Friday, January 22, 2010

Blog for Choice Day

It's blog for choice day again, and I'm hoping this is the year blog for choice day actually inspires me to maintain this blog.

This years theme is "trust women." Now to me, the idea that we should trust women to make their own healthcare decisions is a given, and I'm sure a lot of people feel this way. But is that the way we deliver healthcare to women in the US?

I have the unique perspective of working as a nurse on a labor, delivery and postpartum unit in a large university hospital. In addition to caring for birthing mothers and their babies, we also care for high-risk antepartum women and we provide abortions for fetal anomalies or if the mother's life is in danger. To be clear, it is my personal belief that women should have access to abortion services no matter what her circumstances, but the stories I am about to relate here are composites of my own personal experiences.

I have seen pregnancies that put mothers' lives at risk continued because the did not want to terminate, and have seen some of these same women almost die in an attempt to carry their pregnancy to term when all of their doctors recommended that they terminate the pregnancy.

I have also cared for women transferred from smaller hospitals with babies with lethal fetal anomalies because their hospital couldn't, or wouldn't, terminate the pregnancy. In addition to grieving the loss of a very much wanted child, they feared the scrutiny of their peers if they told them they terminated their pregnancy. It is part of my job to reassure them that the choice they made is okay.

What I find both fascinating and infuriating is that in anti-choice circles, the woman in my first example is a hero, but the second woman is either a. selfish or b. somehow unable to grasp the enormity of her decision. I work with nurses who would happily care for one but not the other. But to me, they're just both women who need care and support.

I have seen both women make extraordinary sacrifices, the former risking their lives because of their conviction and the latter cradling their lifeless, tiny baby with tears in their eyes, grieving the loss of their child.

I just hope it's a choice I never have to make. And I wish it weren't restricted to the point that it is. In my state, there is a mandatory waiting period and mandatory reading material for any women having an abortion including information on adoption and prenatal care, no matter what the circumstances. Because apparently women and their care providers cannot be trusted to make this decision on their own; the state has to tell them , " you know you're stopping a beating heart, don't you?" It's a paternalistic slap in the face.

I also know their are women for whom abortion is an easy choice, and even a relief. On several occasions, that would have been me had I found myself pregnant when I thought I might be. Choice is also restricted by access and social circumstance, and with the current health care reform legislation, it has the potential to be further restrictive.

Abortion is a medical procedure, the need for which is best determined by a woman and her healthcare provider. Restricting access to abortion services is just as morally reprehensible as restricting access to open heart surgery, which also happens, but without the state mandated moralizing.

When I think about trusting women, I also think about how that relates to care of women in normal pregnancy and childbirth. I am off to a Planned Parenthood benefit though, so this will have to be the first in a two part series.

Stay tuned.

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