Why We Really Need Abortion Exceptions

They're not just for us. They're for you.

“Abortion lonely,” by Substack AI

About a year and a half ago, my partner and I were sitting placidly in the waiting room of the Toyota service center in Palm Springs, waiting on an oil change, when all of a sudden, the tidal wave of a horrible cramp in my lower abdomen sent me reeling.

Holy shit. I shifted in my seat and looked at Dave. He was still buried in a book.

The cramp reminded me of something I'd felt before. But it was too unpleasant to seriously consider.

I'm fine, I told myself firmly. Looking around at the impersonal corporate gray of the space, I decided that surely nothing too terrible could happen here.

Magical thinking! hissed my brain. But I gritted my teeth and focused on a nearby palm tree. Count the fronds, I ordered myself, breathing heavily.

Fourteen ... fifteen ... and then all of a sudden, there it was again. I swooned. It was as if someone had grabbed a handful of my flesh, twisted as hard as they could, and then kicked me with a steel-toed boot for good measure.

My rationalization wasn't working. Something was wrong.

"I have to go to the bathroom," I whispered hoarsely, hobbling off as fast as I could go.

Once I'd barricaded myself in the handicapped stall, I fumbled with my pants. Somehow I couldn't quite see what I was doing. It was just as well: I was terrified to look. Finally I sank down onto the toilet and dissolved into ragged sobs.

I stayed that way for about fifteen minutes, alternately panting and weeping. As I did, that bright pain waxed and waned in closer and closer intervals. Every time I thought it might stop, it came back stronger. What am I going to do? I had to get Dave. My purse, with my phone inside, sat eight or ten feet away, where I'd dropped it. Standing up, walking over to it - utterly out of the question. I was terrified I'd fall and crack my head open. Maybe if I crawl?

Fearfully, I eased myself down onto the filthy floor. It was cold, but the tile felt beautifully cool against my skin. I cried as I inched myself along. Then, suddenly, the wracking throbs stopped. I waited, sickened. Miraculously, though, they stayed stopped. It was over.

After a few minutes, I was able to get into a sort of downward-dog position. Then I was standing. Gingerly, I made my way back to the toilet and sat down. As I did, I found that I was seeing clearly again. I could tell by the wide red streaks that marked my path on the floor.

A coat of red covered the toilet, too. Little red splashes decorated the walls - though how, exactly, they got there, I didn't know.

What I did know was that I'd been pregnant. Not for long, granted, but for awhile. Forcing my fuzzy brain into some quick calculations, I determined that I'd been pregnant for just shy of one trimester.

And now I wasn't.

******

On June 24, 2022, Roe vs. Wade fell. The legal precedent guaranteeing abortion rights at a national level to American women was suddenly no more. This represented the fruition of a long-held conservative goal. It was a change liberal women had long been warned about, but one we sort of never thought would actually happen.

Well, we were brought up short.

In the aftermath, many yards of writing were given over to the dilemma of whether abortion should be outlawed wholesale, or whether "exceptions" should exist. These are cases such as those of pregnancy by rape, or by incest, or of pregnancies that are physically atypical, such that forcing the woman or girl in question to carry to term would mean risking her own life. Exceptions are also sometimes discussed for pregnancies in which the fetus is non-viable, or even "incompatible with life:" where something is so wrong with the fetus that forcing the eventual child to try to live, if only briefly, might amount to an act of cruelty.

And for many people in this country, including those who take care to always think and behave in accordance with the very highest moral and ethical values, exceptions are nonsense.

This is hard for me to stomach. I happen to believe that reproductive care is health care. And I believe the health care decisions any individual makes are none of anyone else's business. As such, I believe it follows that those decisions have no business being litigated. The state does not have a place in my reproductive choices.

Except, of course, that now it does.

But I'm not here to talk about any of that today. I'm here to explain why these exceptions are crucial - and I'm talking specifically to men.

Respectfully, many of you have absolutely no grasp of the fact that these abortion laws could affect you.

It's true. In fact, I bet they already have.

Now, now - hang on! Stay with me! I am very sure that your own wives, your daughters, your sisters and sisters-in-law, and your friends would certainly never accidentally get pregnant and come to feel that it would be best not to keep the baby. That would be irresponsible behavior. It definitely wouldn't be appropriate in a good Christian family like yours.

I know you and your loved ones will never encounter circumstances like birth control failing - even within a marriage. I know the women close to you will never have to deal with the fear that they don't have the financial resources to care for a child well, or the maturity, or the proper living arrangements or a strong enough relationship. Hardline Christianity protects you from that.

Luckily, your wives - your daughters, your sisters, etc - only get pregnant within the context of marriage. It only happens in stable, loving homes, after an appropriate period of somber reflection and contemplation. Pregnancy only happens in homes equipped with backyard money fountains, to ensure that the resulting children will always be securely supported, no matter what.

And I'm definitely not talking about a situation where your daughter's perfect-on-paper new husband starts hitting her, now that it seems she's well and truly under his thumb. Again, that wouldn't happen to you. Neither would the unexpected loss of the family's income at a time when they need it the most. Neither would a sudden divorce, brought about by an erstwhile son-in-law's abrupt conviction that this whole parenthood business is just too much pressure, leaving your little girl sad, humiliated, and holding the bag.

But even given all that, you still might find yourself incredibly glad that existing pregnancy procedures and interventions remain legal. Because what actually could happen to a woman you love - and put her life at risk - is a miscarriage.

My unfortunate experience at the Toyota service center is nowhere near as bad as a miscarriage can get, and that's why I don't talk about it much. Stupidly, I didn't even go to the hospital. I was in shock, too shaken up to adequately, viscerally, explain to my partner what had happened: the blood on the walls, and all that.

Once the bleeding and cramps seemed to stop, I picked myself up off the floor and we went home, where I spent the next three days spotting and feeling rather faint. Still very out of it in the aftermath of the event, I only told Dave what had happened to me in the car, on our way back to Twentynine Palms.

Unable to do anything but follow my somewhat dazed lead, he didn't intuit how bad it was.

In fact, he didn't fully understand until a few days ago, when we happened to discuss it again. That's why I think you might not, either.

If your daughter or wife or niece gets pregnant, you will surely think it's wonderful. It'll be a whole new chapter in your family's story, and what a blessing! Every day, your family's excitement will grow exponentially, with all kinds of blissful planning and preparation.

But any one of a hundred little things could go just slightly wrong. And if it does, it could mean, sadly, that this particular pregnancy is not to be.

It happens all the time.

Actually, it happens so often that most women have heard the maxim that, in order to avoid a complicated whole-family ride on an emotional rollercoaster, pregnancy shouldn't even be announced until the first trimester has passed. And there's a strong case for it: after all, that first trimester was the hurdle I tripped over that day in Palm Springs.

*******

When a miscarriage happens in a planned pregnancy, it's sad, of course. It's hard for the would-have-been parents and grandparents alike - for everyone who would've loved the baby. Most of the time, though, the hope is that, after the woman's body heals, a healthy, successful pregnancy will follow, ushering in the catharsis of celebration - now twice as sweet - that should have been this time.

That's what is hoped for. But some of the tools required to get to that place, however, are tools that are also used for abortion.

When a woman miscarries, or when she goes to a doctor appointment and learns that, sadly, the fetus has no heartbeat, then that fetus and it's surrounding tissue need to come out. It's not safe otherwise.

And I don't mean "it's not safe" in the same way that it's not safe to leave the helmet at home for a short bike ride, or to take the dog outside for five minutes while an unsupervised candle burns. It's not "maybe a little iffy, but probably fine." It's an emergency. It's dangerous right now.

To be safe again, the miscarrying woman will either need to take a medication, such as misoprostol or mifepristone, or will require a surgical intervention to ensure that her uterus is emptied of any biological material related to the pregnancy. Very often, this requires a procedure known as either a D&C - a dilation and curettage, for an earlier pregnancy - or a D&E - a dilation and extraction - for when it happens later in the pregnancy.

If the miscarriage happens while the pregnancy is less than ten weeks old, there's a high chance the woman's body will pass the deceased tissue quickly enough to avoid major harm. Thanks be to God, that's what happened to me - though I certainly didn't know that at the time.

My miscarriage at the Toyota dealership occurred between ten and eleven weeks - but it was still very foolish of me not to have gone to the hospital. Why? Because the body doesn't always flush everything out on its own. And when the pregnancy is more mature, it becomes more likely that a woman will need clinical intervention - a D&C - to remove remaining uterine tissue.

If a woman skips this step and it turns out that she shouldn't have, she may or may not have a small window in which to fully realize this and go for treatment. She will almost certainly develop an infection. An infection, if not treated, can turn into sepsis. Sepsis, in turn, causes major organ damage, and can even be fatal.

Yes: having an improperly supervised miscarriage can kill a woman.

Even though women used to - and still do, in some parts of the world - actually give birth in rice paddies or on the farm when there's no better option available. They also have miscarriages in these places.

What did those women do to avoid infection? They may have had access to herbal or other traditional medicines, but most often, if something went wrong, they just died.

Again, in some parts of the world, they still do.

I really hope we can agree that this is not an acceptable outcome anymore - at least, not in 2024, in the country we still say is the most advanced, the “best,” in the whole world.

Most of us know this stuff, or can vaguely recall having heard it before. But did you know that both the medications and the emergency D&C procedure that could save the life of your wife, daughter, or sister are the exact same interventions a woman receives for a voluntary, medically-supervised abortion?

That's right. If you take away that option for women who choose to end their pregnancies - for reasons that are solely their own, whether you approve of their thought processes or not - then you could also inadvertently outlaw life-saving care for women who would treasure children born from pregnancies gone awry.

But the confusion doesn't stop there. There are all kinds of blurred lines between voluntarily ending a birth and saving a mother's life. From the Guttmacher Institute:

33 states have bans on D&E, most commonly used method of abortion in the second trimester. These bans only allow the use of the method when necessary to protect the patient’s life or when their physical health is severely compromised.

21 states ban the provision of “partial-birth” abortion.

13 of the laws are similar to the federal version that was upheld by the U.S. Supreme Court.

7 of them remain unchallenged but, because of the broad nature of their language, are presumably unenforceable under the Supreme Court’s 2000 decision in Stenberg v. Carhart, which struck down a Nebraska ban.

All 20 state laws include some sort of exception.

3 states have bans that include a health exception.

1 state allows use of the procedure when the patient's health is at risk.

2 states allow use of the procedure only when the patient's physical health is severely compromised.

17 states have bans that allow for an exception only when the patient's life is in danger.

What do these situations all have in common? They're all exceptions. Yep, all of these instances belong to pesky legal gray areas, where knowing what to do - not what is possible, but what's allowed and what's not - isn't so easy.

*********

So do me a favor, guys. Picture your wife, your sister, or your daughter at age 37 or 38, sitting calmly in a dealership's waiting room with her fiancé, expecting nothing more surprising from this day than perhaps a slightly higher repair bill than she would've liked.

She wants to be a mom. She'd be a damn good mom. But as she closes in on 40, she doesn't have all kinds of time to wait.

(You guys do. Sometimes I think that disparity causes men and women to greatly misunderstand each other.)

Anyway. There's your daughter, enjoying a regular Saturday with her partner.

Now imagine that something awful inside her body overtakes her. It causes her to get up abruptly and run to the bathroom, leaving a half-hour later, only after limply wiping up a distressing amount of her own blood.

Or perhaps it's even more serious than that. Perhaps she has sense enough to go to the hospital. Once she's there, imagine she's told that, yes, something is seriously wrong - and not just with her fetus.

If that happens, red-voting, exceptions-decrying men, do you want a bunch of doctors standing around, dithering over what they can legally do to make sure your loved one actually lives through the experience? Or do you want them to seamlessly take control, as only doctors and nurses can, working quickly and confidently to shepherd this woman - your wife, your daughter - through this critical time safely?

If you prefer the latter, then perhaps you now understand something useful about the utility and importance of abortion exception laws.