By Joy Pincus
Thursday, August 14, 2008
Monitoring a fetal anomaly left Joy Pincus hoping for the best and preparing for the worst. In the end she followed doctors' advice to have a late-term abortion. The decision is a milestone marking the unpredictability of life and the value of choice.
(WOMENSENEWS)--I have several milestones by which I measure my life; like moving to Israel, deciding to get married or quitting my job to become a full-time freelance writer.
Today, however, my life is divided into two distinct periods: before and after my abortion.
After a few years of trying to conceive, my spouse and I were overjoyed when our first attempt at in-vitro fertilization succeeded; doubly so, because six weeks later we discovered I was pregnant with twins. At age 39, I would be giving birth just short of my 40th birthday. I found a midwife and began to plan for my perfect home birth, which of course would be preceded by as few ultrasounds or other intervening procedures as possible. It all felt like a dream come true.
That feeling lasted about six weeks, until the first test results came in and we understood that fetal development would have to be carefully monitored. From that moment on, my spouse and I found ourselves strapped in a nightmare of a rollercoaster ride. When that ride finally ended, seven months had passed and we faced one of the most difficult decisions of our lives.
Knowing that something may or may not be very wrong with one's unborn children demands a precarious psychological balance. One has to walk a very thin line between expectation and resignation; simultaneously hoping for the best and preparing for the worst. I walked that line as best I could.
After several inconclusive tests, we finally received confirmation beyond a doubt that one fetus was malformed to an extent that would preclude any normal existence. I gave up all hope of having twins, consoling myself with the thought that at least one child would somehow make it through.
The ride had not yet ended.
We soon discovered that the second fetus was suffering from IUGR, intrauterine growth retardation. By 27 weeks she was in terrible distress, some five weeks underdeveloped and with next to no amniotic fluid surrounding her.
The team of doctors following the case--including the specialist who had been monitoring the pregnancy from the first sign of trouble--were now recommending a full termination of both. Such a unanimous decision is extremely rare in a country where it often seems rare for even two people to agree on anything.
I went for one last consultation with my specialist, who explained that there was a strong likelihood that with termination of the first fetus, I would spontaneously go into labor and give birth to the second, with devastating consequences. Even worse, at any moment I might enter labor and give birth to two extremely damaged children. A monumental decision had to be made, quickly. I went home, feeling like Solomon, but without his wisdom.
That night, my spouse and I escaped into the solace of sleep. In the morning, as we looked at each other, the decision was clear for both of us. Born in Israel and raised to be stoic, my husband may have found it easier to accept the circumstances; born in America and raised on happy endings, I felt like I had misplaced my life.
We phoned the hospital and told them we would proceed with a full termination.
In Israel, abortion at any stage of pregnancy is permissible in several cases, one of them being the presence of fetal anomaly. We met with the hospital's genetic counselor, who wrote a petition on our behalf and presented it to the official committee for their sanction. Our motion was approved, and on the following Monday morning, I was admitted for the procedure.
Termination of a 28-week pregnancy entails full labor and birth. After admission into the hospital I was shown to my room, thoughtfully located in the gynecological rather than the obstetric ward; it was explained to me in advance that this was to protect me from having to hear the sounds of mothers and their newborn babies. Mine was the only private room on the floor.
Next I was taken to the ultrasound department, where a doctor administered an injection of KCL, a chemical that stopped the hearts of the fetuses. This was followed by the insertion of seaweed into my cervix, inducing first a roaring fever throughout my body, and ultimately what became extremely severe contractions. Supported by my husband and mother-in-law, I got through the rest of the day and the night, my husband backing me up as I refused an epidural, in order to remain an active participant in what was to come.
By the following morning, it was over and I was able to sleep, and the next afternoon the hospital discharged me.
In Judaism, when a family member dies, one observes "shiva," a tradition of staying home to receive the condolences of visiting friends. In a similar way, for the week following my hospital stay, friends came by, bringing gifts and food and--more important--listening to the story of what had happened.
I discovered that it was a vital part of the process to tell my story, again and again, and in the telling I found understanding, new perspective and a way to remove any sense of lingering shame, stigma or self-pity.
Also helping me to avoid the feeling of stigma was the fact that the Israeli National Health Service bestowed upon me all the privileges given to every other woman who has given birth. In a case of twins, this means a monetary gift of around $2,000 and four months' paid maternity leave. Besides relieving the financial stress and giving me time in which to heal, the recognition and legitimization of what I had been through helped to maintain my sense of dignity.
Today, nine months later, my life has been transformed; not in spite of my experience, but because of it.
It has strengthened my marriage, allowing my partner and me to be there for each other in a time of great need and to discover tenderness toward one another that we had never known. It has taught me to stop measuring events as either "good" or "bad" by how they may affect me personally, and rather to see them for the opportunity they provide for me to develop and grow.
And it has shown me once and for all that while so many things we meet in life are beyond our control, how we respond to them is not. In fact, our ability to choose how we respond may be the greatest gift we have as humans, and one of the most powerful things we have to offer others.
Joy Pincus is a freelance writer, lecturer and workshop facilitator living in central Israel.
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