I know, this has nothing to do with service dogs.
It is somewhat related to my disability,
though.
And I see so much discussion on
this topic on Facebook and in the news and everywhere these days.
I just wanted to take the opportunity to put
some of my own thoughts into words.
I guess I should start by saying I am pro-choice. That doesn’t mean that I think abortion is
something that should be chosen lightly, and I don’t think many women do make
the choice lightly. I can think of three
women I’ve personally known that had abortions (there are probably more but
it’s something most people don’t share with everyone they know) and I know all
three of them put a lot of thought into making that decision. I know two of them considered themselves
pro-life or at least never thought they would choose to have an abortion, until
they found themselves in circumstances in which they could not see another
solution. I know one of them got
pregnant while using condoms and one of them got pregnant while taking birth
control pills; the third was not using any form of birth control because she
was not sexually active when she was raped and became pregnant. I know one of them would have loved to have
another child but it just did not seem feasible at that time, in those
circumstances. None of them was relying
on abortion as a form of birth control.
I’ll also say that while I am pro-choice, abortion is not
necessarily the choice I would make if I found myself facing an unexpected
pregnancy. I actually got pregnant when
I was 16, and both my parents and the father’s parents encouraged us to either
place the child for adoption or have an abortion. I chose not to have an abortion. I gave birth at age 17; my daughter was
mostly raised by her father. I see
abortion as a last resort type of thing.
It’s what I would choose if I felt I was unable to carry a pregnancy to
term for some reason. If I felt I could
carry a pregnancy to term but not raise a child myself, then I would place the
child for adoption.
So what does all this have to do with being disabled? Well, to begin with, being disabled affects
my access to contraception. I’m on
Medicare, and I would like to have a tubal ligation because I definitely do not
want to become pregnant, ever again.
However, Medicare will not pay
for a tubal ligation. My primary care
provider recommends I avoid birth control pills because I have a family history
of breast cancer and the pills increase one’s risk of breast cancer. She and I agree that it is best that I avoid
all hormonal forms of birth control, since side effects can include depression
and I already have a history of very severe depression. That doesn’t leave me with many options, but
Medicare will not cover a tubal ligation.
Unfortunately, I don’t have the $5,000 the surgeon told me it would cost
to pay for it myself.
So because I am disabled, I don’t have access to real
effective birth control. I can use
condoms, and I do, but they are not nearly as effective as a tubal
ligation. Am I just supposed to be
celibate to make sure I don’t become pregnant if I don’t want to be? I’ve been on Medicare since I was in my
mid-30’s. Do our legislators just assume
disabled people aren’t interested in having sex? And none of the pro-life folks have offered
to pay for my tubal ligation in order to prevent an unwanted pregnancy, either.
At this point in my life, if I did become pregnant, I
believe I would have to abort. I don’t
want to have to do that, so I am super careful about birth control (which at
this point means condoms and vaginal contraceptive film). But what if my birth control failed? Even a tubal ligation can fail, although it’s
very rare. I asked the surgeon I spoke
to how that could possibly happen, and it said that in some cases the tubes
simply grow back together, or grow around an obstruction. How bizarre is that? It’s kind of cool, too, if you think about
it, the body’s remarkable ability to heal and repair itself. But it wouldn’t be so cool for a woman that
had a tubal ligation and then found herself pregnant.
And let’s not forget that fact that some women that are
abstinent become pregnant after being raped.
And women with disabilities of any kind are more likely to be raped than
women without disabilities, although of course it can happen to anyone.
Anyway, if I became pregnant at this point in my life, I think
I would have no choice but to abort. I
don’t see how I could possibly get through a pregnancy. And that’s because of my disability.
For a moment, let’s just forget
about my fear of doctors and hospitals.
I’d have to have a home birth, with a midwife, but that’s what I would
have wanted before developing this fear, anyway.
I have severe depression, which is
sort of stable at the moment, but the physical and emotional stress associated
with pregnancy could wreak havoc on my psyche.
The hormonal upheaval scares the crap out of me. Looking back on my life, I think I was
depressed from a very young age, but it was not diagnosed until I was pregnant
the first time. And in the postpartum
period, my depression was very severe; that’s when I attempted suicide for the
first time. Perhaps a second pregnancy
would be easier than my first, but I don’t believe it would. I believe there is a very good chance my
depression would get significantly worse.
I believe I would be at risk for killing myself.
How does a severely depressed,
suicidal person get through nine months of pregnancy? Even if I wanted to spend nine months on a locked psych
ward (and I don’t), that wouldn’t happen.
Who would pay for it? You’d be
looking at about $1,000 a day, maybe more; that’s about $30,000 a month. Medicare isn’t going to cover that; I think
my co-pay for inpatient hospitalization is something like $450 per day right
now, because I’ve already used up a lot of my inpatient days on my Medicare
Part A plan. As far as I’m aware, none
of the prolife organizations offer to pay for inpatient psychiatric care for
suicidal pregnant women, either.
Then there is the issue of quality
of life. Who would want to spend nine
months on a locked psych ward, even if that was an option? Who would want to spend nine months suffering
from severe depression, from self-hatred, from feelings of guilt and
hopelessness and despair?
Medication wouldn’t be an option, since most psychotropic
drugs have not been proven safe during pregnancy and many are now known to
cause serious birth defects. There are
currently some class action lawsuits in the works for women that were given
antidepressant drugs while pregnant and told the drugs were safe.
The bottom line is that I do not believe I would live
through a pregnancy. Now, many prolife
folks, though not all, believe abortion is OK if a woman’s life is at risk. Not all do, though. And even if it is legal to have an abortion
if my life is at risk, who gets to decide whether my life is at risk or if the
risk is great enough? Do I have to
convince a doctor that my depression is that severe? We all know how well doctors listen, right? Who is in a better position to decide whether
or not I really need to have an abortion than me?