By Dan Neil
May 6, 2007
We didn't want to. We didn't mean to. We didn't do anything wrong, which is to say, we did everything right. Four years ago, when Tina and I set out on this journey to have children, such a circumstance was unimaginable. And yet there I was, holding her hand, watching the ultrasound as a needle with potassium chloride found its mark, stopping the heart of one male fetus, then the other, hidden in my wife's suffering belly.
We don't feel guilty. We don't feel ashamed. We're not even really sad, because terminating these fetuses — at 15 weeks' gestation — was a medical imperative. This has been a white-knuckle pregnancy from Day 1, and had it gone on as it was going, Tina's health would have been in jeopardy, according to her doctor. The fact is, multiple pregnancies are high risk, and they can go bad very suddenly. I wasn't going to allow that, though the fires of hell might beckon.
In the midst of this experience, practically on the eve of our procedure, the U.S. Supreme Court announced its ruling in Gonzales vs. Carhart, upholding the federal ban on a rare obstetrical procedure called intact dilation and extraction, or intact D&E, also known as "partial-birth" abortion.
The decision is a watershed in abortion law, the first ban on a particular abortion procedure since 1973's Roe vs. Wade, and the first restriction on abortion to be approved by the court that does not include an exception for the health of the mother. Antiabortion activists were jubilant and immediately began talking about plans for state-by-state campaigns to restrict, and eventually rescind, access to abortion generally. For the first time in a long time, such talk didn't seem like wishful thinking.
I was stunned. Events in Washington that I had once followed with purely newsy and academic interest — the recent appointment of Chief Justice John G. Roberts Jr. and Justice Samuel A. Alito Jr., and the fate of Roe — suddenly struck home in the most personal way possible.
I mean, my wife and I have always been pro-choice, but we never expected to actually confront the Choice. After all, we've been trying like crazy to have children. We had already undergone two in-vitro fertilization procedures before this last time, when we put back five embryos, despairing that any would take. Beforehand, the fertility specialist asked us if we were OK with "reduction" — also known as selective abortion — in the event that too many took hold. We said yes, not really appreciating what that meant.
To our delight, four set up residence. Our initial joy, however, was tempered by the realization that we would have to lose two to keep two. For the last couple of months, Tina and I have discussed our options with our doctors, gradually wrapping our heads around this personal and private decision — only to have the government invite itself to the conference at the eleventh hour.
To be clear, the procedure banned by the court last month — intact D&E — was not an option in our case. But it doesn't take much foresight to see how the court's decision could have huge consequences for fertility and reproductive medicine. For instance, the case upheld a ban on a midterm abortion procedure — that is, one that takes place between 12 and 28 weeks. If the government begins to foreclose obstetrical options in the midterm, it will tie the hands of family health doctors in unexpected and dramatic ways.
Take our case. As soon as we found out at about four weeks that we had too many fetuses, we wanted to undergo the reduction procedure. But our doctor told us to wait to see if the number would reduce on its own, as often happens. Then, at about 12 weeks, we underwent a type of genetic testing (chorionic villus sampling, similar to amniocentesis), reasoning that if we had to abort two, it would be better to abort any fetuses with genetic abnormalities. The results took two weeks to get back, and by that time Tina was experiencing complications so severe that we had to put her in the hospital. The whole time, an awful clock was ticking.
Amniocentesis testing — which involves extracting fluid from the placenta — is usually performed between 15 and 20 weeks. That's solidly in the second trimester as well. If midterm abortions are banned, what will the state tell parents confronting the agony of a fetus with severe abnormalities? Would it oblige them to carry through with the pregnancy against their will? Would it — as proposed by South Carolina's pending "ultrasound" legislation — require women to look at pictures of their fetuses in an attempt to impress on them the humanity of the fetus they are aborting? Believe me, they know.
We got a sense of this kind of heavy-handed paternalism in Justice Anthony M. Kennedy's majority opinion in Gonzales vs. Carhart, in which he asserted that the ban would ultimately be good for women, who would be spared the mental and moral trauma of the procedure.
If only women and their doctors were as smart as Congress.
The court's ruling upholds the Partial-Birth Abortion Ban Act of 2003, which declares the intact D&E — in which the fetus is partially extracted from the uterus before being dispatched with an aspirating needle, scissors or forceps — to be "gruesome and inhumane." But the truth is, there is no such thing as a pretty abortion. The alternatives to intact D&E are no less grim. Is grasping and dismembering the fetus in utero with forceps (as opposed to after a partial extraction) or injecting it with heart-stopping chemicals and then delivering the stillbirth any less repellent?
Gruesomeness is no standard at all. Removing the organs from a brain-dead teenager is gruesome, yet we do it to preserve the life of an organ recipient. The point is, sometimes it's necessary.
Americans need to be careful what they wish for. I think antiabortion advocates imagine a world in which women — promiscuous, lazy or selfish singletons — roll into the doctor's office for midterm abortions and stick their feet in the stirrups while still chatting on the cellphone. Recreational abortions, you might say.
But in the real world, that's not how it happens. Virtually no one takes the matter lightly. I would also point out that even the most fervent abortion opponents may one day find themselves suffering from infertility and may rue supporting the court's from-the-bench obstetrics.
Some wanted to know how we decided to keep the girls. Partly, it was a matter of how the fetuses were arranged. Partly, it had to do with other factors. Some studies show offspring of older fathers (I'm 47) run a higher risk of autism, and males are four times as likely to be autistic. Still, I had reservations about bringing girls into the world now, when forces seemed to be aligning to disenfranchise them (nine of 10 GOP presidential candidates favor reversing Roe vs. Wade). I hate to think my girls will have to fight the battles their mothers and grandmothers fought.
I feel sorriest for our doctors. The three we have seen are all extraordinary people, deeply compassionate, superbly trained. All are parents. All regard abortion with the greatest gravity. And yet they are obliged to be circumspect, if not downright fearful. And who can blame them? The physician who performed our reduction asked that her name not be used, for fear that she might be terrorized by some gun-toting antiabortion extremist.
For our part, we are grateful that she was out there. Without her, we wouldn't have been able to have a family. When Roz and Viv grow up, I hope one day I can introduce them to her. I think she'd be proud.
DAN NEIL writes the 800 Words column for West magazine and the Rumble Seat column for Highway 1.
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