Trigger Warning: Although this story is a work of fiction, it does contain triggering topics such as abortion and fertility issues, please read with compassion and caution.
“I can see it now. One more big push, you can do it.”
Mrs. Appleton lets out a long groan but doesn’t push.
“I can’t,” she says. “I can’t do it anymore.”
She falls back on the pillow and her once strained legs go limp, falling to either side of the stirrups.
“Come on, Mrs. Appleton. We are so close, one more push and your baby will be here, I promise. Just give me one more.”
“You can do it honey, just one more push.”
She lets out a grunt, brings her knees back into position, firmly grips ahold of Mr. Appleton’s hand, sucks in a huge breath, and pushes with a scream so loud I remind myself to keep my hands in position and not cover my ears.
Her yell cracks, she sobs, falls back into her bed, and out slides a beautiful baby boy.
I hand him over to my nurse who works quickly, suctioning his mouth and rubbing his tiny body as I clamp, and Mr. Appleton cuts the umbilical cord. Just as he makes the snip, a tiny wail starts in my nurse’s arms, and they carry him to the back of the room for a quick clean and Apgar test while I get mom situated.
As the newborn is placed on Mrs. Appleton’s chest, I congratulate the new parents on a healthy baby, and leave my nurses to finish up.
“Thank you, Doctor Quinn. We wouldn’t be here without you!” Mr. Appleton shouts as I head down the hall towards my next patient.
I’ve wanted to be an OB/GYN for as long as I can remember but specializing in fertility has been my true passion within the field.
When I was ten, my moms went to a fertility specialist when they decided to have another child. In Louisiana, there were not many doctors who wanted to help a same-sex couple bring another kid into the world, but they got lucky and found an obstetrician who specialized in fertility treatments and was willing to help make their dreams a reality. With the help from the specialist and a sperm donation, my mom became pregnant through an intrauterine insemination procedure, more commonly known as IUI.
I was captivated when they explained the procedure to me, but I was also very confused. Afterall, I had just finished learning about how babies are made naturally in elementary health classes, then there I was, learning an entirely new concept that I thought the doctors invented just for my moms. Come to find out, it had actually been around for hundreds of years. First tested with horses to breed Arabian stallions, then dogs, and finally a successful human pregnancy in the late 1700’s. Needless to say, while my moms are extraordinary in many ways, this procedure was fairly common and highly successful.
The IUI was so successful, in fact, that I got two siblings out of the deal. My mom underwent an ovarian stimulation treatment, which caused two mature eggs to release instead of one, as was intended. When the fertility specialist “turkey basted” my mom with the sperm donation sample, both follicles fertilized and implanted, and so, nine months later, my little brother and sister were born.
“Medicine brought you here,” I would whisper by their crib, “and someday, I’m gonna help other mommies and daddies so they can have little miracles too!”
And so, I did.
After twelve years of schooling, five years as an OB/GYN resident, and three years in a reproductive endocrinology fellowship, I was licensed and dedicated to being one of the few Louisiana practitioners who does not discriminate based on my patient’s race, gender assignment, or partner.
My mind was made up that this would be my destiny before I ever allowed myself the chance to understand the full spectrum of what this job would entail. Yes, there is much celebration and joy that comes from helping women and couples become pregnant, but there is also much heartache when they cannot. Multiple rounds of unsuccessful IUI’s, many IVF treatments, thousands of dollars, and all the prayers in the world sometimes just aren’t enough, and I must always be the one to announce the news to the hopeful parents.
With only a 10% chance of success, we go into treatments gathering all the labs and information we could possibly hope to know about both parents’ fertility. We brace ourselves for the long journey ahead. They know the odds, I know the odds, and even with modern medicine the chances increase with every passing year, and yet…
It doesn’t get easier. With the number of lives I save, the amount of children I’ve brought into existence, I still can’t help but mourn those who never came to be. I feel the parent’s pain and take their outlashes and disappointment. While we learn and do as much as we can, the fact remains that I am not a medical deity, and human biology will always have its limitations.
“Good morning, Doctor Quinn.” A passing nurse greets me as she exits my next patient’s room. “She’s ready for you.”
“Thank you, Abby.”
As I enter the room, Kaycee lays in bed, dressed in the clinic’s green cloth gown, and her boyfriend sits in a chair to her side, but immediately stands and scoots back as I approach the bed.
“Good morning, Kaycee. Dustin. It’s nice to see you both again. How are we feeling so far?”
“Good, I guess.” She takes in a deep breath and lets out a shaky, “Sleepy right now.”
“Yeah, that’s to be expected with the medication we’ve got you on. Mind if I check your heart rate before we get started?”
She shakes her head.
I raise the head of her bed, and place my stethoscope on her chest, asking her to breathe normally, although her breaths come quick and her heart races.
“Not too bad, considering. Looks like your blood pressure was pretty high when you came in this morning, so let’s not waste any more time. I’m gonna ask you once more if you are ready and then we will go ahead and get started.”
She takes in another deep breath and squeezes Dustin’s hand.
“Kaycee, are you certain you would like me to terminate the pregnancy of your additional follicle?”
She nods, eyes clenched shut.
“I’m sorry, Kaycee, but I do need you to tell me verbally one last time.”
“Yes.” She opens her eyes. “I consent to the termination.”
“Very well. I’m going to lean your bed back and have you scoot a little farther down, then we can get started and get you out of here so you can still enjoy the rest of this beautiful Friday morning.”
I take a seat on the stool in front of her bed and guide her feet into the stirrups. After adjusting the light and sterilizing the equipment, the nurse returns with a small wash basin of gauze and soapy water.
“I am just going to clean your vagina and cervix with warm water before we begin. Then I will apply the numbing medication.” I talk through each step of the procedure, inserting the speculum, dilating her cervix, and using the ultrasound to identify the additional follicle, or egg, that we are terminating today.
Just like my mom in the eighties, Kaycee underwent fertility treatments and produced two mature follicles at the time of ovulation. However, due to her personal health concerns, carrying two fetuses to term put her at high risk for eclampsia, which has already progressed with signs of early preeclampsia in dangerously high blood pressure numbers, and if left untreated, could cause seizures and affect her kidneys or surrounding organs. For this reason, she and Dustin agreed to terminate one of the follicle pregnancies to provide a safe and healthy uterus for her remaining fetus to grow.
It is my job to bring babies into this world. I take pride in the amount of successful pregnancies and deliveries I’ve had over my many years of practice. However, it is also my job to make sure the mother is still around by the time that child is born. It is my job, my passion, my calling to help women become mothers, to make dreams come true, just like someone in my shoes did all those years ago for my moms. I take no joy in terminating an implanted follicle when so many of my patients have not had the same luck. But when that follicle threatens the life of my patient and her healthy fetus, it is my duty to protect them as I am able.
“Kaycee, how are you feeling so far?”
“Good. Next, you will feel a little pressure as I insert the tube…”
“Doctor Quinn, stop. I need to see you outside.” My nurse calls.
“Just a moment please, Abby, we are about to begin the procedure.”
“I’m afraid this can’t wait.”
I place the tube back on the tray with the other equipment, apologize for the inconvenience and follow the nurse out of the room.
“What is it? Is Mrs. Appleton okay?”
“Yes, but Bailey…”
“What? What is it?”
“You can’t perform that abortion.”
“What do you mean?”
She holds up her cell phone and there, in bold, black font is the announcement we have anticipated.
Supreme Court Overturns Roe v. Wade.
We knew it was coming. We have protocols in place for cancelling upcoming appointments and helping women find the care they need in surrounding states. With Louisiana’s trigger laws, the moment the Supreme Court’s decision was announced, it became illegal within the state to perform an abortion, and if I were to continue with this five-minute procedure, I could face ten years in prison, up to $100,000 in fines, and possibly lose my license.
I slide down the wall until I am sitting crumpled in my knees on the floor. Abby bends down and rubs my shoulder and I start to cry. I didn’t think I would cry. I knew this was coming, and yet here I am, sitting outside my patients’ door, sobbing into my scrubs.
“Is everything okay out here? Kaycee’s numbing is gonna wear off soon.” My assistant says, halfway out the door. Then she looks down to see me, “Oh shit...Tell me it didn’t pass…”
“What would you like me to tell the patient?” Abby asks, and it’s all I can do to gather my thoughts.
“It should be me.” I wipe the tears from my eyes, stand up, and shake my hair from my shoulders. Then just as I’m about to enter the room, Dustin cries for me.
I race into the room to find Kaycee convulsing on the bed.
“Bring me six grams of Magnesium Sulfate.” I holler to my assistant.
“What’s happening?” Dustin sobs.
“She’s gonna be okay, but she is having a seizure. Help me flip her to her left side.”
Dustin and I flip Kaycee over and the nurse brings and administers the magnesium. Her convulsions lessen until she is still and breathing normally.
“Let’s get an ambulance ready to transfer her to the hospital. I want her monitored overnight and given four grams of magnesium sulfate for the next fifteen minutes or until they arrive.”
“Why did this happen, Doctor Quinn? Can we still proceed?” Dustin asks, stroking Kaycee’s hair to calm her nerves.
“No, I’m afraid I won’t be able to perform the procedure today.”
“Is it bad?” Kaycee asks, her voice scratchy and soft.
“I’m so sorry Kaycee. I’ve only just now seen, but it appears the Supreme Court has announced their decision to overturn Roe v. Wade.”
“What does that mean?” Dustin sits in the chair now, bracing himself for the news.
“It means that while bringing both babies to full term will put Kaycee at risk for continuous seizures and eclampsia, my hands are unfortunately tied. The trigger laws of Louisiana have gone immediately into effect, and I can no longer perform this procedure.”
“Even if my life depends on it?” Kaycee’s eye fill with tears.
“I’m so sorry.” I blink, feeling the heat of my own tears building. “I promise you I will do everything in my power to keep you and your babies safe.”
“I don’t know if I can do this…”
Kaycee sobs into Dustin’s shoulder and I can’t help but think, I don’t know if she can do this either, but goddamn it, we’re gonna try.