In a Post-Roe World, We Can Avoid Pitting Mothers Against Babies

Now that the Supreme Court has overturned Roe v. Wade, states face a new reality about where to draw the line in pregnancy for when abortion is permitted. In these debates, ectopic pregnancy is a key issue.

In an ectopic pregnancy, the baby implants somewhere other than the uterus — usually in a fallopian tube. The situation is fatal for the baby. It’s also dangerous for the mother. The fallopian tube can rupture, and the bleeding can be so fast and so sudden that it puts the mother’s life at risk.

Pro-life doctors and pro-life ethicists agree it is morally licit to save a mother’s life, even at her baby’s expense — but they draw a distinction between the treatment for ectopic pregnancy and an abortion.

From a pro-life perspective, delivering a baby who is ectopic is closer to delivering a baby very prematurely because the mother has life-threatening eclampsia. A baby delivered at 22 weeks may or may not survive. A baby delivered in the first trimester because of an ectopic pregnancy definitely won’t survive. But in both cases, a pro-life doctor sees herself as delivering a child, who is as much a patient as the mother.

A pro-life approach to ectopic pregnancy may countenance similar procedures but still sees it as different from an approach that equates it to abortion. When a mother’s life is threatened by the course of her pregnancy, there is a wide gulf between a culture that assumes she and her baby are pitted against each other and one in which both are valued.

Having gone through ectopic pregnancy, I have firsthand experience of this. And what I have learned is that a pro-life response to ectopic pregnancy isn’t just a matter of what is forbidden and what is permitted, but of what can be offered to parents to make room for their grief and to treat their child with love and dignity.

My goal for a post-Roe world is that we can offer more love and material support to mothers and children, especially in the hardest cases. The logic of abortion has been that you have to pick a side between the baby or the mother. But even in the case of ectopic pregnancy, you can side with both — treating mother and child with dignity. Both can benefit from the attention paid to the other.

My own experience illustrates the difficulties and promise of this approach. My husband and I had lost four children to first trimester miscarriages when, in 2018, I was pregnant again. We went to the doctor’s office, braced for a familiar grief. The technician in the office was silent, and I could feel her pushing the ultrasound wand so far sideways that her knuckles were pressed into my leg.

“Can you see the baby?” I asked. “Where are you looking for the baby?”

A previous surgeon had told me to stop crying during a miscarriage, so this time my husband and I took a train ride to reach the hospital of a Catholic surgeon in New Jersey. We wanted a surgeon who took the loss of our child as seriously as the danger to my life.

The first person to see us was another ultrasound technician. Her voice got sharp when I asked if our baby had a heartbeat. “It’s not a baby, don’t talk like that,” she told me, as I lay on the table. Her voice softened a little, “You don’t have to think of it that way.” For her, part of providing care was denying there was any room for grief.

But when the surgeon came in, he began by expressing his condolences. He talked about our options, he talked about our baby as a baby. He answered our questions about recovery times from surgery as naturally as he did our questions about how to specify that we wanted our child’s body for burial. He took our request seriously, and told us that we should know that, as far as he could tell, our baby had already died, and it was the placenta that was still growing and putting me in danger. But if he could, he would make sure that our baby wasn’t treated as just a tissue sample but as a child lost.

We worked through the hospital checklists and questions as people cycled through our room asking about my blood type, my experience with anesthesia, my plans for getting home. No one asked about our plans for the baby. No one asked the baby’s name. No one, before or after the surgery, mentioned support groups for loss.

But I had a checklist of my own, and as I lay on the gurney, I prayed that I would open my eyes again. I prayed that if I didn’t, I could offer my life for the people I loved. And I hoped that this would be the first baby I could hold, even if I couldn’t see the baby take a breath. Every other child I lost had been miscarried at home, too early to retrieve a body.

I knew that the Trappist monks of New Melleray Abbey would send us a tiny coffin, free of charge, as part of their ministry to bereaved parents. My husband knew that, if anything went wrong, I wanted him to order an adult-size one for me.

We didn’t get to bury our baby. My husband didn’t have to bury me. Our surgeon had been right — our baby had died some time ago, and all he could find was the placenta. But while I recovered at home, we had something to know our baby by. We named this child Camillian, after St. Camillus de Lellis. He was a 16th-century gambler, who was treated so poorly by his doctors that he founded a nursing order and ultimately became a priest and a saint.

The specifications for surgery remain the same, whether the surgeon is pro-life or not, whether the mother kept repeating “baby” to her nurses or stuck to saying “pregnancy.” But I wonder if an observer in the operating room could have seen a difference; if my surgeon was visibly more tender as he worked, knowing he could be the first person to see our child, a child who would not ever see us.

Doctors can’t value women more by dismissing our babies as worth less. Even women who support abortion access may find it jarring to have their child’s life dismissed when they hoped they would hold this baby. It’s better to be honest about tragedy and loss, than to pretend that only one person is on the table.

Leah Libresco Sargeant (@LeahLibresco) is the author of “Arriving at Amen” and “Building the Benedict Option.” She writes about the dignity of dependence at Other Feminisms.”

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