Pregnant women! Have you really considered the risks?

Calling all mums-to-be! I hope you don’t mind me asking but have you really thought this one through? I know, you’re all excited about the impending birth but do you actually, honestly know what you’re doing? And yes, people might have said this to you before, but you should listen to me. I might not know you, but I’m a doctor.*

Pregnancy and childbirth can seriously damage your health. Trust me – I might turn out to have a PhD in something entirely unrelated to healthcare, but I’ve had children, so I should know. Except I don’t. No one ever went through a list of all the possible negative effects with me (and I went to see the GP loads!). In the interests of writing this post, I’ve just gone and googled a list myself. There are a lot of effects I recognise but hadn’t given much thought to until now, plus there are others about which I knew nothing at all. For instance, I had no idea pregnancy could be linked to a loss of bone calcium. And as for prolapsed uterus – well, I knew it could happen, but I had no idea that it affected as many as 11% of women. 11 sodding percent! And all that’s before you scroll down to the really serious stuff (including, naturally, death). Flippin’ heck! Do these children of mine, currently scrapping over whose turn it is to push down the lever on the toaster, have any idea what I’ve risked for them? Do they heck as like. And to make matters worse, I can’t even change my mind and undo it all. The damage has been done, both to the toaster and to me.

You may say “well, that’s just a list you googled. How trustworthy is it really?” And the answer is, I don’t know. But since no one with greater authority has ever considered it a priority to educate me on current risk assessments, I’m just doing my own not-particularly-reliable digging. And as far as I can see, the outlook isn’t great.

Of course, if when I’d gone to my GP and announced that I was having a baby she’d responded by handing me a long list of established risks and sent me away to “take a bit more time to decide”, it would have rather taken the edge off things. Plus I’d have felt somewhat patronised, not to mention confused. I don’t need to know the details to be aware that pregnancy is not 100%  safe, but unless there is a very specific, imminent risk to me, the overall lack of safety is just one out of a huge number of considerations. Basically, while my doctor’s understanding of the physical risks of pregnancy is vastly superior to mine, her understanding of whether or not I’m capable of choosing to have a baby isn’t. If anyone’s the expert on that, it’s me. Thankfully, most medical professionals recognise this, at least as long as you’ve already made the “right” choice and aren’t requesting a termination. Ask to end a pregnancy and suddenly various issues, both real – haemorrhage – and concocted – increased risk of breast cancer, infertility and suicide – become incredibly important, more important, it would appear, than what pregnancy actually is and means.

I realise this is stating the obvious but sometimes the obvious needs to be stated: the difference between having a baby and not having a baby is MASSIVE.  This is why miscarriage, no matter how common, is always deeply distressing. And it’s why a “normal” pregnancy, no matter what the side effects, is absolutely worthwhile for anyone who wants a child. At the same time, this is also why deciding not to have a baby shouldn’t ever be dismissed as a decision made on the basis of ignorance, selfishness or convenience. I mean, the person making the decision may or may not be, in general moral terms, a selfish sod. But the alternative – continuing with a pregnancy – is far too significant to be placed in the “too much trouble for you, is it?” box. It doesn’t matter how knowledgeable or mature or morally aware the pregnant woman is. Once you’re pregnant, there isn’t a straightforward get-out clause and there’s never an easy option. No one can make the decision for you.

It bothers me greatly that the publicity given to statistical risks associated with abortion is continually linked to the decision a woman has to make. In today’s Guardian, for instance, a study revealing that multiple abortions increase the risk of low birth weight in subsequent pregnancies becomes, in the eyes of Andrew Whitelaw, professor of neonatal medicine at the University of Bristol, information that should necessarily be shared with women seeking abortions**:

“Birth before 28 weeks exposes the infant to a hugely increased risk of death, brain injury and permanent disability. Thus an increase (after three or more abortions) of nearly threefold in the odds of having an infant born before 28 weeks is worrying,” he said.

But how worrying is it really, at least for the woman facing an unwanted pregnancy? I am not suggesting that this information should be withheld from her – but if it is felt that she needs to be actively informed, what is she meant to do with this information? How is it meant to inform her decision? Is anyone providing corresponding information regarding all the risks involved in not having an abortion? Which pieces of information are considered relevant and which aren’t? And who gets to decide all this?

The trouble is, while continuing with a pregnancy or not is an enormous decision, it’s also a messy one. The factors that come into play – physical, emotional, financial, personal – are so complex that, even if you don’t personally feel up to the job of deciding what to do, there’s no one else who can decide for you. You can’t go back on having an abortion, but you can’t go back on having a child, either. It disturbs me that one decision is considered worthy of counseling while the other – which also has far-reaching consequences – isn’t. I’m not suggesting that no one offers counseling to women seeking abortions, but I am curious as to how and where we’re setting the boundaries of such advice.

I write this as someone who has never had a pregnancy that wasn’t wanted. I don’t know what it feels like to have an embryo inside me which I don’t feel ready to carry to term. Even so, however much I’ve wanted my pregnancies, there have always been moments of extreme doubt and panic. It’s not clear-cut. But if someone had said to me “do you know, you’re increasing your risk of a prolapsed uterus but any future babies you have will be less likely to be born premature?”, it would have made no difference whatsoever to my choices and my feelings. Such things are a drop in the ocean, yet the importance ascribed to some factors and not others reflects a misunderstanding of the complexities of pregnancy – and in some cases, an unpleasantly dishonest leaning towards pushing a specific moral agenda.

I have often wanted to write a post about this, but held back on the basis that health-wise, I don’t really know what I’m talking about.*** But that’s part of the point, isn’t it? I could know more, but I’m not sure how much I need to. There’s no final summing up, no way in which the pros and cons of what I’ve done will be objectively measured, so that I’ll know whether or not I’ve done the right thing. Having children – or not having children – isn’t like that. And to be honest, whatever happens to my uterus in years to come, I’d rather we lived with these messy decisions than keep hunting down the “perfect” choice.

* To be fair, I’m not a medical doctor. I don’t even have GCSE biology. But let’s set that to one side.

** Whitelaw’s position may be linked to the fact that medical abortions appear to carry a lower risk than surgical ones in this matter. If this does mean that one abortion type is ultimately less risky than another, that is important to know (although I am unsure how much choice a woman really has in this – I’d imagine time constraints mean it’s very little).

*** Not that this usually stops me blabbing about anything and everything, if I’m honest.

PS Five minutes after publishing this I saw this. Which is a much better discussion of the Guardian piece. With less personal ranting and more actual facts…

5 thoughts on “Pregnant women! Have you really considered the risks?

  1. These ‘facts’ are great when people like to bring up the topic of abortion over dinner/in the pub/when they’re feeling morally superior/in the first 3 months of a wanted pregnancy but in my experience (I don’t have the audacity to speak for all women) it’s your gut that does the thinking/feeling/knowing. It did a good job in my case. A higher risk of suicide, a low birth rate in imaginary future children and the knowledge that you’re going to Republican/Catholic/another morally superior organisation’s hell doesn’t really factor in at all. Thank God.

  2. I have mixed feelings on abortion and don’t want to start some big fight or discussion but here are my experience & thoughts.
    My grandmother had 4 daughters & also had 4 abortions (she was married at the time). She deeply regrets having them & feels like she’s killed her unborn children. That’s what she tells me.
    I had bleeding in the first few weeks of my pregnancy & we were terrified I’d lost the baby. I had to have 2 scans before my 12 week one and for those who haven’t had one that early, the difference that 4 weeks make is just astonishing! What was a little flickering bubble at 8 weeks is an actual baby just 4 weeks later! Which makes me feel really weird about abortions being allowed up to 22 weeks & the possible extension of this to 24 some years ago.
    I know that there are medical reasons sometimes & things can’t be helped (rape etc) but I feel that some of the reasons I hear for not having the baby are just not good enough reasons to deprive someone of life (morning after pill, contraception, not having sex are pretty good options imo).
    We went on a bit of a whim with our baby “planning” and were quite surprised it happened first time, Yeah I know. So we were a bit unprepared & in debt & not owning a house/flat & quite childish in our expectations. Also just before I have birth my husband was made redundant. But it worked out for us.
    I hope I’m never pregnant & having that feeling of not wanting the baby inside me. It must be horrible. This is not me judging anyone’s decisions – your body, your baby – just my opinion.

    1. I’m so sorry your grandmother has lived with that regret. To be honest, although I am extremely pro-choice, I have no idea whether I’d feel that way too. I am so glad never to have been in that situation – but also very relieved that whenever I’ve felt that I might be, I’ve also known I’d have a choice.
      We didn’t have children in a “perfect” situation, either. I’m glad we didn’t wait, because that ideal, secure “now we can start a family” moment would never have come along!

  3. I have another complication for you: heart valve infection following childbirth!! My mother had a pretty bad one. Her (terrible) experiences taught me that a woman needs an advocate at such times. To put it more broadly, *everyone* dealing with any kind of health-related anything needs an advocate.

    The blather about what are usually scientifically unproven potential health risks caused by abortion is NOT advocacy. Something designed to cause compliance with a particular agenda through terror (you’ll die of xxx if you DARE to have an abortion) is the exact opposite of advocacy, in fact, and it’s happening far too often right now.

    Pro-choice/pro-child, as they say. I believe every child should be a wanted child, and every woman should be able to bring a child into the world if, and only if, she feels the time is right for her.

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