RIP Dr. Tiller

It has been several days since the Wichita doctor, George Tiller, was murdered while in his church. And I am still sad over his death. I have debated whether I wanted to blog about him and about abortion, about whether I wanted to enter the fray. And I have come to the decision that one of the best ways to honor Dr. Tiller's memory is to be open about the reasons women went to see him.

Back in February, my husband and I, accompanied by our toddler, went to the ob/gyn's office for what I expected would be our last visit before I transferred care to my homebirth midwife. I was approximately 18.5 weeks pregnant and was going to have the now-routine anatomy scan done. Technically, the scan is done to make sure the fetus is growing correctly, that the pregnancy is proceeding normally. But I would say most women see it as the chance to find out whether they are having a boy or a girl. My husband and I were hoping to learn that we would be having a little girl, though we would also be happy to find out we were having a healthy little boy as well.

The ultrasound technician was cheerful and made jokes with us as she began the scan. She remembered my son from our previous two ultrasounds and was joking with him as she went through the scanning process. My husband and I waited anxiously to find out whether we were having a boy or girl, and the technician quickly told us we were, in fact, having another boy. Lying on the table, I gave my husband a wry grin - another boy. We were in for another exhausting couple of years.

As the scan continued, I noticed that the technician became quiet. She stopped talking to my husband and I. She stopped joking with my son. I remember looking at my husband quizzically several times and noting from his expression that he, too, had noticed the change in her demeanor. After over half an hour, the ultrasound technician told us that a nurse would be in to take us to another room to speak with the doctor, and the technician left without looking at us. Both my husband and I knew something was not right. As we sat in the next room, waiting for the doctor to talk to us, I could hear the technician in the hallway, speaking with the doctor. I heard her say to the doctor, "I've never seen a cyst that big before." I was becoming extremely worried.

The doctor came in soon after and told us what the scan had found: the fetus had what appeared to be two large cysts, known as choroid plexus cysts, on his brain. He also had what appeared to be an enlarged stomach. Individually, these would not be cause for alarm, but since our baby had both, there was concern that the fetus might have a chromosomal abnormality. We would need to see a high-risk obstetrician with a more powerful ultrasound machine in order to determine whether there were more soft signs of abnormality and, based on that, we would need to decide whether to have further testing, such as an amniocentesis. I asked what chromosomal abnormality the fetus might have; the doctor said that choroid plexus cysts tend to be seen in fetuses with Trisomy 18, a condition that is generally not compatible with life. The doctor said that she would call the women's center downtown and make an appointment for us; since we were the last appointment on a Friday afternoon, we would have to wait until Monday to find out when our appointment would be.

I know I held it together until we left the doctor's office. I was sent to the lab to have some blood drawn, and the phlebotomist asked about the pregnancy and whether I knew what I was having. I remember thinking, "I don't know that I'm really having a baby" but actually telling her, in a daze, that it was a boy. Once we left the building and got in the car, I broke down crying. My husband and I sat there, with our son in his carseat, holding each other as I cried. I remember thinking this couldn't be happening. This couldn't be possible.

As soon as we got home, I looked up Trisomy 18. What I read was not heartening. If our baby had Trisomy 18, the chances of him making it to term were slim; 95% die in utero. Those babies with Trisomy 18 who do survive to delivery die within days, if not hours. The median lifespan for Trisomy 18 babies who make it to term is 5 to 15 days. I was heartbroken. Instead of sending out a happy email to friends telling them we were expecting another boy, my husband and I were facing the prospect of losing our child. It was at this point that we began to seriously talk about what we would do if the tests showed the worst case scenario was reality. We talked about abortion.

I spent the weekend reading more about Trisomy 18 and about abortion, between bouts of crying. My husband and I found that neither of us wanted to talk about the baby, it was just too painful to consider what might be, but we both wanted to comfort each other. But both my husband and I were honest with each other: if our baby turned out to have Trisomy 18, we would not carry to term. It was that weekend that I learned about Dr. Tiller and his practice in Kansas. I read the stories his patients had posted on different websites. I read about his compassion for women, for couples, having been dealt a cruel hand by Mother Nature and having to make a difficult decision. Above all, I spent the weekend hoping that I and my husband would not have to make that decision, that everything would be ok, that it was just a false alarm.

For nearly 4 days, I and my husband wrestled with the what-ifs, wrestled with the possibility that we would have to make the difficult decision to end the pregnancy. It was with great relief that I laid in a different ultrasound room on the following Tuesday and learned that the baby showed no other signs of Trisomy 18 or, for that matter, any other chromosomal abnormality. A follow-up ultrasound four weeks later showed the two cysts on the brain had disappeared and the stomach, while still somewhat large, was normal in size. It was going to be ok. The high-risk obstetrician discussed with us the very low likelihood of there being a chromosomal abnormality, given the level-II ultrasound results and the results of my bloodwork; based on that information, we opted not to have an amniocentesis. It was going to be ok.

I am grateful that we did not have to make the decision to terminate the pregnancy - to abort the fetus. But I know that there are other women, other couples, who do not receive happy news at their follow-up appointments, who do not get the sense of relief when their testing results come back. And it is for them that I also mourn. For while the service Dr. Tiller provided, late-term abortion, is not one that all people would like to have exist, it is one that needs to exist. And the health of women in the United States, the options of couples and families facing the realities of a pregnancy gone horribly, horribly wrong, is threatened by the loss of Dr. Tiller.

Rest in Peace Dr. Tiller.