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At this point in my 52 years, filling out the forms at the doctor’s office feels like writing a memoir. Any past surgeries? Why, yes. So many! Here we go, in alphabetical order, to the tune of “Twelve Days of Christmas”: one adenoidectomy, one appendectomy, two D-and-C’s, one frenectomy, one hysterectomy, one inguinal-hernia repair, one meniscectomy, one Morton’s-neuroma repair, one trachelectomy, one vaginal-cuff-dehiscence repair … and a partridge in a pear tree. That’s 11 surgeries, eight of which were related either to my children’s births or to disease of my postpartum reproductive organs. We’ll get back to that. Then comes the inevitable question: Number of pregnancies? Followed by: Number of live births? Five and three, I write. Five pregnancies, three live births. But these numbers do not tell the whole story, either about my health or about the gap between births Nos. 2 and 3. And it is in the delta between all these numbers (along with the answer to the question left out—namely, how many of those pregnancies were planned?) wherein everything I hold dear about Roe v. Wade resides: a woman’s right to choose what’s right for her, her family, her body, and her life at the time she finds herself pregnant, whether intentionally or not.

The day when you find yourself six weeks pregnant at the age of 17, as I did, is not a joyous day, particularly after doing all the right things, birth-control-wise, including getting yourself fitted for a diaphragm at Planned Parenthood. For one, you can’t have a baby. You’re still a baby yourself. You would (you know, even then) cause permanent emotional damage to a child, in not wanting to have one, never mind that you have neither the skills nor the means to raise one properly. For another, you’ve just been admitted to college, and though you love your high-school boyfriend dearly, you have no idea who you are or what you want out of love or life. Plus, raising a baby in a freshman dorm was never part of your plan. Nor your college’s. And adoption—for you, personally—is out of the question. The pain of handing over your child to another person would, you know, become a lifetime of “Little Green” sorrow. Your parents drive you to the abortion clinic in Maryland. No one in that car is happy, but everyone is nevertheless grateful for one another’s love and for your right to legally choose this option. The clinic makes you answer a bunch of invasive questions to prove you know what you’re about to do, as if you hadn’t been thinking only about this moment for the past week. You’re awake for the entire procedure, which is painful. You cry a bucket of tears into your saltines in the crowded recovery room after, because it hurts and because you’re still 17, the age of emotional roller coasters under the best of circumstances, which this is not. But not one of those tears can be traced back to shame or to regret over the decision to abort the minuscule embryo of cells inside you. In fact, it was not a “difficult decision.” It was easy: the only rational one, to your mind, to make.

Fast-forward from 1983 to 2000. You are now 34, married, and the mother of two planned children, ages 5 and 3. You love your children! They say funny things and bring you untold joy. You’re about to publish your first book and have started working on a second. Life’s chaotic, as it always is with young kids, plus you are doing all the domestic chores and child-schlepping solo while also bringing home a substantial chunk of the bacon. Even so, you don’t make enough to afford full-time child care in America. America: a country where pro-life actually means pro-blastula, pro-embryo, and pro-fetus, not pro-baby. You know what pro-life policies actually look like? Universal health care, so all women could afford prenatal doctor visits and the birth itself; paid maternity and paternity leaves, to allow parents to actually care for a living baby without emptying their bank accounts; subsidized daycare, so parents could go to work without paying all or most of their income to private babysitters; and a school day that hews closer to the workday, not to some outmoded agrarian schedule designed to get kids home in time to harvest crops. You start to wonder why you ever left Paris, where your kids could have had high-quality, affordable, government-subsidized crèches, after your ample months of paid maternity leave, as well as longer school days. You argue with your spouse about the gross inequity in domestic responsibilities as well as about more pressing relational issues. You are worried that your discord is affecting the children. Put simply, you’re not sure this marriage will last, but you are seeing a couple’s therapist to try to save it. Meanwhile, you had an IUD inserted after your second child was born to make sure you’ll have no more babies. Two kids: That’s enough. But then, one day, you wake up and realize your period is late.

Like, really late. Apparently, seeing an embryo next to an IUD in a sonogram is a rare enough occurrence that the entire ultrasound office is called into your examining room to bear witness. Though you’ve agreed to serve as a teaching moment, you feel a bit like a zoo monkey. While the ultrasound technicians and medical students ooh and aah over the image on the screen, your mind races over this unplanned turn of events. Should you have this baby or not? The next day, you are on the phone, crying to your ob-gyn, “What should I do?” You tell her that you don’t think you, your bank account, your marriage, or your kids can survive a third child right now. She lays out the facts clinically, without emotion: The IUD has to come out, a procedure that often dislodges an embryo. Moreover, the oral Lamisil you’ve been taking to combat a toenail fungus for the past week is contraindicated for pregnancy. That seals it for you. You would never knowingly bring a baby into the world who had possible deformations and disabilities from the start, never mind everything else going on at home. Your hideous, embarrassing toenail fungus has, in a sense, saved you from having to make a more difficult choice this time, but even if it hadn’t, you realize, you would still not choose to gestate this embryo. The marriage is teetering, imbalanced. A new baby, with or without disabilities, would be the final thumb on the scale. On the day of your D&C, a procedure that has improved in the intervening 17 years—you are put under twilight anesthesia this time, so the pain is minimal—both you and your husband are clear in your choice. The only tears this day are those of relief. Related Stories What Happens to a Woman’s Brain When She Becomes a Mother

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Before There Were Home Pregnancy Tests From 2000 to 2005, the marriage improves, somewhat, and you’re back to using a diaphragm for birth control: Your breast tissue has abnormalities that will later lead to more serious problems, and the estrogen in the pill exacerbates this. Plus the IUD was clearly a bust. Moreover, at 39, the chances of you getting accidentally pregnant again while on birth control are low. And yet, once again, your body shatters the odds. When your period is late, you assume you’re entering menopause, but you decide to pee on a stick to confirm this. The little plus sign appears. You curse. Loudly.

Your 8-year-old daughter hears you and comes running into the bathroom. “What’s wrong, Mommy?” she says. In that instant, you feel a sudden jolt of shame for having cursed so loudly, and acceptance of this new and shocking reality. At 8 and 10, the kids are not yet old enough to fully respect your privacy in the bathroom, but they are old enough to require much less care. Hurtling toward 40, you feel comfortable in your own middle-aged skin. You love babies, you have loved being a mother, you even love breastfeeding, and your husband has said he’s always wanted a third child. In fact, he’s been begging you for one, promising to take paternity leave this time. Should you do this? You consider the cons. The money issue is still there, but it will always be there. Your country still has no paid parental leave, and pregnancy discrimination at work, while illegal, is nevertheless real, pervasive, and financially punitive. You’re worried about your own health as well. Pregnancy has not been kind to your body. Each prior live birth has led to two surgeries: the Morton’s neuroma, formed during your first pregnancy, when your shoes got too tight; and the inguinal hernia, popped giving birth to the daughter now standing in front of you. And yet despite all these downsides, the pull of that tiny blastula growing inside you is strong. “Nothing’s wrong, sweetie,” you say. “We’re having a baby!”

That baby is now 12 years old, the family disco ball. He was born on the brink of his older siblings’ adolescence, tempering their drama-fueled needs with his real ones. He’s full of joy and music and light and love. He likes to dye his hair blue and play the ukulele. When his dad moved across the country for two and a half years on the day after your 20th wedding anniversary, and the marriage broke up—it was always going to break up; this should have been clear, in retrospect, two decades earlier, for reasons having nothing to do with the kids—your unplanned but very- much- wanted child’s smile was a balm and a beacon of light during a dark time. But as glad as you were to have chosen to gestate him to term, it was hardly an easy pregnancy. He tried to come out dangerously early, at 30 weeks, turning the end of the pregnancy into six weeks of strict bedrest and constant contractions. This eventually led to the discovery, after his birth, that you had severe anemia and advanced adenomyosis, requiring a partial hysterectomy, followed by a trachelectomy of your diseased cervix five years later, which lead to a near-fatal bleed-out due to vaginal cuff dehiscence three weeks after that. A few months after his birth, you’d keeled over, on a city sidewalk, with the kind of pain that became an emergency appendectomy, not knowing, until sitting down to write this essay, that the risk of acute appendicitis in postpartum women over 35 is 84 percent greater than the risk to the general public. We often forget, in the abortion debate, the real toll pregnancy can take on a mother’s body, never mind the fact that the U.S. has the highest rate of maternal deaths in the developed world by a landslide: 26.4 per 100,000 live births, compared with the next on the list, the U.K., with 9.2. (The lowest, Finland, has only 3.8.)

I’ve had five pregnancies and three live births, I write on the medical forms, but what I leave out is now crucial, as Roe v. Wade once again comes under attack. My youngest was not planned. But he was chosen—I want him to know—with love, optimism, and hope, just as the terminations of the two other unplanned pregnancies were also chosen. My body is now a canvas of pregnancy-related scars. I knew, going into that third birth, the physical toll pregnancy had already taken on me. And yet I chose to go into it anyway. My third pregnancy/second live birth, my only daughter, is now 21. She is extremely responsible and trustworthy, yet she calls me at least three times a year when some glitch in her birth-control-prescription delivery service sends her scrambling to fill in the gaps with her friends’ pills. (Her friends’ pills!) Though I pay a backbreaking $2,298.30 a month for our insurance, my daughter, like all Americans on the pill, must visit her doctor in person for a new prescription every year. This is not easy when your prescribing physician is in New York, you’re a full-time premed student in Illinois, and you work 10 to 20 hours a week on top of that as a condition for your financial aid. What she chooses to do with her body if she finds herself accidentally pregnant—and, given her genes and prescription hurdles, this seems as likely as not—should not be up for debate in 2018.

Instead, abortion should be as inalienable a right as life, liberty, and the pursuit of happiness. Supreme Court justices should not be chosen for their opposition to Roe v. Wade. And our country should be pouring its considerable energy and resources into creating the kind of infrastructure that supports the lives of actual babies, once they’re born: universal health care, paid parental leave, subsidized daycare, proper sex education, affordable college, affordable birth control, and easier access to that birth control to keep unwanted pregnancies from happening in the first place (should the women who are lucky enough to get their hands on it have better luck than I did in the game of birth-control roulette). Only two of my five pregnancies were planned. Three were not. If those were the odds in blackjack, no one would ever play. In other words, what’s at stake in this ridiculous debate over bodily autonomy is choice. It’s always been about choice. To be alive and human is to be in favor of life, but to bring an unwanted child into this world—or to force any woman to do so against her will, her health, her future, her finances, or her well-being, because that is your moral stance, not hers or her doctor’s—is not pro-life. It is control wearing the mask of virtue. It is government regulation at its most invasive. It is being willfully blind to the inevitable bloodshed from illegal abortions and high-risk pregnancies. It is choosing an embryo over the life of a woman. It is, to put it succinctly, anti-woman. Related Video