Physician and Provider Stories

These are collected stories in the words of the people who lived them. These stories help to illustrate the feelings that can come up within a provider around abortion and abortion care. A 28-year-old patient with multiple sclerosis and a history of two prior miscarriages presented with a greatly desired pregnancy to our high-risk office after a recent ultrasound showed a lethal fetal anomaly. The fetus has a very large cystic hygroma, or enlarged pocket of lymphatic fluid behind the fetal neck, which led to high-output fetal cardiac failure resulting in buildup of fluid in the fetal skin, chest, and abdomen (a situation called hydrops). She also had a blood genetic screen showing probable fetal Monosomy X, a chromosome disorder. The severity of this situation meant that the birth defect was lethal, i.e., incompatible with life, and would likely pass away in utero in a matter of weeks. However, the risk to the mother is that during this time, if the placenta becomes hydropic, the mother may develop mirror syndrome (severe preeclampsia), which is a potential threat to her health and life but was not imminent at the time I saw her. Because we live in a state that considers termination illegal, including to save the life of the mother (the governor has not yet signed the addendum to allow saving the life of the mother), this patient has no choice but to travel to another state to terminate her pregnancy. The patient also has multiple sclerosis, so it would be a high-risk pregnancy even in the absence of the finding above. Unfortunately, most states where abortion is legal are now inundated with patients from “illegal” states, and there is a several-week backlog for her to get in. Additionally, this will cost her out of pocket, including travel funds, as insurance does not cover. People have to understand that this patient did not choose for her baby to have a lethal anomaly nor does she desire to end her pregnancy. But ending her pregnancy is really not a choice here, as the death of the fetus is inevitable, and as she places her own life at risk to continue pregnancy. What about her family? People assume termination is for those who do not want their babies, but in my experience as a high risk doctor, patients who may want their babies desperately may choose termination out of love for this baby (not wanting the baby to suffer), love for surviving for their other children, and would give their own left foot to have this baby be healthy, but do not have the choice. The end result was that this patient was very, very angry. Not at me, but at the situation, state legislature, voters in this state, the governor, etc. I cannot blame her.