Commentary Abortion

I Had an Ectopic Pregnancy, and Anti-Choice Laws Could Have Made My Experience Much Worse

Natasha Chart

This isn't how I wanted any of this to go. I didn't go to my ultrasound hoping for a political statement; I wanted a due date.

Last Thursday, I was about to go to the admitting office on the hospital grounds where I’d come for my ultrasound appointment. Before I left, I just had to ask the OB-GYN receptionist, to make absolutely sure: “Is this a Catholic hospital?”

The receptionist hesitated and then asked one of the nursing staff who’d come up if she knew what faith the chaplain was. I turned to the nurse. “No, that’s not why I asked,” I said. “The last time I had a problem with a pregnancy, I had Catholic health care and they sent me home to miscarry. I want to know that they offer a full range of medical care here.”

She understood and said no, it wasn’t a Catholic hospital. She said they were checking me in because they thought this was serious and they planned to treat me immediately. I probably looked a little dazed. She found someone to walk us to admitting and make sure we didn’t get lost.

My ultrasound appointment had started as scheduled, at 3 p.m. that day. I figured we’d hear the heartbeat for the first time, go home with a blurry, indecipherable black-and-white image, and start planning in earnest for a new baby. We already had a nickname. But the tech said she was having trouble finding it. She didn’t play us the heartbeat and said she had to go get the doctor. She was so caring toward us afterward, but I bet she cleans up at poker.

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Then the doctor came in and explained that it was a tubal, or ectopic, pregnancy. Modern medicine can perform many wonders, but a tubal pregnancy can’t be saved. If it’s not removed in time, it’s a serious health risk to the pregnant person. As the doctor explained to me, since it was far enough along to hear a heartbeat, they considered this an emergency situation.

By 5:30 p.m., I was in a hospital bed talking with nurses and doctors about how soon they could get me into surgery, considering that I’d eaten half a granola bar at 2:30. I was shocked and panicked. I was grieving. I was having a hard time being still so they could get the IV started. I was probably not a fun patient, but everyone was about as kind as anyone could hope.

It wasn’t my first time as a surgical patient. As a child, I’d had appendicitis that waited too long for treatment because my parents delayed to find a doctor who would perform major abdominal surgery on a 7-year-old and agree not to use blood transfusions under any circumstances. Jehovah’s Witnesses. It turned into full-blown peritonitis, infection of the entire abdominal cavity. The treatment required two surgeries, rearrangement of my intestines and other organs to clean the infected tissue, more than a week in intensive care, and three months overall in a hospital.

During that hospital stay, the nurses had a hard time keeping IV needles in my arms. That was a problem because my digestive system had come to a complete stop, and it was the only way to feed me. One day, my mother counted, they’d had to replace the IV needle 14 times. I had near-daily blood tests. There was one test where they had to fill several large vials from the one site, and they took so much blood that my arm hurt too much to move it for three days. It made an impression. Needles terrify me. I can’t logic my way out of it. Sorry in advance, every phlebotomist I will ever meet.

Then there was the other surgery, for that problem pregnancy. The one that had started miscarrying by the time it could be diagnosed because I had a massive ovarian cyst that had gone undetected through years of no medical care at all. The doctors said it was urgent, but they couldn’t operate until I’d miscarried. Catholic health care. What if I don’t miscarry, I asked. But you are miscarrying, they said. They sent me home, increasingly shaky and too bent over with cramps to walk straight, until the pregnancy was officially over. I was so weak I passed out during one of my pre-surgery blood tests and was shaking for an hour until I could get something to eat. Then they had me do a 24-hour fast, drink something horrible that kept me throwing up all night, and brought me in for a surgery that I was surprised to wake up from missing an ovary. Someone forgot to discuss that with me in advance as a possibility.

So when one of the doctors last Thursday came to bring me consent forms and said that a possible result of the surgery they were getting me ready for was the removal of an ovary—while one very patient nurse was trying to put an IV in my arm and another was trying to take my medical history—I may have started backing up the incline of the hospital bed, saying something like, “No, you can’t! I only have one!”

Party in my room, everyone’s disinvited.

I calmed down enough to explain the previous surgery and to let my saintly nurse get the IV started. The doctor left to regroup. After a little while, another doctor came in. They’d looked at the pictures again.

She said she could see I was scared. She said there was no better place for me to be under the circumstances. I had to admit that she was right. She said she wanted to keep that remaining ovary as much as I did, because otherwise she’d have to treat me for hot flashes. She said it looked like the attachment point was also all the way on the other side, near where the missing ovary would have been, and that while they might have to take out a small piece of the uterus, there should be no long-term problems.

I thanked her with all my heart. I felt I could trust that she would be making decisions in the operating room that I’d agree with. I relaxed a little for the first time that evening, and my husband and I were able to have some time together to deal with the news.

I was talking to the anesthesiologist by about 9:30 p.m. that night. He told us it would probably be about three hours, and not to worry if it went a little long, not to feel rushed about going home. My husband held my hand as we went down the hall, my son’s grandparents brought him to the end of the ward so I could give him a kiss before going in, and shortly after that I stopped remembering things for a while.

I woke up to a new scar and not pregnant. And very, very grateful for my life. I got to go home to my family that weekend. Thank you, doctors. Thank you, nurses. Thank you, everybody who reached out to us.

Other things I’m grateful for include the many benefits of living in a state that hasn’t been taken over by misogynist barbarians who like tormenting women at what may be the worst moments of our lives. Or creating worst moments of our lives on purpose.

For instance, the doctor wasn’t required to tell me lies about the risks of removing that life-threatening pregnancy while I was also freaking out about whether or not I was going to wake up missing bits of me again. The ultrasound tech was allowed to be decent and compassionate toward us, instead of being forced to play us the sound of that doomed heartbeat and describe what few anatomical features she might have seen, even as my husband and I were both crying over what we’d suddenly realized was our loss. The only waiting period they had to be concerned about was the safe time they could operate based on when I’d recently eaten. I’m grateful that I was able to walk into that health-care facility without a sidewalk circus of nasty strangers talking to me about a baby that wasn’t coming, or calling me names as I went by and blocking my way during a very hard walk, or shouting at my heartbroken husband that he needed to “man up” and stop me.

I’m grateful that during this medical emergency, my doctors were allowed to follow only their best judgment about what care would keep me healthiest, according to the most current standards of their profession. Their only legal concern was my safety. The police had no part in our story. If you want to imagine me at this moment, picture me thumbing my nose at every meddling anti-choice medievalist who was prevented from making a terrible week even worse and threatening my health to boot.

Ectopic pregnancies are dangerous, and the only way to treat them is through a termination. If I were less well-off and in a rural part of a state like Texas, where low-income prenatal care has been nearly demolished in a blunt, smashing fit of rage at abortion providers, I might have had to forgo that routine ultrasound visit and just had to hope everything was fine until I could plan a trip out of town or get to my turn on a long waiting list. I might not have been lucky enough to be near three major hospitals that could admit me at once, where several doctors on staff were willing to take my case without hesitation.

A doctor might not have seen me until the growing embryo and placenta had caused a rupture and internal bleeding, until I’d felt cramps, or felt faint, or maybe passed out from blood loss. They might not have been able to get important details about my medical history if they hadn’t been able to wake me up first, or begun emergency surgery unprepared for the mass of internal scarring and missing organs I told my doctors to expect.

Or they might not have gotten to me in time at all. Because pregnancy is dangerous. It’s dangerous when everything goes right. It’s very dangerous when anything goes wrong.

Modern medicine has given us many wonders. But I think that makes it easy to forget, or to conveniently obscure, that every pregnancy is a risk. We can forget that every pregnancy is so risky that, if it weren’t a pregnancy but a procedure, we would have to sign a thick pile of consent forms and liability waivers to undertake it. If it weren’t a pregnancy, we’d have to opt in for it, rather than have moralizing strangers talk about why we should be forced to stick with it, hell or high water. Pregnancy without modern obstetric care is more dangerous than a kidney transplant, with a high child mortality rate for the trouble, and even now, you just never know.

This isn’t how I wanted any of this to go. I didn’t go to my ultrasound hoping for a political statement; I wanted a due date. And odds are, you’re not one of the handful of people I was planning to share my news with this week. But it happened like it did, and there’s nothing to do but to lie here until this scar heals up some more and try to get my head around the facts of the situation.

Writing has become part of dealing with things like this for me. But as long as I’m at it, I couldn’t help but think about all the ways it could have gone differently if anti-choice laws prevailed where I live. It would have been worse in every way, for no sound reason. The best care I could have gotten was the immediate care that I did get. The best information I could have gotten was the medically accurate information that I did get. For women all over the country, when they’re faced with a pregnancy they have to decide to end—and I trust without hesitation that their reasons are right for them, because who would know their lives better than they do—it is worse in every way.

Because messing with this aspect of someone else’s life should always be seen as the torture that it is. Torture inflicted on unknown women because they didn’t have the political power to demand humane treatment and a right to bodily self-determination.

If you think you know better than women whether we should be pregnant at any given time, that’s how I will always think of you. As a torturer. As someone who would have heartlessly complicated my family’s tragedy without knowing or caring anything about us. And on this, we will be enemies, until you finally decide to recognize the fullness of women’s humanity and our own right to our lives.

News Health Systems

Complaint: Citing Catholic Rules, Doctor Turns Away Bleeding Woman With Dislodged IUD

Amy Littlefield

“It felt heartbreaking,” said Melanie Jones. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

Melanie Jones arrived for her doctor’s appointment bleeding and in pain. Jones, 28, who lives in the Chicago area, had slipped in her bathroom, and suspected the fall had dislodged her copper intrauterine device (IUD).

Her doctor confirmed the IUD was dislodged and had to be removed. But the doctor said she would be unable to remove the IUD, citing Catholic restrictions followed by Mercy Hospital and Medical Center and providers within its system.

“I think my first feeling was shock,” Jones told Rewire in an interview. “I thought that eventually they were going to recognize that my health was the top priority.”

The doctor left Jones to confer with colleagues, before returning to confirm that her “hands [were] tied,” according to two complaints filed by the ACLU of Illinois. Not only could she not help her, the doctor said, but no one in Jones’ health insurance network could remove the IUD, because all of them followed similar restrictions. Mercy, like many Catholic providers, follows directives issued by the U.S. Conference of Catholic Bishops that restrict access to an array of services, including abortion care, tubal ligations, and contraception.

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Some Catholic providers may get around the rules by purporting to prescribe hormonal contraception for acne or heavy periods, rather than for birth control, but in the case of copper IUDs, there is no such pretext available.

“She told Ms. Jones that that process [of switching networks] would take her a month, and that she should feel fortunate because sometimes switching networks takes up to six months or even a year,” the ACLU of Illinois wrote in a pair of complaints filed in late June.

Jones hadn’t even realized her health-care network was Catholic.

Mercy has about nine off-site locations in the Chicago area, including the Dearborn Station office Jones visited, said Eric Rhodes, senior vice president of administrative and professional services. It is part of Trinity Health, one of the largest Catholic health systems in the country.

The ACLU and ACLU of Michigan sued Trinity last year for its “repeated and systematic failure to provide women suffering pregnancy complications with appropriate emergency abortions as required by federal law.” The lawsuit was dismissed but the ACLU has asked for reconsideration.

In a written statement to Rewire, Mercy said, “Generally, our protocol in caring for a woman with a dislodged or troublesome IUD is to offer to remove it.”

Rhodes said Mercy was reviewing its education process on Catholic directives for physicians and residents.

“That act [of removing an IUD] in itself does not violate the directives,” Marty Folan, Mercy’s director of mission integration, told Rewire.

The number of acute care hospitals that are Catholic owned or affiliated has grown by 22 percent over the past 15 years, according to MergerWatch, with one in every six acute care hospital beds now in a Catholic owned or affiliated facility. Women in such hospitals have been turned away while miscarrying and denied tubal ligations.

“We think that people should be aware that they may face limitations on the kind of care they can receive when they go to the doctor based on religious restrictions,” said Lorie Chaiten, director of the women’s and reproductive rights project of the ACLU of Illinois, in a phone interview with Rewire. “It’s really important that the public understand that this is going on and it is going on in a widespread fashion so that people can take whatever steps they need to do to protect themselves.”

Jones left her doctor’s office, still in pain and bleeding. Her options were limited. She couldn’t afford a $1,000 trip to the emergency room, and an urgent care facility was out of the question since her Blue Cross Blue Shield of Illinois insurance policy would only cover treatment within her network—and she had just been told that her entire network followed Catholic restrictions.

Jones, on the advice of a friend, contacted the ACLU of Illinois. Attorneys there advised Jones to call her insurance company and demand they expedite her network change. After five hours of phone calls, Jones was able to see a doctor who removed her IUD, five days after her initial appointment and almost two weeks after she fell in the bathroom.

Before the IUD was removed, Jones suffered from cramps she compared to those she felt after the IUD was first placed, severe enough that she medicated herself to cope with the pain.

She experienced another feeling after being turned away: stigma.

“It felt heartbreaking,” Jones told Rewire. “It felt like they were telling me that I had done something wrong, that I had made a mistake and therefore they were not going to help me; that they stigmatized me, saying that I was doing something wrong, when I’m not doing anything wrong. I’m doing something that’s well within my legal rights.”

The ACLU of Illinois has filed two complaints in Jones’ case: one before the Illinois Department of Human Rights and another with the U.S. Department of Health and Human Services Office for Civil Rights under the anti-discrimination provision of the Affordable Care Act. Chaiten said it’s clear Jones was discriminated against because of her gender.

“We don’t know what Mercy’s policies are, but I would find it hard to believe that if there were a man who was suffering complications from a vasectomy and came to the emergency room, that they would turn him away,” Chaiten said. “This the equivalent of that, right, this is a woman who had an IUD, and because they couldn’t pretend the purpose of the IUD was something other than pregnancy prevention, they told her, ‘We can’t help you.’”

Commentary Sexuality

Black Trans Liberation Tuesday Must Become an Annual Observance

Raquel Willis

As long as trans people—many of them Black trans women—continue to be murdered, there will be a need to commemorate their lives, work to prevent more deaths, and uplift Black trans activism.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

This week marks one year since Black transgender activists in the United States organized Black Trans Liberation Tuesday. Held on Tuesday, August 25, the national day of action publicized Black trans experiences and memorialized 18 trans women, predominantly trans women of color, who had been murdered by this time last year.

In conjunction with the Black Lives Matter network, the effort built upon an earlier Trans Liberation Tuesday observance created by Bay Area organizations TGI Justice Project and Taja’s Coalition to recognize the fatal stabbing of 36-year-old trans Latina woman Taja DeJesus in February 2015.

Black Trans Liberation Tuesday should become an annual observance because transphobic violence and discrimination aren’t going to dissipate with one-off occurrences. I propose that Black Trans Liberation Tuesday fall on the fourth Tuesday of August to coincide with the first observance and also the August 24 birthday of the late Black trans activist Marsha P. Johnson.

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There is a continuing need to pay specific attention to Black transgender issues, and the larger Black community must be pushed to stand in solidarity with us. Last year, Black trans activists, the Black Lives Matter network, and GetEQUAL collaborated on a blueprint of what collective support looks like, discussions that led to Black Trans Liberation Tuesday.

“Patrisse Cullors [a co-founder of Black Lives Matter] had been in talks on ways to support Black trans women who had been organizing around various murders,” said Black Lives Matter Organizing Coordinator Elle Hearns of Washington, D.C. “At that time, Black trans folks had been experiencing erasure from the movement and a lack of support from cis people that we’d been in solidarity with who hadn’t reciprocated that support.”

This erasure speaks to a long history of Black LGBTQ activism going underrecognized in both the civil rights and early LGBTQ liberation movements. Many civil rights leaders bought into the idea that influential Black gay activist Bayard Rustin was unfit to be a leader simply because he had relationships with men, though he organized the 1963 March on Washington for Jobs and Freedom. Johnson, who is often credited with kicking off the 1969 Stonewall riots with other trans and gender-nonconforming people of color, fought tirelessly for LGBTQ rights. She and other trans activists of color lived in poverty and danger (Johnson was found dead under suspicious circumstances in July 1992), while the white mainstream gay elite were able to demand acceptance from society. Just last year, Stonewall, a movie chronicling the riots, was released with a whitewashed retelling that centered a white, cisgender gay male protagonist.

The Black Lives Matter network has made an intentional effort to avoid the pitfalls of those earlier movements.

“Our movement has been intersectional in ways that help all people gain liberation whether they see it or not. It became a major element of the network vision and how it was seeing itself in the Black liberation movement,” Hearns said. “There was no way to discuss police brutality without discussing structural violence affecting Black lives, in general”—and that includes Black trans lives.

Despite a greater mainstream visibility for LGBTQ issues in general, Black LGBTQ issues have not taken the forefront in Black freedom struggles. When a Black cisgender heterosexual man is killed, his name trends on social media feeds and is in the headlines, but Black trans women don’t see the same importance placed on their lives.

According to a 2015 report by the Anti-Violence Project, a group dedicated to ending anti-LGBTQ and HIV-affected community violence, trans women of color account for 54 percent of all anti-LGBTQ homicides. Despite increased awareness, with at least 20 transgender people murdered since the beginning of this year, it seems things haven’t really changed at all since Black Trans Liberation Tuesday.

“There are many issues at hand when talking about Black trans issues, particularly in the South. There’s a lack of infrastructure and support in the nonprofit sector, but also within health care and other systems. Staffs at LGBTQ organizations are underfunded when it comes to explicitly reaching the trans community,” said Micky Bradford, the Atlanta-based regional organizer for TLC@SONG. “The space between towns can harbor isolation from each other, making it more difficult to build up community organizing, coalitions, and culture.”

The marginalization that Black trans people face comes from both the broader society and the Black community. Fighting white supremacy is a full-time job, and some activists within the Black Lives Matter movement see homophobia and transphobia as muddying the fight for Black liberation.

“I think we have a very special relationship with gender and gender violence to all Black people,” said Aaryn Lang, a New York City-based Black trans activist. “There’s a special type of trauma that Black people inflict on Black trans people because of how strict the box of gender and space of gender expression has been to move in for Black people. In the future of the movement, I see more people trusting that trans folks have a vision that’s as diverse as blackness is.”

But even within that diversity, Black trans people are often overlooked in movement spaces due to anti-Blackness in mainstream LGBTQ circles and transphobia in Black circles. Further, many Black trans people aren’t in the position to put energy into movement work because they are simply trying to survive and find basic resources. This can create a disconnect between various sections of the Black trans community.

Janetta Johnson, executive director of TGI Justice Project in San Francisco, thinks the solution is twofold: increased Black trans involvement and leadership in activism spaces, and more facilitated conversations between Black cis and trans people.

“I think a certain part of the transgender community kind of blocks all of this stuff out. We are saying we need you to come through this process and see how we can create strength in numbers. We need to bring in other trans people not involved in the movement,” she said. “We need to create a space where we can share views and strategies and experiences.”

Those conversations must be an ongoing process until the killings of Black trans women like Rae’Lynn Thomas, Dee Whigham, and Skye Mockabee stop.

“As we commemorate this year, we remember who and why we organized Black Trans Liberation Tuesday last year. It’s important we realize that Black trans lives are still being affected in ways that everyday people don’t realize,” Hearns said. “We must understand why movements exist and why people take extreme action to continuously interrupt the system that will gladly forget them.”

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