My abortion experience: The great harm done by one-size-fits-all laws

On June 24, 2022, moments before meeting my new gynecological oncologist, the news broke that Roe v. Wade had been overturned with the Dobbs v. Jackson Women’s Health Organization decision. I’d been viewing the world through shades of rage since the unofficial opinion was leaked the previous month. It was difficult to wade through the grief of an early pregnancy I had just lost and the fear of new cancer cells forming in my body, in order to deal with the devastating consequences that were to come for pregnant people across the United States.

I focused on what was within my control. As senior a member of management at an independent abortion provider with clinics in North Carolina and Florida, I prepared early for this moment: There was a press release for local media outlets and social media graphics to reassure our patients that abortion care was still legal and available at our clinics. Our call center staff was ready for the potential increase in patient appointments. Our clinic staff was ready for the potential influx of out-of-state patients needing abortion care. I consulted with local and federal law enforcement agencies about protecting our patients and staff from the emboldened protestors outside our clinics.

I sat on the edge of my chair in the exam room, my laptop on the tiny counter across from the desktop with the static login screen waiting for the doctor to sign in and review my chart. Fear of what was to come soaked the underarms of my shirt. Calls weren’t making it through the Do Not Disturb filter on my phone, and missed texts piled up. Everything was on hold, waiting for another decision out of my control. I sent the press release emails, published the social media images, and slid my mask down to sip my Starbucks cold brew. The oncology surgeon walked in. We discussed how devastating the Dobbs decision was, and I knew I was in the right place.

My partner and I tried to conceive for a year, but cycle tracking, taking vitamins, and wishing proved unsuccessful. I switched my care to a fertility specialist and finally conceived. We were filled with joy and started plans for the family we wanted. Because of fertility issues, I required an early ultrasound at eight weeks pregnant. At that ultrasound, on May 31, 2022, my fertility specialist told us our much-desired pregnancy was no longer viable. It was a shocking, crushing blow from which I didn’t think I’d recover. I was devastated that this deeply wanted pregnancy wasn’t viable, especially because I was still experiencing extreme nausea and other physical pregnancy symptoms.

I wasn’t having any miscarriage symptoms, so the doctor prescribed Misoprostol to force the pregnancy tissue from my uterus. However, I have von Willebrand Disease, a bleeding disorder that prevents my blood from clotting properly. I work in abortion care, so I know that Misoprostol causes heavy bleeding and was not the best option for me. I went to my local independent abortion provider for a second opinion, and the doctor recommended I have a procedural abortion instead. Because of my bleeding disorder, I underwent an in-hospital procedural abortion on June 3, 2022.

A few days after my procedure, while in a store shopping with my mom, the surgeon who performed my dilation and evacuation (D&E) called to tell me that the pathology showed that I had not been pregnant with a viable fetus, but instead had a complete molar pregnancy, also known as a hydatidiform mole. This happens when one or two sperm fertilize an egg that lacks DNA, causing grape-like cysts to form instead of an embryo. Between sobs, I heard the doctor say that a molar pregnancy can lead to a rare and particularly aggressive form of cancer and that she was putting in orders to have my blood drawn weekly, to ensure my hCG (Human Chorionic Gonadotropin), or pregnancy hormone, levels continued to decline to almost zero. The levels needed to be monitored for at least six months, even maybe a year, before I could try to conceive again.

The emotional hits just kept coming, and the aching emptiness became more all-consuming. I sobbed openly and loudly outside a Nordstrom’s dressing room. I was overwhelmed with mourning the loss of a wanted pregnancy, finding out that there was never a viable pregnancy, dealing with physical and hormonal changes to my body, and now facing a weekly reminder that I couldn’t safely be pregnant again for at least another year. I’ve never felt so lost and alone.

Every week I went to the lab and faced unknowing phlebotomists who happily asked if I was pregnant, got stuck with a needle, had blood drawn, drove home sobbing, and waited for the hCG level to be posted in my patient portal. Week after week after week, desperate to just have my blood drawn without questions or comments from the techs. Week after week watching that level hover around 2,000, a number that usually indicates a sixth week of pregnancy, and me desperate to be pregnant. Then, one week, it jumped to 6,000.

I stared at my computer screen, knowing this was exactly what we didn’t want to happen. This was the potential worst-case scenario for which my physician was monitoring. I knew the increased beta hCG level indicated that tissue, known as persistent gestational trophoblastic neoplasia, had remained in my uterus and continued to grow, which meant I needed additional treatment — another blow delivered to my psyche. I underwent an emergency X-ray and CT scans to make sure the gestational trophoblastic disease hadn’t spread to any of my surrounding organs, and scheduled to see a gynecological oncologist to determine my treatment plan.

On June 24, 2022, after the Dobbs opinion was published, after I sent out digital messaging that our clinics were still providing legal and safe abortion care, I reviewed my diagnosis with the oncologist and we agreed my best care option was to have another D&E to remove all remaining tissue. Medically, I knew only what my surgeon had told me…molar pregnancy…cancer…a repeat D&E…cancer. I had a chest X-ray and the cells had not yet reached my lungs. This was good. But, five days after Roe fell, I had my second surgical procedure. While I waited to be taken to the OR for the second time in a few weeks, I wept for the baby and the family we planned for, and I wept for countless pregnant people I knew were going to be denied this same essential healthcare procedure.

Before the Dobbs decision, thousands of people every year were unable to access abortion care, especially people already marginalized by our healthcare system—Black, Latina, and Indigenous communities, people with disabilities, LGBTQ+, minors, poor people, and those living in rural areas and other health care deserts. The SCOTUS decision left the legality of abortion up to the states, and the anti-abortion movement capitalized on this moment by shoving their anti-abortion, white supremacist, coercive reproductive agenda down the country’s throats as Republican politicians introduced and passed near or total abortion bans in states under the guise of “compromise.”

As a result, patients are experiencing worse pregnancy complications and increased delays in receiving care in states with abortion bans, because they’re forced to comply with medically unnecessary requirements. We’ve seen the aftermath of the extreme anti-abortion movement’s cruelty as people are denied care when experiencing a miscarriage, a partial molar pregnancy, an ectopic pregnancy, or abortions because people just don’t want to be pregnant, all because politicians in their states think they know what’s better for them and their families. These extreme bans and restrictions on abortion access are racist and classist, and put unnecessary hurdles between people and their essential health care. Don’t be fooled, abortion bans and restrictions are not about health and safety.

Our Florida and North Carolina clinics have experienced the predicted influx of patients from southern states that cannot get the care they want or need in their own states. These patients are forced to travel to access abortion  or they are forced to remain pregnant against their wishes because they don’t have the resources to access necessary health care. The anti-abortion movement playbook is a how-to on controlling lives and futures. These politicians don’t plan on stopping. Banning abortion at the state level isn’t enough. They want to see abortion banned nationwide. They’re coming for our birth control, in-vitro fertilization, fertility treatments and gender-affirming care.

What I’ve experienced, and what we as a country have seen this past year, highlights that every pregnancy and every person is unique and that there isn’t a one-size-fits-all solution. Most Americans do not believe that government should interfere in the deeply personal health care decisions that individuals face. Together, we need to have conversations about abortions and organize to fight for individual freedom to choose because, when we do, we win.

I’m taking a moment to reflect on the horrible year I had. Let’s make some time together to reflect on the treacherous year it’s been for reproductive health. Hold each other close, show each other compassion and empathy, mourn collective and personal losses, and celebrate all those we have and continue to support people needing and seeking abortion care. Our movement is creative, inventive and resilient, and I’m grateful that we continue to show up. In this next year, I look forward to collecting petition signatures in Florida to put abortion on the ballot and working with our coalition to hold legislators in North Carolina accountable for their votes to ban abortion.

This morning I sip coffee on my couch at home and plan out my next steps to make the family my partner and I hope for. This planning might not be happening if I had been denied access to the care I needed when I needed it. I continue to fight so that one day everyone has access whenever and wherever they need it because all abortions are good, all abortions are health care, and all abortions are lifesaving. I hope you are in the fight or ready to join.