Friday, January 21, 2011

Choice is not all black and white

Imagine your life-long dream of having a baby is about to come true: You're 5 months pregnant. You and your partner are thrilled. You've read all the books about prenatal care. You've never missed an appointment with the OB/Gyn. You've been eating all the right foods, exercizing, getting enough rest. You've got a positive attitude. Your whole family is excited. The baby gifts have started pouring in. Everything is exactly the way it should be. And then your doctor calls you in to tell you that something disturbing has come through on your most recent ultrasound. Your son (it's already been determined that you're carrying a boy) is not developing as he should be. Maybe his brain is only partially developed. Maybe there are other organs that just haven't developed, at all. Something has gone wrong. Instead of the son you've always dreamed of, you're carrying a fetus that is not viable. He's no less your baby than he was yesterday, but now you know that he will never be alive in this world. What do you do?

In 2010, a judge in Brazil refused to grant a woman the right to terminate a pregnancy, even though the fetus she was carryind had no brain. The judge believed it was a black-or-white issue: human beings either value life, or they don't. Is anything ever this cut and dry? When we state things and pass judgment based on things either being ALL RIGHT or ALL WRONG, what gets lost is the human element. How can there be any human compassion when one is measuring in terms that really have no practical value within the human experience?

A close friend of mine - C - is a Registered Nurse and Midwife. Most people hear "midwife" and think of childbirth. For the most part, this is a safe assumption. My friend, though, deals a lot more with fairly late-stage terminations than with catching babies as they enter into the world. When a pregnant woman faces a situation such as the one described above - a tragedy, no matter how you look at it - my friend is someone they can call on not just for her medical expertise, but for her compassion.

Women have to make choices regarding reproduction all the time - not just when they decide whether or not to use birth control. A woman in the situation described above has some pretty big choices to make. And she has rights. She might choose to carry to term a fetus that is not viable. This is her right. She might, however, choose to terminate the pregnancy as soon as she learns the truth about her baby - that he is no longer alive, or that he will die almost instantly after being born. This, too, is her right. When a woman makes this choice - the choice to terminate a planned pregnancy that has gone terribly wrong - it is my friend who is often called to duty.

C went into Midwifery because she loved the idea of women helping other women through the birthing process. Over time, though, she realized that her experience as a career nurse and her personal feelings about choice made her the perfect person to perform these difficult terminations. She's good at what she does not just because she has the clinical skills to perform the procedure, but because she knows that it's no easy thing for a woman dealing with trauma to make the decision to terminate. Also, she recognizes that, when a woman in this position DOES make the decision to terminate a pregnancy....she's giving up a baby she's planned for and learned to love. A woman in this position has the right to make choices about her own body, and she also has the right to grieve the loss she's experiencing. C knows that the business of deciding to terminate is rarely a black-or-white issue, and that the emotions that accompany it cover the entire spectrum. She is both an excellent clinician, and a compassionate support person.

It's important that we defend every woman's right to reproductive choice. It's also important that we remember few women make these choices lightly, and that the choice can be difficult to make.