Trigger warning: Graphic description of miscarriage
My heart has been breaking all day for the women of Texas. I know I typically write about product management and software engineering, but I needed a space to process my grief, trauma, and fear. I hope that by sharing my story, a few more hearts can be convinced to protect women’s access to quality medical care.
This story is not easy to share. I am not sharing it publicly for pity or sympathy. I’m sharing it in the hope that it inspires action, whether that be action for the women of Texas or action in your own state to prevent abortion rights from being taken away where you live. There was so much about abortion and compassionate pregnancy care that I didn’t know before going through it firsthand.
In January 2019, I was 15 weeks pregnant when I began experiencing some minor cramping and spotting. I went in for an emergency checkup at my OBGYN. The nurse struggled to find a heartbeat but blamed it on the new handheld ultrasound device. She sent me home with a cheery “I don’t think anything is wrong. Lots of women spot and have healthy pregnancies.” I had a regular checkup about a week and a half later. My cramping and bleeding had mostly subsided. I thought we were in the clear. I was confident enough that I didn’t even have my husband come with me. Then, the doctor couldn’t find a heartbeat. She rushed me down to the ultrasound room and confirmed the worst: my baby had died but my body had failed to recognize the terminated pregnancy.
The medical term for this is a missed miscarriage or missed abortion. There are very real risks associated when this happens, the most common being the pregnancy will become septic. I was given three options:
1) “Expectant management” — aka do nothing and wait for my body to finish aborting the fetus on its own
2) Take the abortion pill to speed along the process. Because I was beyond the first trimester, my doctor advised against this path
3) Elect for a Dilation and Curettage (D&C) — aka a surgical abortion
It was late afternoon on a Friday, and I was told “take all the time you need” but the clock was ticking and I knew my providers all wanted to go home and I needed to make a choice quickly. I read the pamphlets I was given and called my husband.
The anti-abortion literature I was handed touted Option 1 as a way to let my body work through the process of miscarriage “in the comfort of my own home.” My nurses told me both Option 1 and 2 would be like going through labor, but less painful because the baby was smaller (only about a pound). Labor with my firstborn was a grueling 30-hour ordeal that I had no desire to repeat without the supervision of medical professionals. There was no way to know how long we’d be waiting for my body to expel the fetus. Option 1 sometimes takes weeks, Option 2 is more typically 24–48 hours. Either way, there was no guarantee I wouldn’t miscarry at work or the grocery store. There was also no guarantee it would be a complete miscarriage and I wouldn’t end up needing a D&C to prevent infection afterward.
I initially balked at Option 3. I had been raised in a very pro-life community and never had a personal reason to challenge my own stance. I didn’t want to have anything that even looked like an abortion. That said, miscarrying at home terrified me. I asked how much blood would there be and how to dispose of the medical waste in a safe and sanitary way. My doctors and nurses couldn’t give me an answer. I was told many women going through miscarriages at home sleep in the bathtub or buy rubber sheets in case of heavy bleeding overnight.
My biggest question was what do I do with the baby after? Again, no one could give me an answer I could live with. I was told some funeral homes may help, but they were hard to find and there were no readily available resources to help me locate one. In my grief-stricken state, I didn’t want to spend my hours of “expectant management” on frantic phone calls hoping someone would help me in time.
I was told some people bury their fetuses in small graves on private land. I live in the middle of Minneapolis. Burying it in the backyard was not an option and the nearest family property was over 300 miles away. The thought of keeping a dead baby in my refrigerator until I could get there was traumatizing.
I was told that most commonly, women who miscarry at home throw their babies away in the trash or flush them down the toilet. I wanted better for my baby. I wanted to know what was wrong and assess my risk of this happening to a future pregnancy. I couldn’t bear the thought of its little body in a bag on the curb or worse yet, flushed away. I opted for the D&C so that we could have the fetus tested for genetic abnormalities and its remains donated for scientific study or humanely disposed of by the hospital.
Because I wasn’t showing any severe symptoms, my D&C was considered a non-emergency elective procedure. They scheduled the D&C for the following Tuesday and apologized for the weekend delay.
I woke up in the wee hours of Monday morning in a pool of blood with severe pain and intense contractions. We immediately called the OBGYN’s after-hours emergency line. The first nurse I spoke to said it wasn’t an emergency unless I passed clots larger than the size of my fist and that I should just try to rest, but that she’d pass the message on to the doctor on call. My baby, when she was eventually born, wasn’t even the size of my fist. When the doctor called back almost an hour later, I told her I knew the baby was coming soon and that I wouldn’t make it until my scheduled procedure, but that I did not want to have this baby at home. She pulled some scheduling wizardry while we coordinated emergency child care for our 1-year-old, then rushed to the hospital.
I continued having severe contractions through the car ride and what felt like a horrendously lengthy hospital check-in process. I was still being treated as a scheduled elective procedure, not an emergency case, despite it being clear that I was in active labor in the middle of the hospital lobby. I remember telling the poor woman if she didn’t hurry up I was going to drop a dead baby right there. All she offered me was a wheelchair. I declined.
We got into a pre-op room and gowned up for surgery. The hospital required a urine sample. I was in so much pain. I was actively fighting to keep a baby inside of me. I needed the nurse to support me on the short walk to the bathroom across the hall. She was a short, stout woman with a kind smile and gentle eyes. I think her name was Sharon. While attempting to pee in a cup, I couldn’t fight my body anymore. There was a sickening plop. I gave birth to my baby in the hospital toilet.
I remember screaming, “That’s my baby!” over and over again while curled up sobbing on the bathroom floor. The image of my baby’s pale, lifeless form there in the bowl as the poor nurse scrambled between yelling for help, pleading, “please, no one flush this toilet” and trying to comfort me will never fade from my memory.
Someone eventually came and helped me back to my hospital room. The doctor recommended we go through with the D&C. Based on what they were able to collect from the bathroom, they did not think I had passed all of the placental tissue and the threat of infection was real. I was numb.
Fast forward to September 2019. We were happily expecting again. It was my husband’s birthday. I started cramping and bleeding. I called the nurse line and was told to wait and see, but I knew in my heart that I was losing this baby too. The deja vu was overwhelming; We again found out that I had miscarried on a Friday. I was only 13 weeks along this time, so the abortion pill would have been a viable option, but after seeing one baby in a toilet I couldn’t fathom possibly seeing another one. We were again told we needed to wait until the following week for the D&C. My doctor this time advocated for me to get the absolute earliest slot available and moved other appointments to make it happen. We again had a scary Sunday night full of contractions and large blood clots and calls to the nurse line. This time, luckily, I made it to the hospital in time. The procedure was uneventful and I was home by dinner time.
Despite this trauma and the significant barriers to accessing timely medical care, I still thank God that I live in a state where I had the right to choose the procedure that was right for my physical and mental health and access to a D&C at numerous facilities near my home. My elective D&Cs meant that my babies’ remains were treated with dignity. It gave us the opportunity to have them tested so we could get the answers we were looking for about why this had happened twice. And most importantly, it saved me the anguish of having to live through another traumatic pre-term birth.
You may be tempted to argue that in my case, the heartbeat law doesn’t apply because clearly there was no heartbeat when I elected to have my D&Cs. I personally read through every word of the law. I encourage you to, too. Here’s the full text: https://legiscan.com/TX/text/SB8/id/2395961
The law allows any resident of Texas to sue an abortion provider for any perceived abortion performed. The burden then falls on the provider to prove it was legally justified. Even though Texas law clearly states that the legal definition of “Abortion” does not include the removal of dead fetal tissue in case of a miscarriage, there are no consequences for bringing frivolous lawsuits. Providers are required to pay their own legal defense fees even if the case was unjustified. Because my miscarriages were not medical emergencies, I firmly believe that a provider in Texas, fearing a lawsuit, would not have offered me an elective D&C even though my babies were already dead.
Any time spent defending my elective D&Cs is time they’re not spending caring for other patients. Every dollar spent on defense in these lawsuits is a dollar closer to the clinic shutting its doors. I had a myriad of good reasons to pursue my D&Cs, but I would never fault a provider for not finding any of them reason enough to threaten the viability of the clinic as a whole.
In 2017, 89% of counties in the United States did not have a clinic where D&Cs could be performed. Roughly one-third of women who had an abortion in 2014 had to travel more than 25 miles each way to get one. Source: https://www.guttmacher.org/fact-sheet/state-facts-about-abortion-texas That number has only increased in the last 7 years. This law in Texas will restrict access even further as more and more clinics shutter when faced with mounting legal pressure and defense bills.
If I’d have needed to travel 25 miles or more to the hospital during my first miscarriage, I would have likely given birth in the car or a ditch, ruining any chance of genetic testing because of potential contamination of the fetal tissue. I don’t know if the hospital would have even helped us with the remains in that case.
Anti-abortion laws claim to protect innocent unborn children never given a chance at life. But the shiny pamphlets and billboards gloss over the hard truth that limiting access to a D&C means limiting access to the kind of compassionate care women need when pregnancies don’t go according to plan.
Shouldn’t the definition of “pro-life” also include advocating for the physical and mental health of mothers?
No woman should have to give birth to a dead fetus alone at home unless that’s how they prefer to process their grief.
Every woman should be provided compassionate options for what to do with the remains of a miscarried fetus, no matter where the fetus was delivered.
After having been through a traumatic birth experience, no woman should be expected to have to live through the waiting game of not knowing when her body will finish the miscarriage process again.
No woman should be fearful that a miscarriage will result in her being labeled a baby killer and her provider targeted with civil lawsuits
No doctor should feel scared to suggest the best option for their patient’s physical or mental health because they are intimidated by the threat of frivolous lawsuits.
“Pro-choice” isn’t just about choosing whether or not a fetus will be carried to term or not. Pro-choice is ensuring that all women have every option on the table and access to the best possible treatment plans when they need it most.
Be pro-choice. Fight this law and anything like it. Abortion rights are human rights.