Every decision I’ve made about my reproductive health has affected my life; every pill, every sexual encounter. It is the same for all women: decisions about reproductive health have power, from contraception to if or when to have children.
But our decisions are controlled by our choices, a word often bandied about recklessly, especially with regard to women’s reproduction. It sometimes implies a sort of freedom from care, the word “choice” giving us carte blanche to make decisions that lead to happiness. The dictionary definition of choice is “the power to make a decision”. Choice is about need, the need to be able to make decisions that allow us to live our lives to their fullest potential. When choice is denied, power over our lives is denied.
The reproductive decision that affected me more than any other was the agonising one I took to terminate a pregnancy. I’m not going to sugarcoat or excuse it. I live with it every day.
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I was 35 when I had my first beautiful baby, who was quickly followed by my second 19 months later. Because of my age, I wasted no time trying for my third, thinking that if I was going to drown in nappies, I might as well drown in style.
But all those planned reproductive decisions suddenly went haywire when I miscarried. Sometimes the unplanned happens. Devastatingly, I went on to lose two more babies. Tests revealed that I had a chromosome disorder and that my babies, especially if they were boys, were at risk of severe medical issues.
By the time these results came back, I was already two weeks pregnant. My longed-for third baby was now a gamble. There was a 50 per cent chance it would be a girl, and even within that bet I still had a strong chance of miscarrying or having a severely disabled child. Every day of that pregnancy was lived in fear. When Ruby was finally born, I relaxed, knowing that all those years of trying to get pregnant, of getting pregnant, of having babies or losing babies, were over.
Except they weren’t. The unplanned happened.
Four days after Ruby was born, my mum had a catastrophic stroke and my world turned on its axis. I spent the next few months spoonfeeding my new baby and my mother, changing their nappies. Perhaps not surprisingly, I was diagnosed with postnatal depression, struggling not only to cope with the emotional and physical challenges of raising three children under six, along with helping to care for my mum, but the mental challenges of just getting through the day.
My decision-making skills were annihilated by grief and depression, but then I had to make the worst decision of all. I discovered I was pregnant. This obviously wasn’t an immaculate conception. My husband at the time had agreed to have a vasectomy, but hadn’t yet got around to it.
I’m an adult who should have taken better responsibility for contraception. My initial reaction to news of the pregnancy was happiness. It’s an incredible feeling to know there is life beginning inside you. But the reality of my situation soon overpowered that feeling. I was a 42-year-old mother of three, on antidepressants, barely able to cope with my life as it was, floored by grief and overwhelmed by childcare and parent care. I had lost three precious babies and had fought so hard for my third child, and here I was now in the terrible situation of being pregnant but knowing, for my own sanity and the wellbeing of my three children, that I could not proceed with this pregnancy.
My reproductive journey had been full of such highs and terrible lows, but this was unbearable. I knew, though, that it wasn’t just about me. It wasn’t about choosing a child over another. It was about survival, mine and my children’s. It was Sophie’s choice, a choice between two unbearable options.
But that decision involved other decisions. Which flight to get? Who should travel with me, and who should stay with my children? I felt like a criminal, having to leave my own country, my own children, in order to protect us all. But after all those plans were made, the unplanned happened again. I miscarried the day before I was due to fly.
It takes nothing away from the decision I had made. There was no relief with that miscarriage. Just a numbness.
Twice as many women over 40 have surprise pregnancies as women in their teens and 20s. Sometimes the unplanned happens, and it’s not just the young who have to make perhaps the most difficult reproductive decision of all. We need the choice to make the best decisions we can.