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A choice of maternal compassion

Anonymous
Physician
May 27, 2022
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It was supposed to be a routine 20-week ultrasound appointment. The specialist abruptly knocked and entered. The next few hours of my life went by in choppy, disconnected segments. The specialist said he was sorry. Her bones were not growing properly. Her rib cage was small. Her lungs were underdeveloped. This baby, whom I had allowed myself to love and believe in after my normal prenatal testing and ultrasounds, living and moving in my body, would likely not live beyond a few days from birth if she made it that far. Her small lungs would not support her, and she would asphyxiate to death.

The decision I made did not feel like a decision. It didn’t take days nor even minutes of deliberation. I knew what I had to do – so did my husband. After a scramble of two weeks, rushing to get multiple consultations that were in unanimous agreement, the course was clear. With heavy hearts, we entered the procedure room where we met with kind nurses and doctors, most with tears in their eyes, and watched as a lidocaine injection through the skin of my gravid belly painlessly and within seconds stopped the beating of her heart. She lay motionless in my uterus on the ultrasound, devoid of life.

I live with the last nurse’s words that reduced my stoic face to tears as she turned to leave us alone after the termination. “I just want you to know you made an incredibly brave, compassionate, and selfless decision.”

Most intuitively know that there is worse suffering than death. We, as physicians, know this. In the traumatic recesses of our minds live the anguished memories of the death and dying in hospitals. Even the most stringent anti-abortion law will allow termination when the mother’s life is in danger, proof to me that anti-abortion supporters understand the life of a fetus is not equivalent to the life of a living human and that the pain of a living human is worse than the pain of an unborn one.

Despite a situation where the answer was clear, the path to getting a termination was fraught with difficulty. It is not easy to find a provider who can or will perform a second-trimester abortion. Amniocenteses are often ordered to help decide but can take several weeks to return. Outside of terminations to protect the mother’s life, insurance often does not cover terminations, and the cost for us was nearly ten thousand dollars out of pocket. We decided the day we received the news, yet it took two and a half weeks to complete; we terminated just two days shy of the 24-week cut-off for viability. Despite both being physicians and possessing the means and knowledge to navigate our medical system, we almost didn’t get to make the choice.

Yet we were fortunate. If we lived in Texas or several other states that have passed stringent abortion laws, we would be forced to carry to term. My OB, rendered powerless, would help deliver my baby and then watch with the rest of us as she suffocated to death.

In the wake of my grief, countless of women, some close family and friends, have shared stories of abortions they’ve had — some like me for medical anomalies, others who understood the ramifications of a new baby on their family. They are silenced by societal shame and trauma. Though I know we did the right thing, I know many would brand me the murderer of my child. I now understand that there is no mother that wants to have an abortion, yet the decision to do so is made after weighing things possibly worse than death in the balance. Maternal love understands all costs at stake. The moral complexity that underpins these decisions is not for others to judge; it is only for the woman who holds this child in her uterus to decide. The government has no role in dictating a singular script when each person holds their version to preserve the sanctity of life. On the eve of when an overturning of Roe versus Wade seems inevitable, I feel incredible anger and sadness for those future women struggling to make one of their most difficult life decisions. We will be turning our backs on throngs of ordinary women.

We named her Atma, Sanskrit for the indestructible undifferentiated conscious spark that animates each living being. Despite our loss, life keeps ticking onwards. Gifted with a black thumb, I have ironically started gardening, planting hydrangeas and peonies. As I carefully plant each one, I take time to notice the sun on my skin, the breeze through our old birch tree, the damp crumbly soil, and the earthworm. I go to work with renewed energy. I cherish moments with loved ones. I forgive and forget more easily. In a seemingly senseless tragedy, I still find Atma’s short existence on this plane had profound meaning. It was her death that taught me more about living.

Post mortem genetic testing on Atma showed she had thanatophoric dysplasia type I. A quick Google image search made me cry – out of terror for those babies afflicted and out of relief that Atma was released from such a fate. I may become the definition of a felon in some states, yet I remain eternally grateful for my freedom to choose. It allowed the expression of my last wish for her, borne out of the depths of maternal compassion. I can only hope for this same freedom for all mothers everywhere.

The author is an anonymous physician.

Image credit: Shutterstock.com

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A choice of maternal compassion
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