Divya and Jordan (names changed to protect privacy) came to Labor and Delivery worried but hopeful. Divya had woken up earlier that morning with the sheets soaking wet. She was almost 18 weeks along with her first pregnancy. Her anatomy ultrasound was next week. She was healthy. She thought maybe she had just accidentally wet the bed because of being pregnant.
When the Labor and Delivery nurse, who I’ll call Molly, helped Divya to the triage bed, Molly knew that there was not going to be a good outcome for this pregnancy—Divya had very obviously broken her bag of water.
A bedside ultrasound confirmed the unfortunate news—that the fetus had no fluid around it. Divya cried, not really processing what this meant. Jordan tried to comfort her, and a few minutes later sat out in the hallway of Labor and Delivery and cried silently.
They were given two options—to undergo dilation and evacuation (D&E) or induction of labor. They wanted to go home and consider their options and talk to their primary ob/gyn.
The next day they decided to undergo a D&E, and it was completed with no complications.
The lab work performed after the procedure showed evidence of severe infection. If Divya had waited longer, which could have happened if she had to undergo two days of a labor induction or an unnecessary Cesarean delivery because nobody could perform a D&E that she needed either for religious hospital rules or lack of providers, she would have been in full-blown sepsis.
Luckily we were able to take care of her before it go to that point. Luckily the hospital she went to had no religious restrictions for her care.
Every woman in this country, no matter their race, income, or immigration status, deserves the option to have appropriate and timely health care, which includes abortion services, and access to providers who are competently trained in all of these options. The way to ensure that all women have all the care they need is to continue training specialists, to expand training for residents, and to codify access to abortion care into law.
Abortion care is part of comprehensive women’s health care. Anyone involved in women’s health care needs to be able to easily access that training, just as women need access to that care. All care for all women, period.