The forgotten women in the abortion debate
The peril of polarized thinking is that we glorify those who share our views while demonizing those who don’t, thus blocking our empathy and compassion for considerable segments of humanity. Nowhere is this more evident than in the factions that have come to be identified, often stridently, as pro-life or pro-choice.
As the Supreme Court is again poised to address the legality of restricting access to abortions, as states are pushing to outlaw ALL abortions, elements of this complicated and emotional issue are predictably stripped of nuance.
As part of my work, I facilitate an ongoing support group that meets at Duke for women who have terminated a wanted pregnancy due to a devastating prenatal diagnosis or serious maternal health complications. These grieving women – some driving several hours to attend group sessions – wish others could only know what they have endured.
These were the pregnant women who took every precaution. They avoided caffeine, they didn’t drink alcohol, they ate salads instead of processed meat and took long walks to be fit during pregnancy. Past their first trimester, they imagined that they were well on their way to a healthy pregnancy outcome. Never had they imagined that one day, later in their pregnancy, they would be among the tens of thousands of American women who, every year, must make the loneliest, most difficult decision of their lives.
Typically, somewhere in the middle of the second trimester, their lives would be forever changed. It might be a physician or a genetics counselor who would say, “I think we see a problem here,” or worse, “Your baby is very sick,” or the very worst, “Your baby has a condition that is incompatible with life.”
While some babies have severe or fatal anomalies that cannot be explained, others have named conditions: Trisomy 13; Trisomy 18; Trisomy 21 (or Down Syndrome); Turner Syndrome; hydranencephaly; hypoplastic left heart syndrome; acrania; fetal hydrops; spina bifida.
For some parents, especially with advances in medical science and invasive surgeries, the prognosis for some diagnoses is not without hope. For others, it means the baby will either die in utero or live for only minutes, hours or days past birth, often with deep suffering. Some women will choose to continue their pregnancies regardless and we should stand with them. For those who elect to interrupt their pregnancies, they need our strength and support in equal measure.
Mothers — and fathers – regard ending such a pregnancy as an act of love in which they believe they took on the pain and guilt in order to spare their child a life of suffering. Who are we to judge the woman who would end the pregnancy of her grievously ill beloved child? Would we be equally condemning of the parent who took their dying child off life supports? Can we say that it is morally superior to stand by as your child dies slowly, sometimes painfully, rather than deciding to end their pain?
And what of the woman who discovers that continuing her pregnancy places her own life at risk, thus potentially depriving her other children of their mother? And for those whose child would at best be profoundly disabled, those parents ask, “Is it fair to burden my other children, present or future, to be the caretaker after we’re gone? Who will pay for that care?”
In today’s ever-divisive culture wars, so many difficult issues are seen in stark black or white, with no consideration for life’s complexity or areas of grey. One thing I know for certain: no woman can foretell what she would do until she has faced a catastrophic prenatal diagnosis. As such, our judgments and our laws need to be forged with humility, temperance and benevolence lest we or one of our loved ones would find ourselves facing a decision of such nightmarish proportions.
William S. Meyer, MSW is an associate professor at Duke University School of Medicine in the departments of Psychiatry & Behavioral Sciences and Obstetrics & Gynecology.
