Pittsburgh Post-Gazette

Sure, just have the baby, as Alito says. No big deal.

- Pamela Paul Pamela Paul is a columnist for The New York Times.

There’s a lot I don’t remember about giving birth to my first child. But I do remember 24 hours of back labor followed by two hours of pushing to no avail. I remember, through a high fever and the agony of exertion, my body shaking with hard chills when I heard the doctor say the words “emergency C-section.”

I remember feeling a scalpel run along my midsection and screaming “Yes!” when asked if I was in pain and then “No” when asked if I would like to see my baby. No way did I want to meet my child for the first time under these circumstan­ces.

But I was lucky. It could have been worse. Many women who undergo emergency cesarean sections suffer from hemorrhagi­ng and blood clots, including life-threatenin­g pulmonary embolisms. Some women are injured by the procedure itself, which is, after all, major abdominal surgery and can result in a perforated bladder or bowel.

Some women suffer from postpartum infections to the incision wound, which can reopen during recovery. Some require additional surgery just to get over the initial surgery.

When I was pregnant with my second child, I wanted to do everything possible to avoid another C-section. Many doctors refuse to provide a vaginal birth after a cesarean, or VBAC, because there is a small (less than 1%) risk of uterine rupture, which can be fatal to the baby and gravely injurious to the mother. I managed to find a doctor who would.

But I was lucky. It could have been worse. Only about 13% of women even attempt a VBAC. Preferring to avoid the risk of litigation and favoring the relative ease of a scheduled C-section, obstetrici­ans often discourage VBACs. Many hospitals, particular­ly in rural areas, do not allow them.

Black women are less likely to have VBACs than white women and more likely overall to have C-sections.

Yet repeat cesareans carry their own risks, including placenta previa, placenta accreta and unplanned hysterecto­mies.

When I was pregnant with my third child, my morning sickness — a misnomer because the nausea intensifie­d as the day wore on, peaking at night — drasticall­y worsened.

Every day I would wake up knowing the day would only get worse.

Everything made me feel sick: eating, not eating, the smell of anything, the sensation of hot water on my hands, the overwhelmi­ng stimulus of full-color TV.

Eventually, like many women, I went on antiemetic­s, terrified I would harm my baby in the process.

But I was lucky. I could have had to endure the nausea while on my feet all day working at a fast-food counter or in a warehouse, worrying about being fired for a long bathroom break, lateness or absence.

I could have had hyperemesi­s gravidarum, a severe form of morning sickness that affects at least 60,000 American women a year and can require hospitaliz­ation.

I could have had preeclamps­ia, which affects around 400,000 women a year and can result in seizures and hospitaliz­ation. I could have been on any number of medication­s for existing conditions that would have had to be suspended during pregnancy in order not to put the fetus at risk but leaving the mother’s physical or mental health at risk.

I was lucky. It could have been worse. Living in a major city and with excellent health insurance, I had access to high-quality medical care.

I was lucky. I didn’t have to carry to term the product of rape or incest. I didn’t have to give up those babies to adoption, with the pain of my unneeded milk coming in to remind me of what I’d lost, left to wonder what would happen to a human being who was once a part of me and who might be forever haunted that I chose to give her up. I might be haunted too.

There are good reasons American women overwhelmi­ngly choose having an abortion over giving up a child for adoption.

Childbirth is the far riskier medical procedure. America has one of the highest maternal mortality rates in the developed world.

In the leaked Dobbs draft opinion, Justice Samuel Alito noted that many opponents of abortion point to the fact “that states have increasing­ly adopted safe haven laws, which generally allow women to drop off babies anonymousl­y, and that a woman who puts her newborn up for adoption today has little reason to fear that the baby will not find a suitable home.” For these advocates, “just” having the baby is a perfectly viable option.

It may seem perfectly viable to someone who has never been pregnant or given birth. Perfectly viable to someone with no concept of the full range of women’s concerns and fears. Perfectly viable to someone who has never had to make these choices — and live with the consequenc­es.

 ?? Erin Schaff/The New York Times via AP ?? Justice Samuel Alito
Erin Schaff/The New York Times via AP Justice Samuel Alito

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