Ask a guy about abortion.

I’ve not posted for quite a while, partly out of lack of desire, partly because I was simply too busy to participate.

I’ve been reluctant to discuss this, because of concerns about security. They better be unfounded.

The title rather says it all, I think. Given the nature of the subject, I figured GD was the only place for it. I’m NOT fishing for sympathy, and think expressing it would be gratuitous for the purposes of this thread. I’ve a rather good idea who would extend it and who would not anyway. Good people of the Dope: I know who you are. The rest? The less said the better.

Last year, my wife and I had a rather rough bout with misfortune, and she was faced with a choice she never wanted to make: Whether or not to terminate a pregnancy. Such is the good health of our relationship that she involved me deeply in the decision-making process, though we both understood explicitly the decision was ultimately hers. She chose to get an abortion, and I did what I could to help her through a difficult time.

Despite us both getting a clean bill of reproductive health, we found it difficult to get pregnant. We waited a while after marriage to start trying, which, in retrospect, perhaps wasn’t wise. My wife is five years my senior (though you’d never know it to look at her), and, as her 39th year began, we chose to seek medical assistance. One attempt with a 50mg qd. course of clomiphene plus IUI did the trick, and our anxieties over our ability to start a family seemed mercifully brief. Worry turned to elation, with all the attendant fantasizing about the arrival of a baby that I’m sure every happily expectant couple indulges in.

The reproductive endocrinologist we worked with advised her strongly to get amniocentesis as soon as that was possible, due to the increased risk for chromosomal abnormalities at her age, but she had a difficult time weighing those risks against the 1-in-200 risk of losing the pregnancy due to complications from the amnio. After a couple weeks of procrastination (during which my anxieties over her reluctance to get the amnio grew to an uncanny degree, though I kept it to myself), she opted first to get a hi-res 3D ultrasound with a Boston specialist who, quite literally, wrote the book on sonography. If that looked good, then she figured it was better not to risk the amnio, and I supported that decision.

It took about a minute of watching the doctor’s face as she moved the probe over my wife’s belly for me to figure out the news would not be good, but it took her at least fifteen (excruciating) minutes of measurement before she shared her concerns with us. Long bones were well under average length for gestational age. There was a considerable asymmetry between the lateral ventricles of the brain. There was marked renal pelvic dilation, indicating a likely obstruction. Lastly, there was a serious ventricular septal defect, in this case a sizable hole between the lower two chambers of the heart. My wife had opted not to learn the sex of the fetus during a previous standard ultrasound, and could not bear to hear it now.

We managed to line up an amnio with my wife’s OB the next day, and got the preliminary results back in a remarkable week, though there was little doubt about what they would reveal: Trisomy of the 21st chromosome.

The following week began the excruciating process of deciding what to do with what we now knew. A consultation with a perinatologist almost made things worse, as all prognoses were in terms of percentages, which now struck my wife as especially devoid of meaning, given her estimated risk of being in this predicament to begin with was reportedly about 1-in-60. The child might have permanent impairment of renal function due to buildup of urine indicated by the distended renal pelves. There might be neurological issues beyond those expected with Down, as indicated by the degree of cerebral lateral ventricular asymmetry. The baby might not survive to term. The baby might die soon after birth. At best, we’d have a baby with Down Syndrome, who would almost certainly need heart surgery to fix the septal defect, but would have few or no more expected health issues, cardiac or otherwise, than were normal for Down. All were possible. Greater prognostic certainty could only be gained by waiting, but every day that went by was a day that made termination more difficult, if we opted for it. Before long, that option would no longer be available, according to the laws of the Commonwealth.

After two days of almost non-stop sobbing, my wife reached her limit. A reasonably healthy baby with Down was one thing, but one with such risk of illness, or even death, perhaps before it left her body, or, maybe worse, shortly after, were too much.

Quickly we made the arrangements, and for two early mornings I drove my wife to the clinic to have her cervix dilated. By the end of the third morning it was done, and I drove her home, vomiting from the general anaesthesia. The nausea went away quickly, but the emotional ramifications did not. There is no denying that a part of each of us felt selfish, and guilty. My wife’s no longer much for organized religion, and I’m not remotely even spiritual, but there’s no question the aftermath of an abortion isn’t necessarily easy, even when a couple has the complete support of family and friends, as we did. My in-laws rather astonished us, actually, with the generosity of their support (which, given their rather conservative Christian roots, neither of us was sure would be provided). Generally, everyone we confided in confessed they were relieved we’d done what we had, under the circumstances. Only we had lingering doubts, which to this day I can’t really explain.

As time has passed, though, those doubts gave way to sad resignation. We don’t regret the choice, though we do regret that she had to make it. We want to be parents, after all. Because the clock is ticking, we barely had time to lick our wounds before we were back to consulting the reproductive endocrinologists again, and getting probed, prodded, and measured as we did before. It’s been high anxiety over Clomid challenges (we qualified for insurance, thankfully, should we need IVF), and a bit of post-traumatic stress over the new appreciation for how risky the whole process can be, especially when you’re older. We’re looking into adoption, too, as one might guess, under the circumstances.

Well, it’s a topic that gets debated a lot. Experience certainly lends a new perspective (though I can’t say I’m fortunate to have it). Perhaps discussing it might be helpful to some.

Ask away.

I have no questions. I am so sorry for your loss. I think the only thing worse would have been the alternative.

I do, too.

Did the decision change your mind about abortion in any way? I’m not sure what your views were to begin with, but I could understand you feeling more sympathetic and I could understand you feeling less.

{{{Loopydude and partner}}}

I don’t do that much, but wow.

My sister had a kid with a spectacularly bad case of Goldenhar’s Syndrome. She and the husband did not know how bad it was going to be. At birth they didn’t expect the baby to ever leave the hospital. She was tough though and lasted for almost 5 years and 40 expensive operations (including creating and installing 4 titanium ribs on the bad side) and expensive wheelchairs and time-consuming procedures. Was a major cause of divorce of sister and husband (who bailed). Derailed sister’s career for awhile as she stayed home to do full-time care. And for all that I admired the kid’s toughness and intelligence and curiosity, she was totally not social, quite possibly autistic, never acquired language. Never became continent either.

I would never seek to second-guess the personal decision that you and your wife made, but I think from the bit that I know that you made the right decision.

for what it’s worth, i also wish to give my best regards.

people think these choices are simple. they simpify them because they’ve never had to make them. only when they’re put in that predicament can they understand. because of that, i can’t (for the life of me) understand why more people aren’t tolerant. people don’t WANT to get abortions (or so i assume). they become viable options given the circumstances.

you mentioned the in-laws and how they were conservative. did they support the rights to have an abortion before these difficult pregnancies? what are their views now that they’ve been put a degree of separation from it?

a very difficult choice, but a noble one. and a correct one considering the circumstances.

i also appreciate your perspective, although i certainly wouldn’t wish it upon you or anyone else.

I certainly have a stronger conviction than ever that abortion should be safe and legal. I don’t think I really at all appreciated before how much of a terror being denied the ability to choose might be. The real risk of delivering a stillborn child, or losing the child shortly after delivery, simply horrified my wife. She was not at all certain she could handle that. Having no ability to avert that option seems cruel beyond words, having witnessed what the fear of it did to her over only a few days.

That said, there’s no denying one can have painfully conflicted emotions after it’s over. Did we truly have the right? Were we cowards? Would things have really been as bad as we feared? Could we have been happy anyway, even with a sick child? These sorts of questions haunted us, and still do on occasion. One day we were walking down the street and passed a mother hand-in-hand with a child with Down. I wound up sitting on a stoop with my wife sobbing into my jacket for about 20 minutes. There is spectre of guilt, rational or not. I think I might be more inclined now to be sympathetic towards those who question the appropriateness/morality/whatever of abortion, given those experiences, depending on how the approached the matter.

But, again, I’d never support making abortion illegal, not for any reason. It’s such an intensely personal decision, made quite possibly under very unhappy circumstances. The idea of the govt. meddling in that makes me shudder.

I didn’t make this clear enough, so my apologies. Actually, they’re a seemingly very odd mix of dyed-in-the-wool MA liberal, combined with some rather old-fashioned views about many things, sexuality especially. Even though my wife was well into her 30s when we got married, and even though a few months prior to the nuptials we’d bought a townhouse together, she actually lived at her parents’ house after her old lease expired, rather than move into her own home, so as not to scandalize anyone.

On her mom’s side, they were rather strictly Presbyterian. On her dad’s side…hoo-boy. Grandpa was a very conservative Lutheran pastor, and grandma was a very self-righteous pastor’s wife. They both passed away before I met my wife, which is really just as well, so she says. Catholics made them a little apoplectic. A catholic as lapsed as myself would have chilled them to the marrow. This is no joke.

So, though my FIL and MIL appear to have fallen a bit far from their respective trees in some ways, discussion about a variety of touchy issues just never happened. It’s really too bad. My wife truly had very little real appreciation for her parents’, especially her father’s, spiritual struggles prior to getting the bad news. She was terrified of sharing her decision with them, because she really didn’t know how they would react. Her parents were completely amazed and sorrowful that she was so afraid of their judgement. They truly were baffled by her anxieties, but such is the nature of familes that don’t always communicate well, I think.

The whole thing kind of unleashed a flood of shared spiritual ruminations among the three of them. My wife’s pretty lapsed, though she’s still someone with spiritual concerns and a desire for a community of wonder about those sorts of things. I haven’t a spiritual bone in my body, so I’m just completely useless as a guide, or a judge of others’ convictions if they are not made explicit. Her parents confessed great struggles with doubt about their religious heritage, and those struggles obviously altered their understanding of the faith they’d inherited. They certainly didn’t see some invisible hand in all of our ordeal, or any reason to believe our misfortune was some kind of moral test we were supposed to pass. They thought our decision was the only sane one, under the circumstances, and simply couldn’t imagine a God who would punish us for struggling under the weight of our predicament.

People can suprise you.

Oh Loopydude, I am so sorry. I’ll keep you and your wife in my thoughts.

That sounds just horrible, and I’m sure their ordeal was worse than anything we might have been facing. I thank you for your understanding of our decision, which I’m sure witnessing the pain your sister (and her daughter) endured gives you one of those fairly rare perspectives on such matters.

There are no easy choices when faced with such adversity, I’m afraid. I think if we knew full well we were in for something like what your sister went through, the decision to terminate still would have been hard, in no small part because we would know the child would live well past birth. I find that rather strange, but it’s the truth.

I’m so very sorry for your loss, loopydude.

This is why we must keep Roe vs. Wade alive. While it gives every mother the right to choose to terminate a pregancy, it also gives the right to keep one to term, such as in cases where a prengnant mom is brain dead but kept on life support until the baby can come to term.

Women don’t want an abortion like they want a fur coat or a Ferrari. They want an abortion like a fox wants to gnaw its leg off when caught in a trap.

I’m very sorry for your loss and the hard decisions you had to make. I wish lawmakers all over the country could see your post (so well written) and understand that Roe v. Wade is one of the most important decisions ever made by our country. Wishing you and your wife a bright future…

I’m sorry to hear your story, Loopydude, and I wanted to offer my support.

One of my children was born very, very ill. I recall crying for two weeks because I was afraid he was going to die, and then crying because I was afraid he was going to live. It’s gut wrenching.

But, it does get better with time.

Best Wishes!

At times that’s a fairly accurate metaphor, unfortunately. At least, that’s about how my wife felt. “Rock and a hard place” doesn’t entirely do the emotions justice when you’re in the midst of it. What was really tough in our case was the lack of certainty about the child’s viability, and the lack of time we had to make a more informed decision. We simply couldn’t wait to try and be more sure. Throw that in the mix with the inevitable disappointment over even the best-case scenerio, and it’s a world of hurt. Oh, and another terrible aspect of the time calculus: The biological clock is ticking. We got a crash course in pre-menopausal female reproductive biology during the period when we happily pregnant, and during the period when we weren’t. The picture from about age 38 on isn’t a pretty one, if you want to have your own kids. Fertility drops precipitously. Risk of problems of the kind we experieced tracks inversely. Say you bring a non-viable baby to term. It can take months afterward before you’re able to be pregnant again. That’s an entire gestational period gone, and chances are considerably worse after that time is lost.

In the final analysis, we’re both grateful she had a choice at all, as much as she did not want to have to make it. We feel we did the best we could under the circumstances. I’m very much at peace with the decision now, but she still has bouts of regret and uncertainty. It’s kind of hard to imagine the average woman jumping for joy about getting an abortion, actually, especially after this. It’s a hard admission for a staunch pro-choicer to make, actually, but it’s an honest one. It’s a difficult, deeply personal decision for some, and that’s just the way it is. No question, the state needs to butt out, IMO.

Loopydude, Thank you for sharing such a personal and moving story. As I read it I wondered if you were in a medical profession or had learned so much through necessity. What a pervasive burden this must have been. I’m glad to hear you are both healing and I wish much strength and peace for you and your wife.

I am, in simple terms of my title, a scientist at a biotech company, and I do a fair amount of work in comparative medicine these days. I’m nowhere near physician-level in my understanding of human medicine (or vet level when it comes to animals, either), but I may have a better initial grasp of some of the concepts and terminology than your average citizen.

That said, obstetrics and reproductive endocrinology have very little to do with my areas of research, so I had to hit the books and the web pretty hard to keep pace with all the info that’s been getting thrown at us. I actually felt I needed to do that very early in the pregnancy, well before we knew we were in for trouble. My wife had a relapse of an upper-respiratory infection that was treated very well with azithromycin. Her PCP was adamant that azith. was contraindicated during pregnancy, and prescriberd her amoxicillin, which didn’t work. The doc was, quite simply, wrong (I think she must have mixed azithromycin up with a tetracycline-family drug). So, my wife stayed sick, and probably had walking pneumonia before switching docs and getting an effective dose of what she should have gotten in the first place (her OB wouldn’t prescribe her anything not related to obstetrics). Given the congenital nature of the defects in our case, I rather doubt the infection contributed in any identifiable way, but that experience left me convinced I had to be educated, and that education has been paying dividends ever since. You can bet my wife had to have me decode much of what the perinatologist shared with us during our consult with him. I think he made things actually sound more dire than they possibly were, and we kind of suspect he may have been gently nudging us in the direction of termination with his breakdown of the prognoses.

Since then we’ve been dealing with the fact that you can get about as many expert opinions on your individual case as you will consultations with different reproductive endocrinologists. Being in the Boston area, we’ve had the opportunity to meet with some of the best in the field, according to the stats. It’s a little disconcerting when bona fide luminaries can’t reach a consensus, so that puts a great burden for making an informed decision on the patient, unfortunately.

Actually, to debate myself, that’s obviously not entirely correct. It can’t be “anything goes”. What it should be…that’s the trillion dollar question, isn’t it.

Your efforts and attention through this ordeal are testaments to your love and devotion to your wife. Which I’m sure will be the foundation to your answer to my other question too.

I like the elegant way you expressed this but I’m sure it must have been a very difficult time in reality. During the decision-making process, did you struggle to find a balance between participating and being supportive? Or were these things not ever in opposition? (If this gets too personal or off-track, please feel comfortable to decline.)

To be clear, I don’t mean to suggest that you and your wife ever disagreed. I’m interested in your experience in taking on just enough of the load that you both felt was ultimately hers.

That is 100% relevant (probably the most relevant issue this guy faced), and it was indeed an almost impossibly delicate balance to try to achieve. Up front and totally honest, I did NOT see myself raising a kid with Down Syndrome when we embarked on this journey to parenthood, and though the risk was in the back of my mind, I most certainly didn’t take it seriously enough. I doubt many people do, or even can.

When I got over the shock of hearing that my wife was pregnant, I did what is probably the usual fantasizing about all those wonderful milestones all my friends and relatives who have kids have experienced. First words, first steps, first everything a “normal” kid achieves. “Oh, he/she is so bright”, “he/she’s got your wife’s sense of humor/eyes/etc.”, “he/she’s probably going to be a doctor/lawyer/engineer/whatever”. You get the Down Syndrome verdict (or some other serious congenital disorder, I assume), and it slams you immediately that those fantasies were just that: Fantasies. The reality could be very different, and it’s a reality you probably never wanted. A swift, relatively painless way out of the predicament is a powerful, almost overmastering temptation, and it ate at me.

Only, when you get right down to it, it’s not going to be all that swift, or painless. I think we basically just tortured ourselves with The Choice. We got the news, and one of the first things we did was seek out parents of Down kids on the internet to try to get a feel for what raising such a child was like. Invariably one contacts these folks through online support groups and foundations meant to be sources of positivity and hope, and the message you take away is that raising a kid with Down can be a wonderful experience. Not without its serious concerns, to be sure, but not the doom-and-gloom scenerio one naturally imagines whenever they find out their child has the disorder.

So, you find yourself pretty much hating the hand you’ve been dealt, and then feeling like a complete asshole for harboring such negative and prejudicial attitudes about kids with Down when there are so many good mothers and fathers out there (folks a lot like us, not religiouis wingnuts or whatever other distorted picture we might have had about those who choose to carry a Down kid to term) who love their children and cherish the experience of raising them. You think, “Well of course they’re going to say nice things, what option have they got now?”, or, “We’re dealing with a rather self-selecting group consulting support-group members.” Then again, you don’t want to denigrate these folks by supposing they’re completely deluding themselves or us. Terrible. I was confounded.

At various stages, my wife sought my input and opinion, and I mostly didn’t want to give it to her. I knew how much I wanted to escape somehow, and had absolutely no confidence in my own ability to render a sound judgement. Then I’d feel like was copping out and throwing all the burden of the decision on her, which she really didn’t want. Ultimately I just fessed up and said “I want out of this in the worst way, but I don’t know if I’m right to want that. I’ve no idea what the ‘moral’ decision truly is. I really don’t know what we should do, and I’m afraid to put pressure on you to take the burden off of myself. I’m sorry, but all I can say is I’ll support you, no matter what.” This just made her cry. She thanked me, and yelled “I HATE THIS!”

Then we saw the perinatologist, and, perhaps mercifully, that pushed her to a decision. We got numbers, about death, chronic illness, the gorey details. His presentation was about as different as the support-group folks as could be. Clinical, statistically precise (at least, he rattled off a lot of numbers that sounded convincing), and lacking in much optimism for the best-case outcome. We went home, I did my best to be a translator and researcher with no agenda (yeah, right), and, probably regardless of what I said or did not say, after a couple days she was at the end of her rope.

I was, to be perfectly honest, relieved. It felt appropriate. But how could I, or can I, render an unbiased, selfless opinion? I can’t. What I can say was, at the point of her decision, my own fears dissipated, and I threw all my attention and energy completely into taking care of her, which in many ways was a very welcome distraction. The grieving over not being a parent came later, once the dust settled. It has been mitigated considerably by the knowledge we will be parents, somehow, someday.

I’m so glad she had somoene she could count on to support her, even if you might ahve, at times, felt that you weren’t doing anything. You were there. You’re lucky to have each other.

(I don’t want to hijack, but as the wife of a disabled person I wanted to mention that your ambivalence and fear and all the things you were feeling are completely normal. I chose to marry someone disabled, but I wouldn’t choose to bring a disabled child into the world. My husband can bear it if I spend whole days hating him. A child is so much more vulnerable.)