My Ectopic Pregnancies

Looking at lost children with love

Thank you to all the readers who posted about your donations to mothers and children in need. As promised, I’ve matched the first $500 in donations with a gift to the National Diaper Bank Network. Because so many of you contributed, I’ve also made an additional $125 matching gift to the Sisters of Life.

I have lost three children to ectopic or suspected ectopic pregnancies. Blaise was a baby we couldn’t find in the womb, though my hormone levels were high enough that the baby should have been visible on ultrasound. It was a “pregnancy of unknown location.” Camillian and Luca were both ectopic—located in my fallopian tubes.

Blaise and Luca I miscarried naturally. An ectopic pregnancy is always a potential medical emergency, but in some cases, it’s possible to opt for expectant management, where we simply waited, did blood tests every other day, and eventually miscarried without medical intervention.

Yesterday, I wrote about how we lost Camillian for the New York Times. In the aftermath of Dobbs, a lot of the discussion of ectopic pregnancies have been about whether treatment will be permitted under pro-life laws. All current laws include either an explicit note about care for women whose children are ectopic or a life-of-the-mother exemption, though people are concerned that any ambiguity or uncertainty about the laws could disrupt care. (I’m talking to some doctor and lawyer contacts for future reporting on this).

I wanted to write about Camillian to describe not just what is allowed but what can be offered to parents who are losing their child when the doctors acknowledge their child as a child, rather than minimizing their loss. These were the paragraphs that meant the most to me to write:

The specifications for surgery remain the same, whether the surgeon is pro-life or not, whether the mother kept repeating “baby” to her nurses or stuck to saying “pregnancy.” But I wonder if an observer in the operating room could have seen a difference; if my surgeon was visibly more tender as he worked, knowing he could be the first person to see our child, a child who would not ever see us.

Doctors can’t value women more by dismissing our babies as worth less. Even women who support abortion access may find it jarring to have their child’s life dismissed when they hoped they would hold this baby. It’s better to be honest about tragedy and loss than to pretend that only one person is on the table.

And these were the paragraphs that drew the most criticism:

From a pro-life perspective, delivering a baby who is ectopic is closer to delivering a baby very prematurely because the mother has life-threatening eclampsia. A baby delivered at 22 weeks may or may not survive. A baby delivered in the first trimester because of an ectopic pregnancy definitely won’t survive. But in both cases, a pro-life doctor sees herself as delivering a child, who is as much a patient as the mother.

A pro-life approach to ectopic pregnancy may countenance similar procedures but still sees it as different from an approach that equates it to abortion. When a mother’s life is threatened by the course of her pregnancy, there is a wide gulf between a culture that assumes she and her baby are pitted against each other and one in which both are valued.

It was the word “delivery” that sparked particular pushback. A number of the people who wrote back to me felt that the use of the world was illegitimate—applicable only to full term births. Others thought it was rhetorical slight of hand—the intention of the doctor and the parent doesn’t matter, just the outcome.

A doctor who works in palliative care offers morphine and other pain medications that can hasten the end of life. One doctor may decide that, to care for their patient, they need to focus on comfort, and prescribe a dose that addresses pain, but also has the effect of shortening life. Another doctor may decide that their patient’s life is not worth living, and prioritize a dose that will hasten their dying. I think these doctors are doing very different things, even if their different ways of thinking bring them to prescribe the same dose.

Especially in the cases where we can do little medically for someone who is dying, the last mercy we can offer is how we see and treat them.

The other two strains of pushback I got were diametrically opposed. Some writers accused me of making up parts of my story, saying that they worked in nursing or had received similar care, and had never encountered someone who would have told a mother in the ER to stop crying or that she shouldn’t say “baby.”

Then there were the other commenters, who mocked me for naming our child and said that using the term “baby” for a miscarried child was misinformation and should be retracted with a full apology from the Times. They said the only appropriate word was “tumor” and the only appropriate way of thinking about my child was as my enemy. If I wanted to see a someone, they wrote, it had to be a someone who wanted me dead.

I think the first set of commenters were writing in good faith, even when they accused me of lying, because they didn’t believe the second set existed. And I think some of the second set of commenters would have expressed the same view (more gently than they did to me on twitter) to a friend they loved, because they believe there greatest comfort on offer is that there’s no one there to grieve.

I wrote the piece for them. In the saddest, hardest cases, I think we do right by parent and child when we admit that someone has died, and we shape our medical care around respect for both patients, even if only one has a chance to survive.

Because of the level of discussion around the piece elsewhere on the internet, I am restricting comments on this post to paid subscribers for the moment. My preference would be all subscribers, paid or free, but substack doesn’t offer that setting. I expect to restore the usual commenting practices next week. I appreciate the many commenters here, including those who disagree with me on this issue, for the way you engage with me and with each other.