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Her fetus no longer viable, Texas woman describes crossing state lines to have an abortion

Austin American-Statesman - 11/18/2021

When she returned home from her OB-GYN's office after learning her fetus would not survive past mid-gestation, the first thing she did was draft an essay titled, "To the Male Politicians Controlling My Uterus."

She needed an outlet for her fury and devastation after discovering that her fetus had an extreme case of a rare chromosomal disorder that would cause its vital organs to fill with fluid, stopping its heart in utero by 20 weeks of pregnancy. Her doctor gave her two options: continue with her pregnancy and have a stillbirth or cross state lines to have an abortion, now that the procedure had been outlawed in her home state after six weeks of pregnancy.

"We had gotten four doctors to confirm that if I had continued with the pregnancy, it would have caused suffering for the baby," she told the American-Statesman. "I don't understand in what world that would be OK."

More: Does the Texas abortion law protect victims of sexual assault?

The woman, 30, who lives in Austin, is one of thousands of Texans navigating the legal minefield of reproductive health care in Texas since Senate Bill 8 took effect Sept. 1 and one of dozens who left the state in recent months to have an abortion.

She agreed to tell her story to the Statesman on the condition that her name be withheld to protect her privacy. She provided a copy of her essay, which was written privately and never published. To verify her story, the Statesman reviewed her medical records, including her ultrasound.

The Texas abortion law is the most restrictive in the nation and prohibits the procedure before most women are aware they are pregnant. It employs a unique enforcement mechanism that permits any individual to sue abortion providers or people who aid or abet an abortion that violates the law. Successful litigants can collect at least $10,000.

The only exception in the law is if a physician believes a medical emergency exists that necessitates an abortion. There are no exceptions in cases of rape or incest.

Multiple legal challenges to the law are playing out in a state District Court in Austin and at the U.S. Supreme Court. Rulings could come any day.

Doctors in Texas largely have stopped performing abortions past six weeks of pregnancy, leaving patients scrambling to find other options.

Supporters of the law — which was approved by nearly every Republican in the Legislature, along with a few Democrats — have hailed it as a success because the number of abortions performed in Texas fell by half since the law went into effect, according to a University of Texas study.

The few exceptions allowed under the law, supporters say, are consistent with the belief that no fetus, no matter how it was conceived or afflicted with disease, should be terminated.

Related: Texas abortion law written to put providers at a legal disadvantage

"I received a call from my gynecologist saying that the bloodwork for my presumably healthy, 12 week baby, showed risk of Turner's Syndrome ... all week we remained hopeful that this was not the case ... as we watched the sonographer try to conceal concern today, we quickly learned our case was not one of the fortunate false positives."

- her essay

When she found out that she was pregnant in April, she and her husband were ecstatic. They hadn't planned on having children just yet, but instead of feeling scared or overwhelmed by the news, they took it as a welcome surprise.

Shortly after, she had a miscarriage. But the experience sparked a new desire in her to have a child, and about three months later, she was pregnant again.

The pair shared the news with their immediate family members and a few friends, but they wanted to wait to share it more widely until the end of the first trimester, when the risk of pregnancy loss would lessen.

During one of her early visits to the OB-GYN, she was eager to learn the sex of her fetus and consented to noninvasive prenatal testing, a tool that also screens for possible chromosomal abnormalities. The results showed that the fetus was at a high risk for Turner syndrome, a rare condition that occurs when a female fetus is missing part or all of one of its X chromosomes. In many cases, fetuses diagnosed with the condition experience fluid buildup or severe heart problems that affect the development of other organs.

She was referred to a high-risk pregnancy specialist to confirm the diagnosis, as the chances of a false positive from the prenatal screening were high.

During the appointment, the specialist used an ultrasound to show her that fluid was building up in the fetus' neck and had started to fill its brain and lungs. She was told that eventually, it would reach the fetus' heart.

Court: Some Supreme Court justices skeptical of Texas abortion law, impact on other rights

She and her husband knew abortion was an option, after spending hours poring over online resources about Turner syndrome. But the first time it was presented as an option by a medical professional was during an appointment with a genetic counselor.

"She said at this phase, about 12 weeks, it was the most intense case that she'd ever seen," she said of the counselor. "In retrospect, I do feel really grateful for the clarity that we got there. ... She said, 'I'm going to help you, and we're going to talk about every option possible, and not just the ones that are legal.'"

The legal option would be to continue with her pregnancy, receiving weekly ultrasounds to monitor the buildup of fluid inside the fetus until its heart stopped beating — likely around 20 weeks of pregnancy. At that point, a doctor would induce labor and she would deliver a stillborn baby.

She also could choose to travel to a neighboring state to obtain an abortion, one that would be illegal in her home state but legal nearly everywhere else in the U.S.

"I would try to compare the absolute heartbreak and devastation that we felt with something your cold, heartless souls could relate to, but alas, you will never have to be in my position. You will never have to choose if you should wait weeks for the heart of the sweet, innocent baby within your womb to stop beating, only to then go into full delivery of a lifeless being, or to make the decision to terminate immediately, where you do not have to be induced, where you don't have to witness the heartbreak face to face."

- her essay

Ultimately, she and her husband decided that the best option was to terminate the pregnancy.

"It came down to: What is the most compassionate option?" she said.

But even then, it was made clear that she would have to cross state lines for the procedure because none of her doctors were willing to contend that her pregnancy constituted a medical emergency that would be permitted under the Texas law.

"There wasn't even a conversation about whether I could potentially be one of those cases," she said. "That was odd to me. It felt like everyone was supportive of my decision, all of the medical personnel that we worked with, but they didn't want to get involved. They didn't even want to potentially open the conversation of, 'Is this something we can file as an exemption?'"

She and her husband have family in California, so she found a clinic and scheduled a procedure for the next Monday. Before they left for the appointment, they called their family and updated their friends on the new circumstances of the pregnancy.

"I was definitely in shock," she said of the moments before the procedure. "It all happened in such a small window of time. It was just complete shock and heartbreak. I was devastated, and I still am. Being in Texas was messing with my head, because I was feeling really guilty. I knew I was doing the right thing, but I felt like because it was illegal, there had to be a reason — but there just isn't."

Her concern about violating the law in Texas persisted, even after she returned home from having the abortion.

Her regular doctor encouraged her to schedule a post-op visit back in her Austin area office, but she fumbled over her words when she tried to schedule the visit with a receptionist over the phone, fearful that the appointment could be construed as her doctor "aiding and abetting" an abortion that violated the Texas law.

"I went to my appointment, and the nurse was like, 'How's baby?'" she said. "Clearly, whatever I said wasn't reported correctly."

Coming home

"So, male politicians that control my uterus, I ask you for something that may not come natural to you — compassion. I ask you to consider the mother who is told her child will likely have a condition like spina bifida, where they will live at most to young adulthood. I ask you to consider the women carrying a child from an abusive, non-consensual encounter. I ask you to consider the woman having to choose between the loss of her life or the loss of her unborn child, both sacred, but ultimately her decision to make. Most of all, I ask you to consider me, and the many women in my exact same situation, especially those with little to no financial, emotional, or educational resources. The amount of pain and heartbreak I feel right now is something I would never wish upon anyone, not even you."

- her essay

The hardest part was returning home.

"They say that after a death, you feel so supported until the funeral and, then after the funeral, everything goes away," she said. "That's kind of how it felt. We were in this bubble together, and then we came home and went back to work."

In the weeks since the procedure, her focus has shifted to her recovery, both physically and mentally. She said she is working with a therapist and an acupuncturist to navigate her new reality — and figure out how to grieve her loss. She also joined a virtual support group for people who have chosen to terminate their pregnancies.

"It's really hard to grieve when it is your body," she said. "After a death, you can take space from someone's house if you don't want to see their stuff or go through their things at that moment. But it's like, when it is you that is also that house? It is a really trippy feeling, and it is hard to respect yourself and know that one day, hopefully, you will house another baby."

For now, grieving involves putting the baby she lost front and center and talking frequently about the life she once held inside her. On Día de los Muertos, she and her husband constructed an ofrenda adorned with cheese — the snack she craved most during her pregnancy.

They also planted wildflower seeds, scattering them in their backyard the same day they returned to Austin from California. If all goes according to plan, the flowers will bloom in April: her original due date.

"I hope that, by that time, we're welcoming those flowers and looking back at how far we've come, and hopefully this stupid law will be undone," she said.

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