Consequences of a Decision and Decisions for Consequences

Decisions. A concept intrinsically entwined with liberty. As we navigate through life, we construct its very foundation with each decision we make. These choices shape our unique perspectives, allowing us to shine alongside others and foster a thriving community. Decisions embody the essence of liberty, granting us diverse options and the freedom to choose our own paths. Our mission as physicians is to dedicate our lives to aiding patients, accompanying them through challenging times, and joyfully witnessing their moments of happiness. We, as physicians, perpetually engage in study, knowledge updates, and research. We do not dictate decisions on behalf of our patients but present them with an array of choices and support them in making the best decisions for themselves.

However, following the catastrophic ruling of the Dobbs v. Jackson Women’s Health Organization case, the spotlight has focused intensely on women’s right to make decisions about induced abortions. While this is a profoundly significant matter to discuss, as a fetal surgeon and maternal–fetal medicine specialist, I have always offered pregnancy termination as an option for families facing complex pregnancies. In such cases, termination was provided to save the life of the pregnant individual. Regrettably, the lifesaving nature of certain terminations has been overshadowed in the past year, presenting an ongoing challenge in our day-to-day work at a high-risk pregnancy referral center in Texas.

I vividly recall a young couple coming to my office, expecting identical twins, with one fetus in a critical condition and facing imminent death. If that unhealthy twin were to pass away, the healthy twin would face severe neurodevelopmental issues or possibly meet the same fate. Unfortunately, at that time, I was unable to offer selective termination for the unhealthy fetus, an option I had consistently presented to my patients throughout my journey from maternal–fetal medicine fellow to team leader. I still remember the frustration and hopelessness we all felt because of the constraints imposed by this law. Moreover, the couple could not afford a lengthy journey to another state where they could pursue the option they had decided on. I never saw that patient again, but the memory of her despair and the disappointment she experienced because of my limitations will remain etched in my mind forever.

Like my colleagues across the nation, I have devoted my youth and my entire life to my profession, assisting pregnant individuals in building their families and reveling in the arrival of healthy babies. Hence, I could not bear witness to the hopelessness in my patients’ eyes any longer. I made a decision. I left behind years of memories forged in becoming a fetal surgeon, finding the love of my life, and watching my children grow in Houston. I relocated to Boston, driven by the desire to provide my patients with the opportunity to witness the growth of their beloved children, free from despair and limitations.

Disclaimer: Published submissions reflect the experiences of individual ACOG members and may not represent official organizational opinions of ACOG. This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. It does not constitute legal advice; clinicians should be familiar with and comply with federal, state, and local restrictions on abortion, including medication abortion, and are encouraged to consult with a lawyer when navigating local abortion laws and regulations. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of a treating clinician.

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