by Grattan Brown, STD and Elizabeth Nelson, MD
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Sometimes what a pregnant woman needs most during a complicated pregnancy is emotional support, practical wisdom about navigating pregnancy, and a birth plan. It may be challenging enough for those supporting her to empathize emotionally or plan practically. Her doctors and nurses have to do all of it. But confident healthcare providers can give a pregnant woman the confidence to avoid choosing to abort her child.
It is not surprising that medical professionals in a Roe-shaped profession consistently recommend elective abortion. Doing so avoids risk to both mother and professional, and it avoids a lot of immediate suffering. But it does not avoid the longer term suffering of having chosen to end a child’s life and the missed opportunity to learn how to take care of oneself and loved ones facing a great, unexpected challenge.
After the US Supreme Court issued its decision in Dobbs v Jackson Women’s Health, I began seeking the stories of medical professionals with wisdom to share from practicing pro-life medicine in a Roe-shaped profession.
Dr. Elizabeth Nelson has this story to tell.
I retired in 2021 after 44 years as an OB/GYN in private practice. During my career, I did perform procedures to address complications during pregnancy and sometimes lost the child in the womb, but never intended to end the life of any child, especially a disabled or unwanted child.
In 1989, a family practice physician referred a woman to me for hormone replacement therapy because she was approaching the age of menopause. She had a history of polycystic ovarian syndrome and had never conceived. She never had regular menses and took Provera to induce them. She had been taking Provera as usual but had had no menses for five months. When I examined her, it was obvious that she was not menopausal. She was five months pregnant!
This woman was not only older but also an out-of-control diabetic who did not follow her diet or take her medications. Because these conditions correlate to a high risk of birth defects, many doctors today would have simply advised her to abort the pregnancy immediately. She would have refused that recommendation, and at that point many doctors would have encouraged her to test for chromosomal abnormalities and abort if the results showed a problem, even if she would have had to leave the state to do so at five months of pregnancy. The risk of birth defects in any pregnancy is 2-5%. In older women, the risk is slightly higher for chromosomal problems. In an out-of-control diabetic, the risk may be as high as 20%.
Instead of testing, she agreed to see a maternal fetal medicine specialist, who performed an ultrasound. There were no visible abnormalities on the ultrasound, but he still recommended terminating the pregnancy because of her out-of-control diabetes.
She came straight to my office distraught and in tears. She did not want amniocentesis because of the slight risk of loss of the pregnancy, and she desperately wanted this chance to have a child.
The experience changed her life. We reviewed the risks of her diabetes and age, and she agreed to take her medications and follow her diet. The maternal age risks were on her side for chromosomal problems (99 cases out of 100 have no problem), but the diabetes could cause problems for the fetus that would become evident only after delivery. Some of those problems, such as macrosomia (large size) and hypoglycemia (low blood sugar), could be minimized by excellent control of diabetes. She became compliant, did all that was requested of her, and stuck with it.
She wanted me to be present for her delivery, but I could not guarantee that I would be there because I too was pregnant and due about the same time. In the end, I was able to be present at her Cesarean delivery, but my hands were so swollen from my own pregnancy that I could only assist by cutting the suture. She was delighted with the emotional support and delivered a perfectly healthy baby.
Postpartum, we addressed continued compliance so that diabetes would not shorten her life and she would be present for everything from kindergarten graduation to high school graduation and a wedding.
That is all I know. She went on with her life without keeping in touch. But I am confident that the work she did to care for her child in the womb prepared her to raise her daughter.
Elizabeth Nelson, MD is a retired OB/GYN and maintains an active Florida medical license in order to volunteer in clinics and pregnancy centers. She is currently responsible for the abortion pill reversal program at the Choices Women's Clinic in Orlando FL.
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