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The XX files 

When the choice is yours

Pregnant with my second child. Week 21. Routine ultrasound.

            The technician squirts goo onto my swelling belly and presses the ultrasound wand against me. I'm mesmerized by the ghostlike baby on the monitor. Gray pearls strung in a gentle curve form the spine. A blob of black is the bladder. "There's the..." the technician says, smiling. "Well, it's a boy!"

            Suddenly, she's silent, pressing the wand against my side. The screen seems all blurry. What's she looking at? I can't tell if it's the stomach, the lungs, the head.

            I start to panic. Why didn't I ever learn to read ultrasounds? I wasted four years of college reading books and drinking beer when I could have been learning something useful like radiology or neonatal care.

This is how it happened to me. This is how I came to consider having an abortion. Mine is just one of millions of women's stories.

            The fetus had an eight-millimeter cyst on his brain.

            This meant one of two things: he was fine or he had trisomy 18, one of the most disfiguring genetic disorders. Sometimes babies with trisomy 18 endanger the life of the mother. Sometimes they die in utero. If they do survive the pregnancy, the mundane tasks of baby life --- breathing, swallowing, crying --- are too challenging; few live past the first year.

            At the time there was little medical research to guide us. Recent advances in ultrasound technology enabled us to see formations --- like the cyst --- that had never been seen before. But physicians hadn't yet been able to interpret what this cyst meant. The only studies available were small and inconclusive, showing anywhere from a 25 to 90 percent chance of getting trisomy 18.

            My husband and I came unglued together. Half the time we called "it" "the fetus," in an unsuccessful attempt to distance ourselves. The other half of the time we called "him" "our baby" as we had before.

            Because it was the 21st week of the pregnancy, we had to decide on a course of action soon. In Tennessee, where we lived at the time, abortions were legal only until the end of the 24th week.

            My doctor suggested amniocentesis --- a test of the fluid surrounding the fetus. It could rule out trisomy 18 and other possible disorders. The results would come back in 10 days.

            "If it's bad news," the doctor said carefully, "you'll have to decide very quickly what you are going to do."

We slipped into the trance of the unlucky. The half-panicked, half-numb condition of people who get scary medical diagnoses. The state of mind where anecdotes, professional advice, and tabloid headlines have equal weight.

            My Southern Baptist neighbor said her best friend's baby was born a dwarf. "If I were you," she said urgently, echoing most of my friends, "I'd get the amnio and then, if --- God forbid! --- the baby's sick, have the abortion."

            The director of the ob/gyn department of a major Boston hospital, a family friend, said he thought my fetus would be fine.

            The tabloids at Kroger taunted me. "Nashville Mom Pregnant with Alien/Elvis Love Child."

            I just wanted some concrete answers. What were the odds, exactly? What do other women do in this position? The Internet was useless --- this was seven years ago --- and my family was merely loving and supportive. What good was all that life experience they supposedly had if they couldn't tell me what to do?

            There is no way of knowing how you are going to feel in any given circumstance. I was pro-choice; I had donated to pro-choice organizations in the past and always kept a wary eye on legislation and politicians that threatened to restrict my right to choose.

            But when it came to my own pregnancy in this particular set of circumstances, I wasn't sure I wanted to abort this fetus, sick or not. My husband agreed. This led us to decide against amniocentesis, since the results weren't going to change our decision to keep the pregnancy.

            This is how our thinking went: We had already hatched one perfect specimen --- our toddler son --- and we couldn't imagine discarding the second one, even if he was deformed and destined to die. We'd give him the best few months a baby could have.

            This attitude completely surprised us both.

But that's the way it should be. Having a choice means looking deep into yourself to find out what is right for you. You might even find strength you never thought you had. Strength to make room in your life for an infant under less-than-ideal circumstances. To end a pregnancy that will result in a child you are not prepared --- or are not well enough --- to care for. To make a choice that is right for you in your particular set of circumstances at that particular moment in time.

            Having no choice --- that is, if abortion were illegal --- would have made our whole exercise in strength moot. I never would have learned this about my husband and myself: that we were ready to face anything together. I wouldn't have learned that in the end we didn't need science, religion, parents, or statistics to help us decide. All we needed was a mutual blind faith that life would work out one way or another.

            If we'd never had that choice, and I had to carry the baby to term no matter what, I would have felt trapped, angry, alone. And if the fetus had in fact been diagnosed with a major genetic disorder in utero and had my circumstances been slightly different --- an abusive marriage, unemployment, cancer, an older child with special needs --- you can be sure I'd have gone looking for an illegal abortion.

            Judging from the statistics about back-alley abortions before January 22, 1973 --- when Roe v. Wade was passed 30 years ago --- that might have been the beginning of my problems. Infections, sterility, and death were not uncommon results.

Over the following months we watched the fetus develop into a healthy baby at weekly ultrasound appointments. The cyst disappeared --- "resorbed" was the word the doctor used --- and no other disturbing symptoms appeared. I am happy to report that right now our son is running around the house making altogether too much noise.

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