics, encourage bedrest, and wait. The main risk is that an infection will develop, as the baby is no longer protected in her amniotic sac. Here in the US, my doctors, at a top research hospital that is currently saving babies born at only 22 weeks, refused to administer antibiotics. They told me that the risk to me was too great. The likelihood that I’d develop an infection was 100%, and if we took antibiotics it could mask that and would jeopardize my life. They urged me to induce labor immediately, if labor didn’t start on it’s own.

Baby A, Alexis, still had all of her water. Neither girl was showing any signs of distress. I understood the risks to my own life and reproductive health. It should have been my decision to take those antibiotics. I should have had the choice. There are hundreds or even thousands of stories out there of women who got the antibiotics and reached viability. But my ability to choose was overridden by people who thought they knew what was best for me and my babies.

We refused the induction and went home to wait. We were told that if we didn’t go into labor within 1 week, we actually had a good chance of making it to viability. The week passed. Then at one week, one day, Alexis’s water broke as well and contractions started. By the time we reached the hospital, her foot had come through my cervix. She was born the next morning, after passing away during labor. She was beautiful and absolutely perfect and the pain of losing her is beyond my ability to describe.

The infection the doctors had feared set in by that point. My uterus was having trouble contracting as a result. Zoe did not come for another 8 hours, by which point an adverse reaction to a medication left me in convulsions. I hemorrhaged so badly they estimate I lost over half of my blood volume. I never got to see or say goodbye to Zoe. My husband tells me she was beautiful like her sister. I was rushed to emergency surgery, and then a day in the ICU.  It was my choice to stay pregnant and take that risk. I am grateful every day that I got to make that choice, despite the consequences. 

After that, we were assured by our doctors that what happened was a fluke. A risk of a twin pregnancy that had experienced recurrent bleeding. So there was more surgery and more hormones, and amazingly, they led to a singleton pregnancy. Another little girl, who we named Quinn.

I asked the doctors for some additional monitoring during her pregnancy. They refused. As a result, we didn’t know until it was too late that my cervix had opened, allowing bacteria into my uterus once again. Emergency surgery was attempted, but despite its apparent success, Quinn’s water broke 48 hours later.

Again we were refused antibiotics. Again we were pushed to induce labor immediately. Again we made the choice to remain pregnant, so long as I wasn’t showing signs of infection and Quinn had enough water for lung development. 

At the hospital that has saved 22 week old babies, my daughter was born at 21 weeks, 3 days. She was born alive and spent her hour of life in my arms, and my husband’s arms. Feeling her move as I held her is the single most important memory I have, and it was the memory that got me through the grief that followed.

It was my choice to stay pregnant. I’m grateful I had that choice. But because I made it, Quinn suffocated to death as her lungs weren’t capable of breathing. I question myself every single day. I question if I made a selfish decision, trying to keep her alive. I wonder if the better thing to do, for her, would have been to induce labor earlier, and let her pass warm, inside, as her older sisters did. That would have spared her the horror and perhaps the pain of the death that she experienced. 

The reality is that I made a choice. I have to live with it. But I believe that every parent should have the right to make that choice. I honestly can’t tell you what I’d do if faced with the same situation a third time. But I can tell you that just as antibiotics should have been my choice, knowing the risks to my body, termination or continuation of the pregnancy should always be my choice. As a parent, I owe it to my children to make those choices on their behalf, with their best interests in mind – even with the knowledge that perhaps the best interest means ending their lives. No parent ever wants to be in that situation. No parent ever should be in that situation. Still, many of us are. The choice should be ours.