The Politics of Women's Health
My Late-Term Abortion
On November 5, George W. Bush signed the first federal ban on any abortion procedure in the 30 years since Roe v. Wade, and the first ban of a surgical technique in the history of this country.
"I'm pleased that all of you have joined us as the Partial-Birth Abortion Ban Act of 2003 becomes the law of the land," Bush said. After singling out 11 political supporters of the bill -- all of them men -- the president whipped the 400-strong, antiabortion crowd into a frenzy. "For years a terrible form of violence has been directed against children who are inches from birth, while the law looked the other way," he said to cheers and whoops and hollers.
The signing ceremony staged by the White House was part evangelical tent revival, part good ol' boy pep rally, ending with the audience muttering "Amen." The president stoked the crowd's moral indignation with emotional platitudes like "affirming a basic standard of humanity" and "compassion and the power of conscience" and "defending the life of the innocent."
But on that Wednesday afternoon, President Bush never addressed what, exactly, the ramifications of the bill would be. His administration portrayed it as a bill aimed solely at stopping a "gruesome and barbaric" procedure used by healthy mothers to kill healthy babies. That portrayal served to spark a national, emotional knee-jerk reaction, which precluded any understanding of the practical outcome of the legislation. But it was those very real practicalities that immediately prompted three lawsuits and got three federal courts to prevent the bill from actually becoming law, starting a fight that will probably drag on for years.
At the heart of the debate is a term that legislators concocted. They created a nonexistent procedure -- partial-birth abortion -- and then banned it. They then gave it such a purposely vague definition that, according to abortion providers as well as the Supreme Court, which ruled a similar law in Nebraska unconstitutional, it could apply to all abortions after the first trimester.
Though some proponents of the bill say that they merely want to ban a specific medical procedure -- properly called intact dilation and extraction, which accounts for fewer than one-fifth of 1 percent of all abortions in this country, according to a 2000 survey by the Alan Guttmacher Institute -- they never specifically called it that. Instead, the bill is written in such a way that the much more common procedure -- dilation and evacuation, which accounts for 96 percent of second-trimester abortions, including my own -- would also be banned.
Supporters of the ban have argued that this procedure is used on babies that are "inches from life." But in the bill, there is no mention of fetal viability (the point at which a fetus could live independently of its mother for a sustained period of time). Nor is there any mention of gestational age. Thus, the ban would cover terminations at any point during pregnancy. (In fact, Roe v. Wade already protects the rights of a fetus after the point of viability, which occurs sometime after the 24th week of gestation, in the third trimester of pregnancy. Massachusetts bans all abortions at and beyond the 24th week, except to protect the life or health of the mother. Indeed, according to the Massachusetts Department of Public Health, in 2001 there were only 24 abortions after the 24th week, out of a total of 26,293 abortions.) By not mentioning viability, critics say, this ban would overturn Roe v. Wade, which clearly states that women have the right to abortion before fetal viability.
So what does it all really mean? It means that all abortions after the first trimester could be outlawed. No matter if the fetus has severe birth defects, including those incompatible with life (many of which cannot be detected until well into the second trimester). No matter if the mother would be forced to have, for example, a kidney transplant or a hysterectomy if she continued with the pregnancy. (Legislators did not provide a health exception for the woman, arguing that it would provide too big a loophole.)
In the aftermath of the signing of the bill, its supporters spoke about having outlawed a medical procedure and protecting the nation's children. "We have just outlawed a procedure that is barbaric, that is brutal, that is offensive to our moral sensibilities," said Bill Frist, the Senate majority leader. Its opponents bemoaned an unconstitutional attack on legal rights. "This ban is yet another instance of the federal government inappropriately interfering in the private lives of Americans, dangerously undermining . . . the very foundation of a woman's right to privacy," said Gregory T. Nojeim, an associate director and chief legislative counsel for the American Civil Liberties Union.
But lost in the political slugfest have been the very real experiences of women -- and their families -- who face this heartbreaking decision every day.
I don't know what was worse, those three days leading up to the procedure (I have never called it an abortion) or every day since. I clung to Dave. He was always the rock in our relationship, but I now became completely dependent on him for my own sanity. Though abortion had never been part of his consciousness, he was resolved in a way that my hormones or female nature or whatever wouldn't let me be. But I worried about him, too. The only time I saw him crack was after his brother -- his best friend -- left a tearful message on our answering machine. Then I found Dave kneeling on the floor in our bathroom, doubled over and bawling, his body quaking. That nearly killed me.
I don't remember much from those three days. Walking around with a belly full of broken dreams, it felt like what I would imagine drowning feels like -- flailing and suffocating and desperate. Semiconscious. Surrounded by our family, I found myself tortured by our decision, asking over and over, are we doing the right thing? That was the hardest part. Even though I finally understood that pregnancy wasn't a Gerber commercial, that bringing forth life was intimately wrapped up in death -- what with miscarriage and stillbirth -- this was actually a choice. Everyone said, of course it's the right thing to do -- even my Catholic father and my Republican father-in-law, neither of whom was ever "pro-choice." Because suddenly, for them, it wasn't about religious doctrine or political platforms. It was personal -- their son, their daughter, their grandchild. It was flesh and blood, as opposed to abstract ideology, and that changed everything.
I was surprised to find out that I would no longer be in the care of my obstetrician, the woman who had been my doctor throughout my pregnancy. It turned out that she dealt only with healthy pregnancies. Now that mine had gone horribly wrong, she set up an appointment for me with someone else, the only person who was willing to take care of me now. I felt like an outcast.
As we drove to his private office in Brookline that Monday, April 7, 2003, I couldn't shake the feeling that we were going to meet my executioner. I had never met this doctor, but I did look him up online. With thick, mad-scientistlike glasses, he looked scary. In person, though, he reminded me in both looks and manner of Dr. Larch in The Cider House Rules. He had the kindest, saddest eyes I had ever seen, and he sat with us for at least an hour, speaking to us with a heartfelt compassion and understanding that I had never encountered from any doctor before. His own eyes teared as Dave and I cried.
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