I WAS LUCKY TO HAVE A CHOICE | A CASE FOR "LATE-TERM" ABORTION
by Ashley Hillman
* Trigger warning: Abortion, child loss
You now officially know someone who has had an abortion. Me. Not just any abortion, but a “late-term” abortion. My story could be like any other woman who has had to make this excruciating decision. We shouldn’t have to tell you our private health history for you to see us as human beings who deserve the same autonomy, dignity and respect that you do.
I was in love, had an established career, and I was financially stable. I also loved my baby beyond measure. I was “lucky” it would seem, until I found myself faced with a horrific decision.
At the age of 38 I had to decide if I would deliver my baby or have what some call a “late-term” abortion.
I went alone to my first appointment. I was just going to get confirmation and a due date, pretty transactional. We nicknamed this life inside of me Poppy, because one of the apps I was using said she was the size of a poppy seed. Based on the calendar and biology, it looked like I was about 8 weeks along when I went to this appointment.
As soon as the ultrasound tech started the exam, she was clearly very surprised. “That’s a big baby!” and then very quiet. Very. Very. Quiet. She spent 10 minutes in silence. She excused herself to go talk to the doctor. She came back in and told me I could get dressed and the doctor would be in. The air was heavy.
When the doctor came in, she was very kind, very sweet and her bedside manner couldn’t have been better. I only remember the first few words as she explained the baby was about 20 weeks and there were “anomalies” but I would have to see a specialist to know more. Fortunately, the specialist could get me in shortly.
My poor, sweet husband. He was at work, and with a blizzard working its way through town, could not get to me. He thought about trying, but I could barely make it to Village Inn (our local version of Denny’s or IHOP) to pass the time. Our texts that morning were excited and happy. Then, my emotions switched to nerves as I was much further along than expected - EEEK! Next, my emotions quickly changed to dread… wondering what we were going to hear. What a roller coaster! All this time he was talking to clients and trying to be professional.
I arrived at the specialist and the imaging tech saw me first. She was really distracted as she completed a 20 week anatomy scan. Her phone rang a couple of times and she apologized. Other than that, she, too, was very very quiet. I convinced myself that she was just distracted by whatever was going on… on the other end of the phone.
I was wrong. The specialist, a neonatologist, greeted me with a clip board and a smile that was both comforting and disturbing at the same time. He very calmly and kindly explained that I had a baby girl and she was not well. She was 21 weeks (gestation or development). As he began to talk about her spine and midline defects, I had a little hope. We knew that we would welcome a special needs child with open arms.
Then he said words that changed the situation irreparably. “Incompatible with life.”
Her spine was only formed about half way around in some places. The most critical condition was that she only had a few ribs. This created a situation that there was no protection for her internal organs. Your ribs form a nearly-impenetrable cage around your organs and protect them from the outside world. Without a spine and ribs, she could not survive.
As I cried silent tears I asked him to please write out my options on a piece of paper. Although I wasn’t thinking clearly, I did know I would need this information to make an informed decision. My options were to terminate the pregnancy or attempt to make it to term. If she had made it to term, she would feel immense pain as she was delivered and death would follow soon thereafter. What kind of cruel choice is that? Either way, I was still grateful that I had options… even if they weren’t the choices that I had wanted to be making.
The doctor and technician were so kind to give me some ultrasound photos. None were of her spine or torso. Her little feet were perfect and I adore the photo they gave me of her feet. It gives me joy and peace every time I see it and think of her.
As I drove home, my eyes blurry through tears and snowflakes, I prepared what I would say to my husband. We cried. We held each other. He supported whatever decision I wanted to make. He just wanted to be there for me and for Poppy.
I went to several other appointments over the next few days. First, for a second opinion, same result. The words of the neonatologist rang in my ears “immense pain.” How could I let my baby go through that trauma? I felt selfish even considering it. I chose to protect my baby from that trauma, and in doing so I fully embraced my motherhood and the immense love that I had for that child of mine. I chose to terminate the pregnancy and my husband didn’t hesitate to support my decision.
Once that was determined, I saw a specialist about terminating the pregnancy and she would be the one to perform the procedure. She gave me the options. I could stop her heartbeat and deliver her little body. I could otherwise have a Dilation and Evacuation (also know as D&E, and a procedure used after some miscarriages). This would stop Poppy’s heartbeat and they would remove her vaginally. Either way, this would terminate the pregnancy. I chose to have the D&E. I didn’t see the benefit (for either of us) of laboring a baby that had already died. That wasn’t the choice for me, and I was “lucky” to have a choice.
I was 22 weeks and I still had several things that needed to be addressed and worked out before the termination. The doctor asked what insurance company I had. If I was employed by the government terminating a pregnancy for medical reasons is not covered - and once again I was considered “lucky”. As it was, my deductible and copays were several thousand dollars, though still a fraction of the inpatient procedure. I was approaching 24 weeks now, and 24 weeks is the last chance to terminate a pregnancy in my state. Many states do not have that option. Many hospitals don’t perform the procedure as they have religious affiliation. We have a stellar secular medical facility just minutes from my home. I sure didn’t feel “lucky” and yet each day I realized just how fortunate I was considering that these were issues that would have complicated the situation, made it much more gut-wrenching, and taken away my freedom of choice.
I had two procedures over two days before my actual termination. I had two sets of laminaria placed in my cervix to open for dilation. On the third day, I arrived for my procedure at Denver’s University Hospital. We had what seemed like dozens of medical professionals. They were all very nice and I always felt safe. The person who was taking my blood didn’t get it quite right and I ended up with a fountain of blood. Oddly enough, it was a nice distraction to think about something else other than what was going to happen.
The procedure required general anesthesia so I remember the IV medication, and the next thing that I recall is waking up in recovery. My husband was there and my doctor checked on me right away. I was able to go home the same day since the procedure went on without complications. I was tired and sore, but mostly just sad. I spent a lot of time in bed. I had another follow up and was released from care within a week. I had the option to have Poppy’s remains so we could have a service. We chose not to.
I can assure you none of the decisions we made were easy.
It was not a decision I made on my own. I had no less than 6 medical doctor’s involved from start to finish. Every single one checked to make sure this was my decision and I was educated on the risks and my options. There was no doubt about the condition of my baby. I trusted their expert opinions. Once that was determined, my physical and mental well-being was made a priority of my providers. That went a long way with me.
I am not sure what my personal cut off would have been to not terminate the pregnancy. Would it have been 24 or 30 weeks? I don’t know.
I just know I am grateful to have the choice. I have no regrets. I would make the same choice today.
What concerns me is that women (today) in certain states may no longer have this choice. Many states have recently passed legislation preventing abortion after a fetal heartbeat is detected. Many people even argue that “late-term” abortions aren’t medically necessary and that this is infanticide. Do we not trust our doctor’s anymore, and assume that they have ill intentions for the unborn? I grieved this loss - and my baby was wanted - and my choice shouldn’t be open for your discussion. And yet, here we are. These decisions should be private and between doctor and patient. To assume that people are carelessly making a decision like this, without listening to the advice of medical professionals, is ignorant and unthinkable. About 1.3 % of abortions happen at 21 weeks gestation or later, according to the CDC. Why are we so interested in taking away the dignity and respect of the 1% of women who have to make these difficult (and traumatic) decisions, so much that we demoralize and dehumanize them with new laws and bills?
I wrecked myself thinking about the things I could have done differently. I was taking birth control, but I wasn’t 100% perfect on when I took it. (I’m sure others can relate.) Should I have known I was pregnant earlier? Possibly, but biologically my body was still proceeding as if I wasn’t pregnant. I still had my period like normal for several cycles after I was pregnant. What other signs were there? Would they have known about her abnormalities before an anatomy scan? With so many complications, I may never have all of the answers… and neither will others who are faced with similar or unique abnormalities and circumstances.
We did genetic testing and testing on our baby. It was expensive and not covered by insurance. We wanted to know. She was simply an “anomaly.” A fluke. She didn’t have chromosome issues or conditions we could name or a cause we could point to. She just wasn’t well.
Nine months later, my husband and I made a choice. Again, a choice we made together. We decided to have a baby. Poppy wasn’t planned, but once we realized we were going to have a baby, we wanted it more than anything. We got pregnant almost right away.
There was never a doctor’s visit, ultrasound, or test in those moments later on that I didn’t think of Poppy. Because of Poppy, I needed a high risk doctor. I chose the doctor who was the first specialist to care for me and Poppy on that very first day. His office has several doctors but I only saw him. On our first visit for the new baby I was really proud of myself. I was eating better. I stopped using face lotion that had chemicals. I declined x rays at my dentist. I stopped eating sushi and lunchmeat even before I got pregnant. He took my hands in his and stopped me mid-sentence.
“It was not your fault. Nothing you did caused her problems.” I needed to hear that.
The new pregnancy was nearly textbook. She was petite, but nothing concerning. Because of my age I was induced at 39 weeks. She was born at 7 pounds, 9 ounces. She had all of her fingers, toes, and ribs.
Today that baby is 20 months old. She is happy. She is healthy. She is such a light in our lives. Maybe I really am lucky. Maybe life and it’s challenges - that offer us perspective - are a gift in disguise. Maybe we should trust a woman’s intuition, and honor her ability to know what is right and wrong for her well-being and that of her offspring. Maybe she deserves empathy, grace and dignity, because she will not always be as “lucky” in her circumstances or options as I was.
Ashley Hillman is a wife and a mom. She’s a career professional and a proponent for life-long learning. She lives her life in the pursuit of kindness. She loves dogs and beaches and hopes to live with her dogs and family near a beach someday soon.