Skip to Main Content

This is part of a series of snapshots from post-Roe America.

He loved peaches. He loved ice cream. He loved blueberry waffles, evenly gridded, which she’d pulled from the crinkly package in the freezer and popped in the toaster to eat on her way to work. L. knew all this from the way he moved, the way he made her sick. His name was Kai. He was due on December 18. The first time he kicked was while she drank a chocolate milkshake on National Ice Cream Day. The one morning she went without waffles was the most nauseous day of her entire pregnancy; she knew Kai wasn’t pleased.

advertisement

Now, when he kicked, she wondered if he was in pain. She worked in the ICU, and she knew about pain. She tried to stave off people’s delirium, reminding them who they were, where they were, the day of the week. They told her what they were too afraid to tell their families. They felt lost, they felt hopeless, they were nothing but a burden. She would scoop her arm around their necks as they learned to sit up again. She would dab lavender oil on a little strip of gauze to help them fall asleep.

She didn’t want his life to be IVs and intubations and chest drainage tubes. She couldn’t put that on him. She couldn’t imagine carrying him and then him dying in her womb, having to give birth to him once he was already gone. She didn’t want to end the pregnancy, but she had to. The diagnosis carried risks to her own health, a higher chance of hemorrhage, a higher chance of preeclampsia. She knew that she couldn’t continue, and she started making calls.

Now, when he kicked, it was a reminder, a prod from the inside, telling her again and again about her loss. She was losing him before she even got a chance to meet him. She was losing a part of herself. She didn’t want to eat; food might inspire him to move. She didn’t want to sleep; when she closed her eyes, she just saw his anatomy scan, his hand raised, as if he were waving. She couldn’t bear to look in the mirror and see her changed profile. She couldn’t bear to touch her belly. She couldn’t breathe.

She called every clinic she could find anywhere near San Francisco. She was a few days past 20 weeks, abortion was legal in California until 24. It shouldn’t have been an issue, but every place was slammed. She couldn’t get through to some. Others were booking weeks out. Even here, in California, with its legal protections for abortion, she could feel the effect of Roe being overturned. She could feel it physically, a claustrophobic internal buzz. She had a friend who’d been in a similar situation a year earlier, and who’d gotten an appointment for the next day. Now, L. was told that demand had skyrocketed, with patients pouring in from restrictive states.

advertisement

California had been a dream to her. She’d grown up beside a cornfield in small-town Ohio. Her high school had a bring-your-tractor-to-school day. She’d wanted everything for Kai that she hadn’t had herself: city life surrounded by people from everywhere, hiking in the sierras, hiking in the desert, a sense of the vastness of the world.

She finally heard back from the abortion clinic affiliated with her hospital. Their next appointment was in two weeks. She couldn’t wait two weeks.

They could still have been in Kentucky. At least there was that. If they hadn’t moved, then she would’ve been one of those people, trying desperately to arrange an appointment out of state. She’d have had to dig into their savings.

L. and her husband had met in Kentucky. They were both in college. L.’s roommate’s boyfriend had brought a friend along to a birthday party, and L. noticed him right away: 6 feet tall and tanned with a cute splash of freckles across his nose. She was shy at first. She’d been busy making her roommate a Funfetti cake, and she looked like hell, unshowered, wearing an oversized T-shirt. This isn’t ideal, she thought.

But then when they got home from dinner, someone had poured beer on the cake, and people were blaming this guy. That was her in.

How dare you pour beer on my cake, she said.

He swore it wasn’t him. She said she didn’t believe him. Soon, they were ribbing each other, flirting. He rooted for the Louisville Cardinals, she the Kentucky Wildcats. Her favorite subs were from Jimmy John’s, his from Penn Station. They told each other about where they were from, their siblings.

Later on, once they were dating, she was upfront. In her hometown, the expectation was to settle down by 25, get married, start procreating. That wasn’t for her. She saw herself getting a master’s, doing research, maybe going into academia. She wasn’t going to be with someone threatened by her success. If he had a problem with a woman being the primary breadwinner, there would be issues, she told him. He didn’t.

In 2021, they moved to San Francisco with their two dogs. He’d lost his job because of pandemic cuts. She’d been working as an occupational therapist in the ICU, was tired of spending her days with dying Covid patients while neighbors insisted that Covid wasn’t real. More than anything, though, they wanted to feel like they were on an adventure, and California had a dreamy glimmer. They found a two-bedroom a mile and a half from the ocean, sandwiched between Golden Gate Park and the Presidio.

J.S. holds the sonogram of her son at her home in San Francisco, Calif.,
L. holds the sonogram of her son at home. Constanza Hevia for STAT

At first, she thought it was Covid. She’d just turned 29. That Saturday, they celebrated at a Giants game. Tuesday, she woke up feeling off. Her Covid test was negative. She still had a pregnancy test under the sink, from a scare about a year earlier, and she thought, can’t hurt to take it and make sure. It was positive. But it was almost expired, they’d been using protection, that couldn’t be right.

She ran out for three more tests, got three more positives.

Her first reaction was fear. She wasn’t sure she could be a good mom; they hadn’t been planning for kids. The surprise was so huge it was hard to think about. They went for a walk with the dogs to talk it through. He knew she got quiet when she was nervous, and she hardly said a thing. She said she was hungry, but then hardly touched her food. It was only when her husband asked her, point blank, “Do you want to not have this baby?” that she knew: She definitely wanted to have this baby.

Everything changed for her. She’d be heading to work, like normal, but it wasn’t normal; she kept thinking, I’m making a human inside me right now. There were rooms she couldn’t go into at work, Covid rooms, rooms where a patient had open sores. There were things she couldn’t eat. She’d always eat a Trader Joe’s salad for lunch — a habit so steadfast her colleagues joked about it — but Kai had different plans. She’d be raising a forkful of greens to her mouth and feel a wave of disgust. Instead, she wanted fried chicken. They fixed up a nursery, painted the walls a light blue, set a floppy-eared toy rabbit on a ledge. They put up the map of the United States from their wedding, with pushpins showing their friends scattered from coast to coast. Someone sent them a onesie. Someone else, a baby book, the ABCs of San Francisco.

She wanted Kai to have her husband’s nose but not his feet. She wasn’t fond of his too-long toes. She would rub her belly and talk to him. Oh, hi there. She knew him, his likes and his dislikes, his habits within her.

She knew the sound of a worrisome finding. She was a clinician herself. What’s wrong, she asked, at her 20-week scan. The tech had paused over the umbilical cord, as if it were a mystery to be unraveled. There was no answer, besides, I can’t say, I’m not allowed to interpret. Then, as if to make up for it, the tech became reassuring, joking about how squirmy Kai was. You’re going to need tennis shoes to keep up with this one.

Eventually, a maternal-fetal medicine specialist came in. Kai was missing three fingers on one hand. To L., that wasn’t an issue. People lived without fingers all the time. Babies were born, perfect, with more or less than ten fingers or toes. But this wasn’t a healthy pregnancy, the doctor told her. The cord wasn’t properly connected to the placenta. It didn’t have its protective coating of jelly, to prevent abrasions, forestall bleeds. It was harder for Kai to get nutrients, meaning he was likely to need time in the NICU.

She spent all night in the nursery, under the map of their friends, reading papers, crying over the statistics. She couldn’t help but feel a rush of guilt. She knew it wasn’t her fault, but still, she thought, I made him this way. It was my job to grow him, and he’s sick already.

She felt guilty for not being sure at first. Why had she wasted that time, being uncertain, second-guessing herself, instead of loving him from the get-go?

She wanted to know why, but there was no why, just a suite of merciless facts. Her body was a testament to all that had gone wrong. Living in it felt impossible. She kept having panic attacks. Waiting in this state for two weeks was untenable.

Eventually, after many frantic calls, a medical resident helped, offering L. a termination on the labor and delivery floor in the next few days. It was August, a few months since the Dobbs decision, and the hospital was doing this more and more, to deal with the overwhelming need.

L. and her husband went from decorating his nursery to packing Kai’s things away in a box. The day before the procedure, they sat down to say goodbye. They read to him, moving through the ABCs of San Francisco: D for dogs on leashes, M for mustaches in the Mission. They told him they loved him, that they would always miss him.

Then, they headed out to the appointment. Being there, she felt an overwhelming mix of gratitude and anguish. It messed with her mind. It was weird, to thank someone for something you didn’t want, but that you needed, something that left you at once bereft and relieved. It felt surreal, to have to go to the place where she was supposed to deliver her son and walk out without him.

She wanted to talk about it, wanted people to know what this was like for her, but didn’t want to be too identifiable, given the divisive rhetoric that surrounds abortion. She asked to be identified only by her middle initial.

For a while, she wouldn’t see anyone. She was scared to go out without her husband. Her sister invited her for a visit, but she was scared to fly. She was scared something would happen to her husband. If Kai’s illness had been a lightning strike, what would stop her from being struck again? She would see a stroller and begin to sob. She’d be grocery shopping, catch sight of blueberry waffles, and break down in the frozen foods aisle.

She went to therapy. She went back to work. They went hiking. They walked the dogs. Kai’s due date approached. They talked about how they would mark the day. They knew now they wanted to have kids, and they wanted their kids to know they had an older brother. They would light a candle. They would each write a letter to Kai. A few days before, her husband still wasn’t sure what he was going to say. It just hadn’t crystallized in his mind yet, there was still something huge and unknowable about it. Once he sat down, on that day, in that moment, the right words would come.

This story is part of ongoing coverage of reproductive health care supported by a grant from the Commonwealth Fund

STAT encourages you to share your voice. We welcome your commentary, criticism, and expertise on our subscriber-only platform, STAT+ Connect

To submit a correction request, please visit our Contact Us page.