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The Tally Ho

Tuesday, June 28, 2005

Terminology

Did you hear about the 16-year-old boy who had a late-term abortion? No, it's not the setup for a sick joke. It's an extremely rare fetal anomaly, and Bitch. Ph.D is using it as a hook for her discussion on how we might reframe abortion. (Let me say, right now, it's tough to reframe the abortion debate. Ever since Roe, we've had two diametrically opposed sides, who are so convinced they're right that they've completely stopped paying attention to the other side. Abortion is not THE issue, but if we could resolve this issue to everyone's satisfaction, the other issues would all look a lot easier.)

It seems clear to me that no one will argue with the removal of a parasitic twin from an adolescent boy's body, given that the twin is presenting serious health risks and has no chance of independent survival. Some folks will say that under NO circumstances will they consider an abortion moral, not in cases of rape or incest, not to preserve the health of the mother. Even these folks, if they are sane, will agree to abortion procedures to save the life of a woman whose fetus has no chance of survival. Ectopic pregnancy (outside the womb, most commonly in an oviduct) is fatal in every case if the fetus is not aborted--and there's currently nothing to be done to save the fetus or allow for for re-implantation. So, as much as the anti-abortion crowd would like to deny it, the question is not if abortion is moral, but when it is moral.

Friends of mine, quite recently, have been trying for a baby. For three years. With fertility drugs. And adoption plans. And donor sperm, guaranteed to be "A+" swimmers. Like others in this situation, they carry a high risk of multiple pregnancy/birth. They are also aware of every pregnancy, even the non-viable ones which implant for a couple days, raise the HCG levels, and waltz off into oblivion. When they told me they were pregnant, I was not impressed. When she went back the next week and the embryo was still there, I was slightly hopeful. They went for their five-week checkup and ultrasound last week, and there was a baby/pregnancy. One of each, in fact; an ectopic pregnancy and a normal, viably implanted embryo. Since that moment there has been a crisis of terminology: is it an embryo, a baby, a "product of conception," or what? How is it possible for these two embryos, fertilized minutes apart, developing at the same rate, to be two such different things? In the minds of the doctors attending them, one is a baby. The other is a problem.

The owner of the uterus/womb, not surprisingly, is torn up about this. She couldn't handle the thought of a termination, nor would it be the best course for their other embryo/developing child, so they went home for the weekend and hoped that things would "take their course". (Ideally, the ectopic pregnancy would not continue developing, and remove itself without requiring surgery or further trauma.) When they went back at the beginning of the next week, they found two heartbeats, amplified by the miracle of modern technology. For the baby/uterine pregnancy, this is a solid developmental milestone. For the embryo/ectopic pregnancy, this is a signal that they have to do surgery. They did so this morning. Mom and baby are fine. The other problem has been removed.

My friends were desperate to avoid this circumstance. Suddenly all the facts they know about this situation were called into question: Was there any way to move this embryo/baby/tubal pregnancy, to save it? (No.) Could they decline to act and see what happens? (She would have ruptured, bled out, lost her life and that of their child.) Was there any way to convince themselves that this "product" was not their future baby, if only it could have developed in the right place? We couldn't find any way to convince them that; we couldn't even agree on which nouns to use when describing their problem.

They were filled with what-ifs (was this the long-awaited girl, this aborted tubal pregnancy?) and told their other children much earlier than they planned to, since they could hide a pregnancy but not a surgery. She is still at high risk of miscarriage. They don't want to talk about baby showers yet. They are experiencing tremendous grief, didn't want to do what they did, despite the knowledge that she would have died, surely, without this intervention.

We can't agree on the nouns, but we keep using the same adjectives: scary. heartbreaking. uncertain. It is not an easy task, bringing life. Nor is it easy to terminate it. Woe to those mothers who must decide to do both at once.

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