During pregnancy, a woman is truly never in the clear in terms of her safety and her baby’s safety. Complications can arise at any time, and depend on a variety of factors. For low-risk pregnancies, the 20-week mark can be a big milestone marked by a routine anatomy scan.
The ultrasound that occurs between 18 and 20 weeks of pregnancy gives expecting parents a very detailed glimpse into their growing fetus. It also gives a doctor an opportunity to look for 11 rare conditions which could be life-threatening to mom, the baby, or both — like the genetic disorder trisomy 18. While the technician can’t say anything during the scan, as their job is to take detailed sonograms for a doctor to review, the time period between the scan and results can be an anxious one.
For many women, they’ll receive a call that the scan looked great. Coupled with previous genetic testing, they’ll breathe a sigh of relief and try to enjoy the last half of their pregnancy. But not everyone, like a Texas woman named Kate Cox, is so lucky. Instead, they’ll receive nightmarish news, perhaps confirming their baby has a fatal fetal anomaly, and the best course of action is to terminate the pregnancy. A heartbreaking and unfathomable turn of events that comes with a lot of grief and devastation after being pregnant for nearly five months.
For Cox, this hellscape scenario started a few weeks earlier than 20 weeks thanks to a screening test that first showed that she was at an increased risk for trisomy 18. This put her on track to have more tests, more ultrasounds, only to end up 20 weeks pregnant and now in the middle of a public battle for access to an abortion.
Only 50 percent of fetuses with trisomy 18 who are carried to term will be born alive. From there, the average survival rate for live births varies between 2 days and 2 weeks. As Cox wrote in an editorial published in The Dallas Morning News, “it isn’t a matter of if I will have to say goodbye to her, but when.”
Up to 95 percent of infants born alive with trisomy 18 die during their first year of life. Despite her attempts to be optimistic, even thinking maybe her unborn daughter “will have a really nice life in a wheelchair,” more ultrasounds have only brought more bad news. “There are issues with her spine, heart, brain and limb development, among other conditions,” she said.
While Cox wanted to terminate the pregnancy, a decision doctors told her she could make, they also told her their “hands” were “tied” under Texas’ abortion ban. Under Texas law, if a doctor is convicted of performing an illegal abortion they can face a $100,000 fine and up to 99 years in prison. Technically, Texas makes an exception for abortions when a pregnancy or the life of a woman is seriously threatened, but as I’ve previously reported for Salon, experts have long doubted such exceptions would work as intended — as we’re seeing play out in Texas at the moment. And it will play out, again and again, as we also witnessed this week when AP News reported today that a Kentucky pregnant woman has filed a lawsuit demanding the right to an abortion. Her embryo "no longer has cardiac activity," AP reported, quoting her attorneys Tuesday.
In response, Cox and her husband sought a court order to block Texas’ abortion bans from applying in her case to grant her access to an abortion in Texas. Last Thursday, their request was granted. But then Texas Attorney General Ken Paxton sought an emergency stay from the state Supreme Court, pausing the lower court’s approval. As a result, on Monday, it was announced that Cox would be traveling out of state to get an abortion. Later, the Texas Supreme Court ruled against the lower court's order, denying the request. Being forced to go to such lengths is the definition of cruelty.
The word "cruel" originates from the Latin word crudelis, which is defined as "hardhearted, bloodthirsty, unmerciful and inhuman." And it’s exactly what can be used to describe denying a pregnant mother of two an abortion for a fetus with a genetic disorder who will have low chances of surviving. “I do not want to continue the pain and suffering that has plagued this pregnancy or continue to put my body or my mental health through the risks of continuing this pregnancy,” Cox said. “I do not want my baby to arrive in this world only to watch her suffer.”
As Cox has said herself, she was so excited to learn she was pregnant with her third child. She wants to grow her family. But due to circumstances out of her control, she has become the one in 2,500 pregnancies to face the diagnosis. An abortion, Cox said, was something she never imagined she’d “want or need.” She never saw herself being in the situation she is in right now: 20 weeks pregnant with a baby that very likely won’t survive, and a pregnancy that could jeopardize her own health and future pregnancies. Carrying a pregnancy with trisomy 18 to term is associated with increased risks of gestational diabetes, preterm delivery and cesarean section.
There will be a choir of anti-choice advocates trying to justify Cox carrying the fetus to term, to pray for a miracle. They will trivialize how much it can cost, emotionally and financially, to travel out of state to get her wishes fulfilled. As Allison Chang, who also had a fetus with a trisomy 18 diagnosis, wrote for STAT News, “What is being accomplished by forcing women to carry these babies to term other than ensuring that these children are as aware of and sensitive to their pain as possible?”
As any parent knows, leaving your children to travel out of town is never easy, especially on a whim. Chances are high that Cox is going to have to go through this procedure alone. Of course, Cox will also be seen as one of the lucky ones who has the resources to even travel of out state to terminate her pregnancy, which not all women have.
What these narratives refuse to acknowledge again and again is the pain of the mother carrying the fetus. The pain of forcing her to seek permission for an abortion while she grieves the loss of hope for another child. The pain she faces as she has to weigh risking her own health for an unborn fetus, and the chances of being there for her children who are alive right now. The pain of forcing her into a situation that could keep her from having another child in the future. And finally, the pain of being dragged into the spotlight over a private medical procedure that ideally should only be between her and her doctor.
Anti-choice advocates say they’re defending life. But really, they’re failing to prioritize and value women’s lives, many of whom are already mothers with children. Instead, they’re adding to women’s pain in a culture that’s obsessed with minimizing and ignoring it.
“I’m trying to do what is best for my baby daughter and myself and my family, but we are suffering because of the laws in Texas,” Cox said. “I need to end my pregnancy now so that I have the best chance for my health, for parenting my children, and for a future pregnancy.”
