If I Got Pregnant Again, I Would Have An Abortion. This Is Why.

Mike slammed the door behind him on his way back from the pharmacy. He was enraged that the man at the checkout counter had commented on his purchases, assuming his most optimistic tone and asking, “Is this a good thing?”

Aside from my husband’s fury, there was anguish in his eyes. I’d sent him out on my behalf after putting the children to bed to buy “a ton of pregnancy tests.” As desperately as I hoped they would all tell me I was not in fact pregnant, I knew that until my overdue period arrived I would use one every time I went to the bathroom, just to calm my nerves. I hadn’t punched a clinic’s number into my phone, hadn’t even moved a hypothetical Google search from my brain to my computer, but the second a plus-sign appeared on one of those sticks, I was scheduling an abortion.

In all the years of our marriage, we’d been through two pregnancies and three children, the youngest 4 years old. Although another baby would no doubt fit into our hearts and our lives and our family, the physical toll was too much. We knew what a pregnancy would mean for me: bed rest, anemia, crippling and untreatable pain, a pre-term C-section, most likely postpartum depression, but most importantly, cancer. Most people are familiar with the list of don’ts for pregnancy. Don’t eat raw fish, don’t eat deli meats, don’t eat soft cheeses, don’t clean cat boxes. What they don’t understand is the why of it.

A pregnant body is a body hijacked. It’s not just a body occupied; it’s reformed and reconstructed around the concept of building another body. The pregnant body is transformed like a butterfly in a cocoon, but most of these changes are invisible. The pregnant brain rebuilds itself, structurally shifting as hormones rewrite the needs of the new parent. The pregnant bones slide and grow. The pregnant lymphatic system adjusts. And the pregnant immune system fails.

A pregnant body suppresses its own immune system, so as not to reject the foreign tissue of a grown zygote or fetus. While a healthy body does not succumb to toxoplasmosis, a parasite often found in cat feces, a pregnant body might. And while every body is filled with atypical cells, a healthy immune system stops them from producing at a rate to form cancers. A pregnant immune system, though, might not.

Anti-abortion activists sometimes claim that having an abortion increases your risk of breast cancer, and the truth is having a pregnancy can increase your risk of cancer — many cancers. And the longer you’re pregnant, the more often you’re pregnant, the higher the risk is. There are specific cancers, breast cancer first among them, but also cervical cancer, Hodgkin’s disease, and leukemia. For me, it’s melanoma. About 1 in 1,000 women gets these cancers during their pregnancies. To put that in perspective for you, 1 in 700 babies has Down syndrome. Spina bifida myelomeningocele affects about 1 out of every 2,000 babies. So while cancer as a pregnancy complication is more rare than preeclampsia or gestational diabetes, “rare” just isn’t rare enough.

In the course of a single pregnancy, my last pregnancy, I had six cancerous or precancerous moles removed, and several polyps from my colon. Those are the ones that scared me the most, because if I was pregnant, melanoma could be growing anywhere in my body — in my colon, in my lungs, in my brain.

As so many Americans are, my family has already been touched and devastated by cancer. We as a society fight to protect each other from cancer risks. We don’t insulate with asbestos; we don’t fill our children’s lungs with secondhand smoke; we don’t allow companies to pour toxic chemicals into water supplies; we walk for cures and run for research and put ribbons on our bumpers and send hopes and prayers. But none of that would matter for my family if the line turned blue on my pregnancy test.

For a solemn moment, my husband and I were at a loss for words. He is wishing, no doubt, the doctor had given us the option of a tubal ligation during my second emergency C-section. I am remembering a friend’s wife who passed away three months after the birth of their daughter. She was a breast cancer survivor, but over nine months of pregnancy, her cancer returned, unseen. In the weeks after the baby was born, they found it had grown everywhere, its metastasizing tissue as protected from her immune system as the child she loved and wanted and waited for, and it was too late. The only thing she could do was say goodbye to her husband and leave him alone to raise a child who would never know her. She never even got to take her baby home.

Almost no birth control is perfect. Mike got a vasectomy, but there was a problem during his procedure, increasing the likelihood of spontaneous reattachment of his vas deferens. I have a medical condition that makes taking hormonal birth control unsafe, and a copper allergy to boot. But even on the pill, even with an IUD, pregnancies can still happen. The odds were astronomically small, but higher than zero, and my period was two weeks late. My body ached and swelled and fatigued in a way that could have been pregnancy or a nasty round of PMS, so much worse since multiple C-sections and plausible endometriosis, but might have been simple stress. Working two jobs, while raising three kids, while managing your family’s health care under less than ideal circumstances in the midst of a busy school year is stressful.

My husband dropped the bag of pregnancy tests on the coffee table and swore under his breath about the cheerful man who asked whether my husband was excited that his wife might be pregnant, and I held his hand.

We could probably afford another child if I didn’t have to end my career over six months of bed rest and three months or more in an NICU; if we could maintain our health coverage and somehow get by with only the babysitter for childcare during my high-risk pregnancy.

We would definitely love another child. We would cherish another child. But for how long? How long until the aggressive cancer that ran rampant through my pregnant body, and only my pregnant body, dug in its heels and took me down? How long until I left my husband, himself a cancer survivor, in the limbo of waiting for recurrence, alone to care for our brood?

My children need me — me specifically. My children need me in the way I need them, in that we are not complete without the other, that my love for them is the home in which they live, is the security that enfolds them, is the assurance that the sun will rise and the earth will turn, and there are no monsters under the bed. They need me in the way that children who lose their parents are always broken inside, always grieving and always wondering what would have happened, how much better and simpler and kinder the world might have been to them if their parents, both their parents, had been with them and healthy and safe and loving and good. Whatever my other faults might be, I was always a good parent. I was always loving. I was always compassionate with them, kind to them, supportive and optimistic and protective, not perfect but the best parent I could hope to be.

My visions of being the best mother I could be did not include making them watch me succumb to preventable melanoma before hitting double digits, so no, a pregnancy was not a good thing.

In truth, many abortions are performed on women like me. Moms in their 30s, who know what they face in their lives and their families if they must endure another pregnancy. The truth is that provisions in health care laws “for the health of the mother” do not take situations like mine into effect, where a pregnancy does not threaten my immediate life, but threatens it mercilessly nonetheless.

The truth is that I look like every woman in this country who pees and pees and pees on little plastic sticks, in constant dread that one more line will turn blue. The truth is that we love our children, so profoundly and so deeply, that the horror of having to end a pregnancy, to cancel the creation of a child we already know we would love despite any other conflict, is less than the horror of having to abandon all our children, forever, because of some failure of birth control or fate. The truth is that being a good mother should not and does not require dying to bring one more child into the world.

My husband sank into the couch next to me and produced a box of cookies along with the stacks of pregnancy tests, and together we ate, holding each other in our limbo. Between us hung the unspoken truth that, even if I were not at risk of dying from a pregnancy, even if any baby we created were not in need of emergency, life-saving care before growing long enough to be born on its own, even if a pregnancy did not mean risking my career and income along with my health, it might not be “a good thing.”

What if another child disrupted the happy balance of our family? What if we were unmatched to the task of raising whoever they might be? What if their needs were such that I had to quit my job anyway, to advocate for a child I loved, but with needs I was not yet capable to meet? What if a new child demanded so much of me that their older siblings fell by the wayside, and the relationship I had built with them fractured under the strain of their perceived abandonment? What if, God help me, with postpartum depression I found myself incapable of loving another child? What if, what if, what if?

Mike put his arm around me, tenderly, as though my body might not be mine for him to touch, and the distance broke my heart. I felt as insecure and unsure as a teenager, but I wasn’t 18, experimenting with sex in college. I wasn’t 15, exploring my sexuality and unsure what the consequences might be. I wasn’t 14, a survivor of sexual assault and unsure how to navigate my body and what might be inside it. I was a grown-ass woman, as I told myself so often, and this was my body, my decision, my burden.

I was a mother, and nobody said it would be easy. Nobody told me it would be this hard, either.