Women ... choosing their battles

By JoAnne Young

 

More than a dozen years ago my daughter had a choice.

 

After a surgery to remove uterine fibroids that produced some scary results, she was advised by her doctor to consider a hysterectomy to prevent any future complications. She was barely in her 30s and knew she wanted kids. She chose not to lose the option of someday having a baby. 

 

The doctor continued to present the option. She continued to say no. 

 

Several years later she got married. She and her husband decided to try that dream she had of being a mother, even though she was operating with just one ovary. She lost one pregnancy but then was successful on the next. OK, she had a daughter, she could consider that hysterectomy. Again, she chose to stay the course. 

 

She got pregnant again and had a boy. Still unwilling to have the surgery, she had another daughter two years later. This pregnancy was even more perilous because of the reduction of blood supply to her uterus from the original fibroid surgery. The fetus was not growing properly, the result of a condition called intrauterine growth restriction. Both mom and baby were at risk of serious problems before, during and after birth. 

 

Elizabeth and Adam now have three healthy children. 

 

A different take on “Her body. Her choice.” 

 

With the country focused on Roe v. Wade this spring, pro and con, the center of attention is embryos/fetuses/babies and whether or not women should be forced to bring that being nesting in her body to delivery. 

 

We rarely talk about the effects and risks of pregnancy and delivery to a woman. There’s a lot that must be considered, a lot that can go wrong. 

 

Nobody else should be able to make the choices we must make as women when it comes to the substantial risk we take when pregnancy results from a sexual encounter. 

 

I had three babies. Two of them carried obvious danger to me: pre-eclampsia and post-delivery bleeding. But all pregnancies are consumed with degrees of risk that range from minor to major, from discomfort to life threatening. From the high blood pressure of pre-eclampsia and eclampsia to diabetes particular to pregnancy; a fertilized egg that attaches dangerously outside the uterus; a liver condition that causes intense itching for weeks or months; depression; anemia and infections, to name a few.

 

What science tells us but doctors and educators don’t is that pregnancy is by nature a battle between the embryo/fetus/baby and the mother’s body from the get-go. I had no idea about this until last year when I listened to an episode of Radiolab, in which reporters Heather Radke, Becca Bressler and Molly Webster interviewed Dr. Harvey Kliman, a Yale University scientist who studies placentas. 

 

Pregnancy isn’t a peaceful, gentle kind of miracle, but more like a knock-down, drag out struggle between a foreign invader and a body system trying to keep this pregnant person alive, the reporters learned. 

 

Without the protection of the placenta, which starts out as an invisibility cloak for the cells working to become an embryo, the mother’s immune system would gather a brigade of white blood cells to find the developing embryo, shred it and kill it. 

 

After the hiding, the placenta goes on the hunt for food for the embryo, “to suck as much nutrients out of the mother as possible.” It latches on with long thin claws, trying to get through the uterus and into the mother’s blood supply, while the uterus fights to deter its success. 

 

Around week 7, the placenta creates a diversion and busts through to the blood source, sucking in more and more of the blood supply until the third trimester by which time it’s rerouting about a quarter of the mom’s blood to the placenta. 

 

If the baby isn’t getting what it wants, the placenta can force an increase by raising the mom’s blood pressure, potentially causing a condition known as pre-eclampsia, which can be life threatening to the mother, and in fact, one of the leading causes of maternal death. 

 

If the battle is a draw, the result after about nine months is birth. 

 

My daughter, my Baby No. 2, must have put up the biggest fight. She had to be delivered three weeks early because of pre-eclampsia. My sons, No.’s 1 and 3, waged a more efficient battle, although No. 3 left behind a treacherous blood leak. 

 

All of this is to say that a woman must be the one to decide what risks she is willing to take, which ones she will forego or delay. And when. 

 

Many, many women choose to take those risks, to allow the foreign invader to set up its fortress and claim squatters’ rights. They even pat that swelling fortress lovingly, plan a future, consider themselves the lucky ones.  

 

Above all, the choice must be theirs. For better or worse. For richer or poorer. For all the considerations and complications and questions hanging heavy over their heads ... and in spite of all the battles going on  in state legislatures, in the courts, in churches and in the streets.