This blog is about resilience and tonight I am going to talk to you about the women’s reproductive rights and how those relate to wellbeing and resilience. I’m a nurse-midwife, and while I haven’t practiced in a few years, I have personal experience as an OB provider that I want to share. I rarely talk about politics on any public platform, but tonight – 4 days from the election – I feel I need share my perspectives in hopes that it might help the women in our country to become more resilient.

Tragedy in Texas

Today, I read the article on the horrible set of circumstances that led to Nevaeh Crain’s death. The full article is on ProPublica at this URL – https://www.propublica.org/article/nevaeh-crain-death-texas-abortion-ban-emtala I will start by saying how badly I feel for this family who lost a daughter and a granddaughter because her care was not timely. What was going on in her body that took her life took several hours to develop and it is often treatable if it is caught early enough. Because of Texas laws, her family faces an uphill battle pursuing justice for the negligent care that she received.

Joyful Births

Before I dive further, let me say that I love birth. I attended a couple thousand in my practice days. There is no happier or more spiritual moment in the world than when a family welcomes a new member into the world through birth. And, a large percentage of pregnancies end in those happy moments.

When Pregnancy Isn’t A Happy Place

I have seen the other side of pregnancy, though. Early in my career, I recall caring for two women who performed DIY abortions on themselves. Young women scared to tell their rural, conservative families that they were pregnant. One teen stabbed herself over a dozen times through the uterus with a coat hanger. She nearly died and her baby only survived a few hours. She will never be able to have children. And, yes, Row V Wade was the law, but the local resources and cultural values limited these women’s choices.

I also remember the woman who had a rare complication of pregnancy that would likely become fatal in time. She was very ill. The religious-affiliated hospital would not admit her for a termination of pregnancy until she was closer to death. Fortunately, the little hospital where I worked allowed her to receive the care she needed and she survived. Why would we wait until she was actively dying to intervene? We don’t do that with anything else that we know is fatal but treatable.

I have cared for women who carried babies with congenital malformations incompatible with life. We gave them a choice to carry or terminate. For some, the emotional and physical strain of carrying a child that could die in utero or would die shortly after birth was too much. Most of my patients chose to carry the child. But, not all. And, if the child does die in the womb the woman is at increased risk of life threatening illness herself if she isn’t closely monitored. And if the child is born alive, either by medical means or naturally, should we really render life-saving measures like CPR, meds, IVs? Or, as with hospice, should we just provide hospice-type support to the family? No one is going to “kill” the baby if it is born alive – that’s different than offering full life-support.

I’ve cared for many women with unwanted pregnancies. Most pregnancies are unplanned and most times, people adapt and are eventually thrilled to be pregnant. But not always. And until you are in the room with these women and their families making gut wrenching decisions, then you don’t know.

• Do you stay in a relationship with a person who is abusive to you and the other kids because you can’t afford to leave if you have another child?
• Do you give up college and/or career plans to rear a child with limited funds and support?
• Do you risk your own health because you are accidently pregnant and your body will not do well carrying a pregnancy?
• Do you carry your step dad’s (or other relative’s) baby to term. (I remember delivering a 13 pound baby to a 13 year old girl – the second child fathered by her step dad. A baby that large indicates that her pregnancy was not a healthy and both she and the baby were put at-risk because of that.)
• The list goes on.

Not One Right Answer

There is not one right answer to any of those questions. It varies with the woman, with her spiritual beliefs, with her support system, with her financial situation. My job, as a nurse-midwife, was to provide her with options – all options – continue the pregnancy and keep the baby, adopt the baby out after birth, or terminate the pregnancy. Most my patients eventually decided to carry the baby. Abortion has never, in my experience, been chosen lightly.

The Unintended Impact Of Restrictive Laws

I want to digress for a moment and talk about Texas. I practiced there in the 90s and I remember legislation was passed that said OB providers had to notify the county sheriff if a woman seeking OB care was underage and unmarried but she listed a boyfriend who was 18 or older. I mean, the sheriff would come stand in the hallway of the clinic while we finished our exam so he could question her before she left. So, the at-risk pregnant teens started choosing not to get prenatal care. It was a disaster until the legislation was reversed. I understand the fear that the OB providers live with in a restrictive environment and how their choices are also limited.

The Road To Resilience For Women Through Reproductive Rights

How can women be resilient if they have their options taken away? Nevaeh Crain’s body could no longer be resilient – but she tried. Her family sought care for her 3 times! The young mothers who tried to do their own abortions where trying to be resilient – they didn’t want their families to reject them because they had gotten pregnant. The woman who had the life-threatening complication of pregnancy and was able to terminate before she got deathly ill was resilient. The women who carried babies with anomalies incompatible with life might choose different roads to resilience. But, only they know that road. In fact, it is true that each circumstance is so unique that only the woman and her support team knows the road to resilience. As soon as we create barriers to certain roads, we decrease her roads to resilience.

I don’t know if anyone will read this blog. And if they do, I don’t know if it will change anyone’s mind about who to vote for this election. I may lose some readers who have a different perspective. However, I know that if I don’t put it out there, no one can learn from my experience. So, it is my choice to speak my mind. I am a huge advocate of improved outcomes for women and babies. In my opinion, we can only improve outcomes if we let women have the rights to make choices that are right for her and her situation.

VOTE!