When Women Decide To End A Pregnancy, They Can Face Drastically Different Circumstances

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Trisomy 18 is a rare chromosomal disorder that occurs in 1 in 2,500 pregnancies. (severyanka/Pixabay)
Trisomy 18 is a rare chromosomal disorder that occurs in 1 in 2,500 pregnancies. (severyanka/Pixabay)

Allison Chang's unborn baby was diagnosed with trisomy 18, a rare chromosomal disorder that occurs in about 1 in 2,500 pregnancies. Chang and her husband planned to end the pregnancy, but it ended naturally when the child died in the womb.

Chang, a fourth-year medical student at Harvard Medical School, says that she received medical, emotional and financial support from health care professionals in Massachusetts because she had health insurance.

"I just want to be clear that I'm not advocating that all couples and all families make the same choices that we did," she tells Here & Now's Robin Young. "Instead, I wanted to make the point that ending a pregnancy under these circumstances can be a loving, compassionate and medically reasonable choice."

Others, like a woman named Jamie that Chang met through an online support group, did not receive the same care when she decided to terminate her pregnancy. Jamie lived in Missouri, a state that doesn't cover abortion in the case of severe fetal impairment. The hospital would have charged her up to $8,000 to perform an abortion, so she had to go to a clinic with screaming protesters outside.

"That really to me spoke to the fact that these policies don't just affect the destitute and the uneducated, but this is something that extends well beyond upper-middle-class young professionals," Chang says.

Interview Highlights

On how she found out her baby had trisomy 18

"The pregnancy progressed normally until we went for our nuchal translucency scan, which can tell you how at risk is this baby for chromosomal abnormalities. And the probe hit my belly and about two seconds later, the radiologist who was doing the ultrasound just said, 'Oh, I don't like the look of this, Allison.' And basically there was fluid everywhere, fluid surrounding the lung, fluid in the lymphatic ducts and the neck. And this is when I started thinking about what is she able to feel of all of this? Because if an adult had this level of fluid in their bodies, they would be devastated."

"It had a lot more to do with managing end of life, rather than any sort of political feeling about what we should and shouldn't be able to choose."

Allison Chang

On arriving at the decision to terminate her pregnancy, before her unborn child died in the womb

"I think knowing what life-sustaining interventions can look like is something that I think we've been able to see as people in the medical field that other people might not see. What she would likely be looking at if she were born, that's not something we would want. I wouldn't wish that on my worst enemy, and this was my child that I was thinking about. So it had a lot more to do with managing end of life, rather than any sort of political feeling about what we should and shouldn't be able to choose."

On how she found out about Jamie's story 

"She's actually someone I met through a pregnancy loss support group on the internet, and I was trying to find information online about what do people do when they're in the situation where they know that they're going to lose a pregnancy? And the advice that I got from that time was treat the baby as much as like a living child as possible, and this kind of came as a surprise to me in a way because that's just so different from how I've heard people talk about abortion in the past.

"And she found the same pregnancy loss support group when her own child was diagnosed with trisomy 18, and the first thing I was confused about was the fact that she didn't have the kind of placental biopsy that I had. This is known as chorionic villus sampling, and it's basically what you do if you're a little too early to get an amniocentesis. But she had a couple different screening tests basically, which can tell you how at risk you are of having this kind of diagnosis, but it's not a diagnosis itself. But that was still kind of the first little bit of a red flag to me about like, 'Oh, she is not getting the same care that I'm getting.' "

On what Chang learned from Jamie's experience

"They were saying, 'That's daddy's little girl you're killing,' and to be going through this experience and to have people shouting this to me, speaks to the fact that people don't totally understand all the reasons that people pursue abortion. And I think as a community we have a responsibility to make sure that the most vulnerable are protected. And I think that for a lot of people, they would argue that the fetus is the most vulnerable here. But I think that we should place more trust in parents to choose what is best for their families and support them in that."

Marcelle Hutchins produced this interview, and Kathleen McKenna edited it for broadcast. Samantha Raphelson adapted it for the web. 

This segment aired on January 17, 2019.


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