Choices

Today, I visited a nationally-known family planning clinic, as part of a class assignment. I have always been pro-choice, but my perspective stemmed from abstract political and idealistic positions. The topic had never been real to me. I had never known anyone who was faced with the decision of whether to proceed or terminate a pregnancy. I had never seen an abortion procedure before. Today, my abstract sketch became a gritty, beautiful, full-color picture.

I was fortunate enough to have time to speak with the physician who performs abortion procedures, and who gave me a history of women's reproductive rights, as well as the current ethical, legal, and moral issues of today. He described that in the past, pre-Roe v. Wade, abortions were completed all the time, at the physician's discretion. Teenagers who were not ready to be mothers and older women with unplanned pregnancies were those most commonly provided for. At that time, abortions of fetuses under 20 weeks and/or under 500 grams were considered miscarriages. Those over 20 weeks required death certificate registration.

We also discussed today's legal dilemmas. First, when is an embryo/fetus considered a person? If "personhood" is considered at time of conception, are the 400,000 frozen embryos at fertility clinics considered people? If "personhood" is determined at viability (at present, 24 weeks), will that change as our technology becomes more and more advanced? Some may consider abortion permissible under the cases of rape or incest. However, who is to judge if a woman is raped or not? What constitutes rape? Some may support abortion, but object to women who continue to have abortion after abortion, as a form of birth control. The doctor believes that this is someone's personal choice, and ethically, we are obligated to provide care. Who are we to deny a woman a service, simply because they have had it before and we believe they are acting irresponsibly? Are we also to deny a patient with chest pain emergency care, because he continues to eat fast food and doesn't exercise? Who are we to judge who is "deserving" of medical care? Ethically, what applies to one should apply to all.

And then it was time for the procedure. The entire procedure took about 15 minutes, but seemed as if it lasted an hour. First, an ultrasound was done to confirm and date the pregnancy. I had seen and performed ultrasounds before, but this time was different. The mother was not excited to see the fetal heartbeat. She didn't wish to know the gender of the baby. She didn't discuss future names, or where she plans on delivering. She didn't want a copy of the sonogram. It occurred to me-- this was the last time that fetus would be shown alive and well.

After confirmation, the doctor began the procedure. A nurse stayed at the head of the exam table to hold the patient's hand. I stayed at the "business end", with the physician. First, the patient's cervix was sterilized and numbed. Then, dilation began, using metal rods of increasing width. Judging from the patient's tears and cries, this is a painful process. After the cervix was dilated to an appropriate size, a suction was inserted, and bloody tissue filled the tube. After 5 minutes, it was over.

While the patient rested, the physician and I went to the sink to filter the tissue to ensure that the pregnancy had been terminated. It was just expelled tissue, until we saw the tiny fetus. I saw its spine, its legs, its toes. Abortion had never hit me as being that real. Pro-choice activists claim that the fetus is just "a clump of cells". That was what I had expected, but not what I saw. And what I saw will stay with me, burned into my memory.

My experience was emotionally trying, yet enlightening. As a future family physician, I may be asked to complete or assist abortions in the future. Given my personal standpoint on children, I had flippantly decided that I would "just get an abortion" if I happened to become pregnant. After witnessing the procedures, I'm not sure if I could. While I remain firm in my belief that women have the right to choose whether they carry a pregnancy to term, I'm now unsure of what choice I would make in that same position.