During my fellowship, I cared for a single mother with two young children who was barely scraping by. Jackie was pregnant and suffering from heart disease that was made worse by her pregnancy. She had had a infection during her childhood that caused her heart valves to work poorly. During pregnancy, Jackie’s heart condition deteriorated and she was considering surgery to replace her faulty heart valves, likely strained from her other two pregnancies. Left untreated, she might suffer shortness of breath, fluid on the lungs, and poor heart function. This would make it difficult for Jackie to attend to the needs of a new baby, as well as care for the children she loved and looked after already.

Because of Jackie’s condition, one of her previous pregnancies had resulted in preterm birth, and her youngest child required intensive support for developmental delay. Jackie was worried that if her health continued to deteriorate during pregnancy, she wouldn’t be able to function well enough to take care of all of her children.

She decided to have an abortion so she could remain healthy enough for surgery and so that she could care for her young children. New York Medicaid covered Jackie’s abortion, but in many other parts of the country it would not have been, since her health—but not her life—was at risk.