Wasp-waisted island off the coast of Maine. The point in the afternoon where the heat has gathered itself up in folds. Independence Day, which feels, this year, like a sour joke. I’ve stolen away to the third floor of the old, expansive house where we are staying. To write, I have a blunt pencil and a notebook, ostensibly mine, though seventy-percent full of patriotically-colored maps, courtesy my older son. The maps are loop-de-loops, whorls. Not recognizably places, though mostly contiguous.
The fury within me — it might, if I tried to draw it, look like these maps. Or it might be a scrawl that builds upon itself until the off-white page becomes inexorably minked, along with the pinky edge of my hand.
My sentences trail off, and caterpillar with cross-outs. What is it that I am trying to say, exactly? I am furious, but shamefully distracted. By the far-off keen of a child, the unexpected flatness of the IPA I’d squirred up with me, by my shadow, elongated, almost formidable as I slant towards the surface of the pool.
My uncle, in town from San Francisco, remarked upon the difficulty of pulling off a polemic. We’d been discussing newspapers, which of the local ones were still any good (the Houston Chronicle, we both agreed; my uncle plugged the Sacramento Bee, the Miami Herald, the Raleigh News & Observer). My uncle balked when I said that really, I got all of my news from the Times, apart from the weather, which I get from the Globe. The Times has terrible op-eds, he said. I don’t read op-eds, I said. They seem so self-aggrandizing; I don’t like the way the heds are written, and anyways, they’re either hyping up the crowd or deliberately antagonizing it. And why should I care what Bret Stephens has to say about, well, anything? Exactly, my uncle said. That’s because the Times will take op-eds from anyone, on spec; whereas at the Journal, they are all commissioned. I said I didn’t read the Journal; I respect a paywall but a hardgate — well, how am I to know it’s worth paying for if I can’t sample a single story? My uncle was not dissuaded. The well-crafted polemic, he said, was a rare art indeed, and no one did them better than the Journal.
I have not, in the week since, subscribed to the Journal, but the polemic remark has stuck with me. The intersection of cruelty and illogic — nothing riles me more; nothing is more deserving of a well-crafted polemic. But I do not have the artistry to pull one off; I knew that in Maine and I know it still.
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19 weeks. The baby – wild thing – kicking, kicking, pawing with one miniature arm the walls of her watery world. We follow the doctor, this assured, benevolent man, reassuring in these behaviors, to a small conference room (I have mentioned, already, my surprise at the existence of this room. That the activities of a conference room – talking, planning, filling up white boards – extends to a children’s hospital.).
At some point, the discussion of the condition and the surgery ebbs; the doctor yields to the social worker. She is kind, open-faced, wears colorful glass beads, purple glasses, a long, tiered skirt. All future social workers I encounter will dress this way, as if from the same how to soothe manual. There are other options, she says. She is earnest; her very pores exude supportiveness. I am momentarily confused. I thought there were only probabilities.
The other options are to terminate the pregnancy, or to carry to term and forgo interventions. Sometimes, babies with this condition live for a few days, or a week – maybe even two weeks. The room is quiet. I look at the bell curve the doctor has drawn on the board, at the heart diagram, with its still foreign, industrial components.
Those are not good options; they are versions of the same terrible option. I do not, in that moment, understand the rationale for these terrible options.
Someone else brings up genetic testing. We should have it done as soon as possible, if we are planning to have it done.
The outcome of genetic testing, we discern, can be the rationale for termination.
The social worker notes that we have up to twenty three weeks to terminate.
I think of Arielle Levy’s perfect, shell-pink baby, delivered in a hotel bathroom in Mongolia. 19 weeks.
At home, I research, to the best of my ability, the relationship between TGA and genetic abnormalities. I find very little. I don’t want to do the amnio, I tell my husband. He has read the research papers I’ve forwarded him, or at least my optimistic summaries. She’ll be fine, he says.
I don’t do the amnio. I do try for the MRI, and mostly fail – the machine engenders in me such a vivid claustrophobia that later, I think it must have been a proxy, a cover for my fear of what the process might find. I am twenty three weeks at the MRI; I have committed, already, to the first option.
I have health insurance, through my employer. Each time a baby is born, we pay, in dribs and drabs, something to the tune of three thousand dollars. Without insurance, this would be more like twenty five or thirty thousand.
Throughout the next twenty weeks, I worry about the baby, but now and then, I also worry about the cost. In two or three prenatal visits to the maternal fetal care center, we blow through the deductible. I read and re-read my health insurance plan. It says that 80% of in-patient surgery and hospital stays are covered. I research the cost of open heart surgery, of NICU stays. 20% might still come to over a hundred thousand dollars.
In fact, there is an out of pocket maximum. My husband finds this. Seven thousand, five hundred dollars.
The surgery, the NICU and CICU stays, the many, many doctor drop-bys – when I stop adding them up, the bills have amounted to something around five hundred thousand. We pay seven thousand, five hundred.
I’m worried, writing this, that I’m accidentally making the opposition’s case. The point isn’t that look, the baby passed her trials with flying colors and aren’t I glad I didn’t get a later abortion. The point is that I didn’t need to. We were lucky, and we were extremely privileged, financially and geographically.
In the NICU, there are many, many parents who drive multiple hours a day, each way, to see their infants. “See,” in some cases – many of the infants are under incubators, distinguished only by the different colored baby blankets that hang across the plasticine tops. Clusters of balloons drift by a few of these incubators – 1 month, two months. These are age milestones, not NICU stay milestones – except they are often one and the same. The mother of one of the two month babies, Nepalese, dressed, each time I see her, in many yards of brightly striped wool, brings coolers of breastmilk to distribute to the other babies. The nurses, at first, tried to explain that there was a special process for donor milk, that it had to be tested. But the Nepalese woman spoke no English, and the hospital had not been able to locate a translator. Besides, she wanted to give, this woman. Her baby had been born at twenty two weeks; he was months away from needing the quantity of milk she was able to produce. So the nurses take the milk, save it in the woman’s bin, and then bins. You never know – something could happen with her production, and then wouldn’t it be nice to have this backup stock?
I’m digressing. Yes, there were moments of sweet, selflessness and so much generosity in this intense and often somber place. But the tolls – they were the underscore. The hospital had a few overnight rooms in its lobby, and the social workers would help parents find discounted rooms nearby – but even at a discount, the cost adds up. Many families could not suspend their lives for weeks and months on end. They had other children, jobs. They could not suspend their lives and so they did everything, all at once. The two month old with the new trach tube – his mother learned how to clean it. She was determined that he come home. But he seized constantly; for the duration of our time in the NICU, he was snowed out; I never once saw him awake.
To say human life is priceless: well, whose? Only someone who has never raised a child would believe such a thing.
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In 2016, the writer Jia Tolentino, then at Jezebel, interviewed a woman who had had an abortion in her thirty second week of pregnancy. Erika lived in New York, but New York wasn’t one of the handful of states that allow abortions after twenty four weeks. She had to go to Colorado, to one of the very few clinics in the country that perform this service. She flew to this clinic, with its quadruple panes of bullet-proof glass, to get the medication administered; she had to pay $10 thousand in cash for this, as insurers don’t cover abortions. She had to wait for the baby’s heart to reach “stasis,” the term the deeply kind staff used to imply they were checking for something, rather than the absence of something. And then she flew home to New York to deliver her son, now dead. She flew home to New York because her insurance would cover the delivery; to deliver at the clinic would have cost another $15 thousand. The delivery was the kind that would be traumatizing even with a healthy baby at the end of it. The epidural didn’t take. Delivery was manual, forceful. After, she was asked if she wanted to look at her son. People regret not looking, but no one regrets looking, the nurse told her. She regretted looking.
Despite being only two weeks removed from the stillbirth, Erika, throughout the interview, is not only strong, but incredibly generous – “are you okay?” she asks Jia, at one point. “Oh—are you okay? This is much easier for me, I think. I’m just listening,” Jia responds. The interview is a master class in the power of reacting to what the interviewee has to say; there is an immediacy to it, and a natural flow. This has to be deliberate, a decision to bring the reader into the room where two women are speaking of a series of devastating events, made needlessly worse by cruel, illogical policy.
In a follow-up interview published this past May, Erika, now an abortion-rights activist who was instrumental in getting the state of New York to decriminalize abortion at any stage in pregnancy, noted that it was the prerequisites of making that trip – ten thousand dollars in cash, the ability to take time off work, government-issued IDs – that pushed her into activism.
“I think a lot of people have the moments for them that can be portals to understanding a larger struggle and how we’re connected and how, ultimately, we’re fighting the same forces.”
Portals to understanding. Her story was mine.
I am pro-choice, vehemently, broadly. (I do not understand how anyone who has given birth can be otherwise). But it is the widespread endorsement (attitudinally, legally) of gestational limits on abortion that roils me most. To be against abortions after some fixed number of weeks considers not at all the reasons these abortions are needed; it sends a hideous message to people who are already working through some pretty goddamn tough circumstances that they are at fault for this, that the resolution they seek is something unnatural, criminal.
More grievous still is that this position, which moderates and incrementalists and many a blue state legislature support reflexively, puts as many barriers in front of physicians and healthcare workers – low pay, no funding, no insurance, bomb threats, death threats, being shot during a Sunday morning church service – as as it can pile up. The Colorado abortionist was grim when Erika asked him about the future of abortion rights in this country; the past six years have shown, time and again, that he was right to be so. He is eighty three, now, and still practicing. When he leaves, it is unlikely anyone will take his place.
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I started this post thinking I’d center it entirely on cost. $600,000 for open heart surgery. $10,000 for a single shot. $272,000 to raise a child in her first eighteen years of life. And those numbers don’t include opportunity cost, which can be intergenerationally crippling. Abortions, and, in particular, later abortions are disproportionately needed by people of color, the young, the poor (and Medicaid does not cover abortions, meaning that patients – many of whom are eking by on under $13,000 a year – have to raise the thousands and sometimes tens of thousands themselves).
Very often, abortion seekers are already mothers.
It is the eve of Ottelie’s first birthday; I have successfully crept down the front stairs without waking anyone else; I’ve instructed myself, firmly, that this bit of writing is to be finished before her birthday.
Is it mawkish to be weaving her story into these stray cat, if fervent, arguments I have against gestational limits? Is it (irrational thought) looking a gift horse in the mouth?
The house is quiet, but in the way the moments before a race are quiet. I am alert to the bang of the hall bathroom door (Perry), soft pitter patter down the stairwell, followed by loud inquiries as to my whereabouts (Irv), cries, tentative and then indignant (Ottelie).
How many minutes, seconds do I have? The price of these interruptions — the prolonging of a post I was struggling to start, and then to finish — is less than the value of the interruptors. But it is not nothing.
To wrap, some resources:
- The National Abortion Foundation supports both seekers and providers of later abortions (you can opt to give your donation to either, or both)
- The Abortion Care Network supports independent providers
- Partners in Abortion Care is raising funds to open a new clinic in Maryland — one of the southernmost states where, post-Roe, abortions are still legal, and thus a critical access point for patients in the southeast.
- Who Not When provides educational resources for understanding the reasons for and importance of later abortion access. Many of the data points here come from Who Not When’s journalist resource sheet.
Most of the images in this post are from the Portuguese painter Paula Rego’s Abortion series, created in response to Portugal’s anti-abortion referendum, in 1998. More here.
The cover image is a still from Lingui, the Sacred Bonds, which chronicles a mother’s quest to secure an abortion for her 15 year-old daughter. It’s set in Chad, but it might as well be Mississippi, or North Dakota.