Ending a pregnancy in the last days of Roe

Four days before I was due to get my period, I knew I was pregnant and I knew something was wrong. I was having cramps on one side of my abdomen, and when I googled “early pregnancy cramps one side,” the words “ectopic pregnancy” appeared. I only had a vague and ominous idea of what that meant, but quickly learned it happens when a fertilized egg implants and grows outside the main cavity of the uterus, usually in the fallopian tube. If the fallopian tube ruptures, it can almost immediately cause life-threatening bleeding. By definition, ectopic pregnancies are never viable and never result in a baby.

On the day of my missed period, I took a pregnancy test that came back faintly positive. Unlike the positive pregnancy test that had resulted in my son, who was now a vibrant three-and-a-half-year-old well into his “why?” phase, this one didn’t spark excitement and iPhone photos of the test on my bathroom counter. I had badly wanted to be pregnant — my husband and I had always planned to have two kids — but I felt only dread, knowing something was off inside my body. In the middle of the night, I woke up to shoulder pain, one of the hallmarks of ectopic pregnancy. In a panic that I could be in imminent danger, I roused my husband and had him drive me to the emergency room. 

But this isn’t the story of a standard ectopic pregnancy, though I would read plenty of those on Twitter in the coming weeks. At the hospital, a urine test didn’t show I was pregnant, and a blood test showed my levels of hCG, the pregnancy hormone, in the in-between range: I might be pregnant, or I might not. A transvaginal ultrasound also didn’t show anything, though as the technician told me they wouldn’t expect to be able to see anything at only four weeks. Anti-abortion rhetoric claims life begins at conception, but there I was, at one of the best hospitals in the country, several weeks after what would have been conception, and nobody could even definitively say I was pregnant. 

Thus began weeks of waiting and seeing. I was sent home to follow up with my obstetrician in a few days for another blood test; this one showed my hCG levels increasing, which was a sign I was pregnant. Still, I needed to wait another couple weeks before we’d be able to see anything on an ultrasound. It could indeed be ectopic; it was just impossible to tell yet. I had to keep living in the gray area.

There I was, at one of the best hospitals in the country, several weeks after what would have been conception, and nobody could even definitively say I was pregnant.

In the meantime, life went on around me. Spring came, and my son gained the courage to go down the big slide at the playground. “Wow, buddy! I’m so proud of you!” I exclaimed as I enveloped him in a bear hug. But the pain in my abdomen was relentless, and I didn’t feel well enough to chase him down the sidewalk on his bike or go on walks to the library. It wasn’t the typical exhaustion and nausea I had felt the first trimester of my first pregnancy. It felt like something was wrong. 

Without discussing it, my husband and I began ensuring I wasn’t alone with our son for very long periods of time, just in case my fallopian tube burst. Our neighborhood was exploding with crabapple blossoms, and I often stayed home curled up on the couch while the two of them went to the playground with our friends. We hadn’t told anyone what we were going through, not even our closest friends and family. I thought we should wait until after the first trimester, as we had with our son, or at least until we knew more. But the ache of loneliness made me feel worse.

On one of the rare occasions when I walked my son to school alone, I gamed out what I would do if my body broke down during the 10-minute walk: How fast could my husband sprint from our house? Could I ring the bell at the fire station for help? Would my son run into traffic as I bled out? While my thoughts raced, he happily continued closing every garbage can lid we encountered. It was trash day, and the garbage truck had just come through, leaving the scattered cans wide open. I should have brought Purell to clean his hands, I thought absentmindedly, the mundane intruding on the life-or-death.

RELATED: Many states’ abortion bans have life-saving “exceptions.” Experts doubt they will work as intended

At night, I barely slept, waking up in a panic every few hours. I interrogated every minor ache and pain as potentially something that could kill me in minutes. The thought of my son growing up without a mother filled me with terror.

Then, the night before my ultrasound appointment, Politico publishedleaked draft Supreme Court opinion striking down Roe v. Wade. Like many others, I had known this decision was possible, even likely, but it was a gut punch to see it in writing, made real. I have always been pro-choice, but having my son had made me militantly so. I have seen firsthand how pregnancy and childbirth can be dangerous and terrifying, and I wish them on no one who didn’t choose them.

The thought of my son growing up without a mother filled me with terror.

I had only become more afraid of pregnancy in the years since my son had been born. Not that that pregnancy had been unusually scary. Toward the end, my blood pressure had been borderline high — a sign of preeclampsia, a dangerous pregnancy complication that can lead to seizures and strokes — and my OB had sent me to get it tested twice a week. My son arrived via unplanned C-section, and when I came out of surgery, a nurse told me my urine did indeed contain the level of protein that signals preeclampsia. “Well, good thing the baby’s out!” I said breezily. The nurse just stared at me, and then proceeded to religiously check my blood pressure every few hours until I left the hospital. In my ignorance, I didn’t know that I could have had a life-threatening hemorrhage well after delivery. But it all worked out. I went home, recovered quickly, became a mother. 

After my first go-round with pregnancy, a growing knowledge of the risks of pregnancy in general scared me. I learned that the maternal mortality rate in the U.S. was more than twice that of most other high-income countries, and that my generation was more likely to die in childbirth than my mother’s generation. Of the many friends I had who were mothers, only a few had an entirely uneventful pregnancy and delivery. Most had some near-miss, some complication that could have turned tragic. The kind of story that makes you shake your head and say, “Thank god everything is OK,” and then the conversation moves on before anyone can really contemplate the alternate ending.

Given everything that could and did go wrong, I knew how important it was to have the right to make whatever decision I wanted about my own pregnancy — whether to avoid it altogether (as I had done throughout my 20s and early 30s), to end it if I needed to, to access fertility treatments if I needed them. I wasn’t immediately worried about my reproductive rights where I lived in Massachusetts, bastion of liberalism, but I did worry about women in Texas and Oklahoma and Mississippi. Even in Massachusetts, losing those rights certainly wasn’t out of the question. The same day the Roe decision leaked, the Washington Post reported that Republicans planned to enact a national abortion ban as soon as they got a chance. Here in my bastion of liberalism, approaching the end of my child-bearing years, I still desperately needed the freedom to make decisions about my own body.  

RELATED: Pregnant people are scrambling to reschedule abortions cancelled in trigger law states

When my husband and I finally went for the ultrasound, it showed a floating black oval, which the technician measured on the screen. “It’s so small,” she murmured. “What are you, four or five weeks along?” “Six,” I said clearly and maybe too loudly. She seemed doubtful. I didn’t take it as a good sign.

Later, the nurse gently told me they still couldn’t rule out ectopic pregnancy. She scheduled me for another transvaginal ultrasound the following week. How many times can a woman have a wand stuck up her vagina in the course of a month? I wondered. Still, I was willing to do whatever it took to figure this out. Sitting in the car with my husband, I sobbed. I didn’t know how much longer I could go on this way: feeling like crap, fearing for my life every second, vacillating between hope and not-hope.

I diligently tried not to think of the future, but it was hard. I typed the date of my last period into a website and found that if this pregnancy did result in a baby, it would be born just before Christmas. A Christmas baby, with maternity leave during the coldest months of the year — not bad, I thought. I looked around my son’s room as I put him to bed at night and thought about how I’d rearrange the furniture to fit a new baby. Then I’d give myself a proverbial slap across the face and snap out of my reverie. Allowing myself to hope was only going to end in heartache. I had to stay in the gray area.

At our next ultrasound, the image on the screen hadn’t changed: still a black void where there should be something pulsating by now. The tech was silent. Again, I sobbed uncontrollably in the car as my husband held me. My OB called to confirm: the pregnancy was not progressing, and it was not going to progress. It might be ectopic or it might not, they still couldn’t tell, but it would never turn into a Christmas baby. We could wait for what could potentially be weeks for a miscarriage, induce one via medication or have a D&C, a surgical procedure to empty the contents of my uterus. Both latter options are abortion procedures, though she never used that word. I cried on the phone with her, but almost as soon as we hung up, I felt a rush of relief. Finally, I didn’t have to wait and see anymore. Finally, I could stop being afraid all the time and feel like myself again.

I lived in between that pregnancy being viable and nonviable, peering at an ultrasound machine and begging it to see what couldn’t be seen in the depths of my body.

That afternoon, Senate Democrats failed to advance legislation to guarantee abortion rights nationwide. It had been a largely symbolic effort; they were well short of the 60 votes they needed to move the bill forward. But it was not symbolic to me. I had decided to go ahead with ending my pregnancy via medication, and I had to fill the prescription for misoprostol that afternoon. In Massachusetts, this was as easy as filling a prescription for amoxicillin for my son’s ear infections. But what would have happened if I lived in another part of the country? Would I be able to access abortion pills for a maybe-ectopic pregnancy that was seven and a half weeks along? The thought that I might not made me sick to my stomach. 

In our arrogance as human beings, we think we can divide the world into the categories we’ve created: life and non-life, viable and nonviable. (See also: male and female, gay and straight, love cilantro and hate cilantro.) But our biology is often more complicated than that. There was a time when I lived in between being pregnant and not pregnant; the difference was a hormone number on a blood test. I lived in between that pregnancy being viable and nonviable, peering at an ultrasound machine and begging it to see what couldn’t be seen in the depths of my body. Modern medicine can do amazing things, but its limits are humbling. The mysterious workings of the human body will always defy categorization on some level. We’d do best to admit our shortcomings and recognize that we should not — we must not — impose laws and regulations on something of which we understand so little.

Mine isn’t a particularly dramatic or unusual story. I ended a pregnancy because I needed to. I was sad and also relieved. I went back to taking my son to the playground and chasing him down the sidewalk while he rides his bike and going on adventures with him around the city. I know how lucky I am to have him — a shockingly gorgeous kid who literally jumps up and down when he gets excited and has taken to snorting uproariously when he laughs. I want to have another baby, but my top priority is being around to be his mother. There is no gray area there.

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