The Day a Disabled Child Walked Into My Exam Room And I Discovered She Was Pregnant

By NIRAN AL-AGBA, MD (7)

I will never forget her face.  She was only thirteen.  She had a significant cognitive disability, a result of an anoxic injury at birth.  She found her way to my clinic one late Friday afternoon in July almost two decades ago.  Her mother was a nurse and noticed her daughter had not had a period in the last two months.  Her pregnancy test came back positive.  I wanted to cry.  

The questions I had to ask this young girl were agonizing.  When asked if she had sex, she looked at me and shook her head back and forth, to say no, she had not had sex before.  She was telling the truth.  Having sex implies consent.  When I asked if someone had touched her private area, she nodded her head up and down and said there were two boys.  She thought they might have been about her age. She did not know who they were.  She had never seen them before or since. I asked if she could remember their faces.  She could not.  

The two boys pushed her down on a grassy area next to the high school football field when she was walking home one day.  She remembered it was raining because she had been looking up at the sky until they stopped hurting her.  She told me about the pain she experienced, down there, and she pointed to her vaginal area.  She told me there was some bleeding afterward at home.  She did not tell anyone about what had happened, even her mother.  I am not sure if she really understood what had been done to her.  I tried to put myself in her place to understand how hard it must be to be telling me her story now.  

Taking her small hand in mine, I told her she was pregnant.  Her shoulders slumped forward and she looked at the floor.  “Do you know what that means?”  She nodded her head up and down, then said “there is a baby in here” gesturing toward her abdomen.  It was more question than answer.   She was not capable of understanding how horrifying it was that she never made a choice to become a mother.  

She was still a child herself.  

For the record, in regard to my uterus, I am pro-life.  I believe children are a gift to those of us who are lucky enough to have them, if even for a fleeting moment.  As a pediatrician, I have devoted my entire life to taking care of children, from the instant they are born until they go on to have their own children.  And then I have the privilege to care for those children as well.  There is no greater thing on earth than a child and protecting that child, the one in front of me, will always be my priority.  

But how can any civilized society reconcile being pro-life with forcing one child to bear another child – one that the child never consented to produce in the first place?  

It is inhumane. 

How many other victims can tell the same story? There are far more than the pro-life movement wants to acknowledge.

Like the fourteen-year-old girl I met one night in the emergency room.  She had recently gained weight and her mother was concerned something might be wrong.  I remember her uncertain expression; she was so young and seemed so afraid.  Her pregnancy test was positive. I asked about sex and she denied having it. Then she said she and her mother had recently lost their home and out of necessity, had moved in with her aunt and uncle.  

Shortly thereafter, her uncle began visiting her room at night. She had asked him to stop touching her, but her uncle threatened to kick her mother and her out onto the street if she told anyone about what he did to her at night.  By the time we met in the emergency department, incest had forced her into quasi-motherhood without her consent.  

How can victimizing her twice — by then forcing her to give birth –be considered legal, ethical, or moral? 

There is a great deal of irony on both sides of the political spectrum:  conservatives support government-sanctioned uterine intervention, while vehemently fighting government oversight everywhere else.  And at the same time, progressives endorse uterine autonomy while supporting government intervention on the rest of healthcare issues.  

It is time to value a consistent stance:  healthcare decision should be private, between a physician and a patient.  If we prioritize this sacred relationship then it makes sense to be sympathetic toward parents who are resistant to vaccinating their children while supporting uterine autonomy for women and children.    

The Alabama Human Life Protection Act is not intended to protect human life; this legislation is a veiled attempt to place value on one life over another.  And by exempting victims of rape and incest, Alabama will serve as judge and jury, disrespecting the work already done by the highest court in the land.  The question of legalized medical abortion has already been asked and answered by the Supreme Court in 1973.

The Alabama legislature is sanctioning physicians to be jailed for up to 99 years for performing an abortion, while at the same time, knowing full well that a first-time rape conviction carries a sentence of 20 years or less.  The pro-life movement wants the nation to believe being pro-choice is akin to being anti-life, while obscuring the fact that women and children will be forced to give birth after victimization. Fighting to protect the right of women and children to make decisions about their own bodies is not the same as being pro-abortion.  

In my opinion, Alabama is not pro-life.  They are trying to legalize morality, which is dangerous.  For the record, I am pro-life; the kind of pro-life that believes all human beings are equal.  No civilized society should prioritize the life of an unborn child over that of the defenseless child who stands in front of them.  Physicians, especially, must not acquiesce to politicians who want to force vulnerable women and children into back alleyways with coat hangers.   The lives we must protect are those of the innocent women and children and their choice not to give birth to children they did not consent to make.  Those who support Alabama are not pro-life; they stand in support of birth by force.

7 thoughts on “The Day a Disabled Child Walked Into My Exam Room And I Discovered She Was Pregnant

  1. Niran sent us this:

    The paper here went crazy. Two oped columns about mine were published this week. One called me prolife, the other called me a non Christian. 😂😂😂

    1. Thanks Francine. I have found this column seems to make people think about a topic most of America would like to largely ignore.
      Whether one is pro life or pro-choice, The story should make everyone realize often the answers are not simple.

      It is a great example of the reasons reforming healthcare is not as simple as it seems easier.
      Paying doctors less (which for me means under 100k annually) for the intangible things we face and what we do, means many of us will just walk away.

      What I do every day on the front lines is hard, emotionally and mentally, and if I can’t support my family while doing it, there would be no reason to continue.
      The US healthcare costs will go down but to what end?
      Physicians are specialists for a reason. We have trained for most of our lives to serve patients and we tend (though there are bad apples) to make decisions in their best interest— whether the country believes it or not.
      The recent NYT article is one example of what government overreach has done and it would be a shame to make it worse.
      Have a good day everyone.

      Niran

      1. Someone HAS to wade into these issues, although no one wants to. Agree with Niran that it should be a physician. A book could be written about issues like this, and Niran is right about them being the reason health care is never reformed. To do that would require making compromises our country is not willing to make.

  2. Wanted to say that the piece was brave. Stepping into this issue is fraught with danger. When doing a Master’s in Philosophy and Anthropology I took a class on compromise in politics from ethical view. Each class member had to take a stand on abortion rights, but we were assigned the topic. The stands went from immoral to not have sex with everyone as it is defacto abortion, to the topic I was assigned, can abort up to age 4. The goal was to stretch our minds and to see if there was something new that might be realized and written about the issue. We failed.

    You are so caring and passionate but this piece offers no new insights or help with how to deal with the human toll of the actions, or the debate. Picking the rare, dramatic anecdote is not the norm of the issue; also, from a logical, decision making framework, the” utility value” of having to carry a child versus the “utility value of a death” opens an ethical debate that is also fraught with danger, as are all aspects of any discussion, in my view, for this topic.

    But, I want to thank you for trying.

    1. Bob, Are you asking for more nuance and complexity that can be offered in one blog? Niran created a powerful set of images and lessons; argued warmly and wonderfully for society to stop harming women and children. Courageously turned the pro-life meme on its head. Brava.

      We are not in a world now where one can argue from general principles. We need heart-tearing examples. Dead Syrian blond infants washed onto beaches. Central American children killed by a common cold while in a caged warehouse. The horror, the horror. Of course any discussion on abortion is freighted with enough pain, ambiguity and uncertainty to make our heads spin. But reasonable people are under siege. And the barbarians control so much of the media and so many of the state legislators. A long and balanced discussion is not possible in a blog format. Niran was “accused” of being pro-life and non-christian: a venn diagram chaos of confusion.

      From deep appreciation for all who try for decency in these indecent times.

      Ross

      1. I blogged about this after reading Niran’s post.

        1: Now the whole earth had one language and the same words.

        2: And as they migrated from the east, they came upon a plain in the land of Shinar and settled there.

        3: And they said to one another, “Come, let us make bricks, and burn them thoroughly.” And they had brick for stone, and bitumen for mortar.

        4: Then they said, “Come, let us build ourselves a city, and a tower with its top in the heavens, and let us make a name for ourselves; otherwise we shall be scattered abroad upon the face of the whole earth.”

        5: The Lord came down to see the city and the tower, which mortals had built.

        6: And the Lord said, “Look, they are one people, and they have all one language; and this is only the beginning of what they will do; nothing that they propose to do will now be impossible for them.

        7: Come, let us go down, and confuse their language there, so that they will not understand one another’s speech.”

        8: So the Lord scattered them abroad from there over the face of all the earth, and they left off building the city.

        9: Therefore it was called Babel, because there the Lord confused the language of all the earth; and from there the Lord scattered them abroad over the face of all the earth.

        There was a time in America when we were one people. There was a time when nothing we proposed to do seemed impossible. Our communal tower touched heaven and we certainly made a name for ourselves. Since then, a different type of Lord, similarly threatened by our success, has confused our language in a new and more insidious manner to the point where we no longer understand each other’s speech, and a frustrated populace gave up on trying, reverting to primate screeching and screaming instead. It is painful to watch, and it is agonizing to participate in the decaying remnants of our once glorious public discourse.

        This is not about who says tomato and who says tomahto. The modern confusion occurs when I say tomato and you hear cucumber. There is no way for us to cook some spaghetti sauce for dinner with my tomato, or tzatziki with your cucumber. I don’t understand why I should chop some dill for the sauce when basil and oregano are the obvious choices, and you have no idea why I’m trying to boil a big pot of water instead of grabbing that Greek yogurt container from the fridge. Salt and garlic are the only things we can agree on, although in vastly different amounts, but nobody can survive on salted garlic. And so, we end up yelling at each other, and eventually we both go to bed angry, exhausted and hungry, each one of us convinced the other one is a hateful idiot and a traitorous saboteur of dinners. The Lord has prevailed.

        Today, when I say Socialism, I see a democratic nation with a generous welfare system and thriving private economy, like Sweden or Denmark. You see Cuba or Venezuela, with millions starving in the streets while murderous, mustached dictators are wallowing in palatial riches. When I say Capitalism, I see hundreds of thousands of businesses innovating and competing to serve their customers while creating a land of plenty for all. You see racist, bigoted, exploitative tyranny of a few billionaire owned corporations, employing slave labor tactics to enrich themselves further while the rest of us starve to death. And that’s where the conversation ends, and the yelling commences. There can be no further discussion, no objective analysis, no learning and certainly no compromise. From both our perspectives, this is a fight between Good and Evil. You don’t discuss things, let alone compromise, with Evil.

        Abortion

        Now let’s discuss abortion, which is perhaps the ultimate example of how fake language acts as a paralyzing venom in service of our predators. If you listen to the public debate now raging on social media and all other media, you would surmise that the battle lines are drawn between two distinct camps. The “pro-choice” camp stating that abortion is Good, without any caveats, and the “pro-life” camp which insists that terminating a pregnancy is Evil, again with no caveats. If you propose to restrict abortion in some cases, you are enslaving women. If you suggest allowing some abortions in special circumstances, you are a baby killer. Both pro-choice and pro-life terms were carefully selected to make polite debate impossible. You cannot be anti-choice or anti-life without being Evil. There is no terminology for anything in between. Oh sure, you can launch into a tirade, but nobody will listen to Evil.

        Fake language creates fake realities. Few if any Americans are absolutist pro-life or pro-choice. There is a spectrum of opinions and feelings that was rendered all but inaudible once the screeching, screaming and yelling has begun. Recent polls (grossly tilted towards non-religious people) show that while most Americans label themselves pro-life or pro-choice, only 27% (at most, and likely a lot less) are firmly entrenched at the ends of the spectrum. The remaining vast majority is somehow rendered irrelevant in the current shouting match. If you want to stay relevant in this circus, we call public debate, or rather electioneering politics, you must recite the precise words of the gospel. And when opposing gospel reciters meet, this is what Babel sounds like:

        Pro-death: Government has no business telling women what to do with their bodies. My body, my choice. Male members of the old white patriarchy have no say in this debate anyway, because they don’t have a uterus. Besides, the Supreme Court decided this already and we have a constitutional right to abortion.

        Pro-coercion: The Supreme Court decision was wrong and must be overturned. Abortion is murder. Plain and simple. You don’t have a right to murder other persons, even if they were not born yet. Killing a baby in the eighth or ninth month of pregnancy, by tearing her to pieces in the womb, and finishing the job after birth if she survives, is infanticide. Is that okay with you?

        Pro-death: Do you seriously want to prosecute and jail a twelve years old girl who was raped by her uncle and got pregnant? Do you want to force little girls to carry babies? Those late abortions don’t really happen, except in extreme cases to save the woman’s life. It’s a far-right myth. You’re watching too much Fox News. So that’s a straw man, but sure go ahead, I’m sure you don’t care if women die and children are jailed.

        Pro-coercion: Oh yeah, you go ahead, lecture me about caring for children, while you massacre hundreds and thousands of babies every year. And if that wasn’t enough, now I’m supposed to finance your Commie holocaust. F*** off….

        Pro-death: You’re the biggest hypocrite I’ve ever met, and a liar too. If you care so much for children, how come you refuse to fund public education and early childhood programs? How come you keep sending so many black boys to prison? You’re just a racist Trumpkin, in addition to clearly being a rabid misogynist, and I bet you love putting immigrant children in cages too. You can f*** off yourself… Idiot…

        And on and on it goes. Note that both sides put forward reductio ad absurdum arguments, while responding solely with tangentially related ad hominem attacks on their interlocutor. Why is that? Well, maybe it’s because nobody in their right mind can defend imprisoning twelve-year-old rape victims, just like nobody in their right mind can defend terminating a perfectly good baby five minutes before it is due to be born. It is disheartening, but it is also a good sign that we haven’t gone completely mad just yet. Another thing to notice is that on both sides people are either not fully aware of simple facts or would much rather conduct this Babylonian conversation on a fact-free emotional level.

        Did you know, for example, that when the Roe v. Wade decision was issued, plenty of progressive voices found it poorly reasoned and even counterproductive? None other than Justice Ruth Bader Ginsburg is on the record saying that “the Court ventured too far in the change it ordered and presented an incomplete justification for its action”. Now make no mistake, RBG is staunchly pro-choice, but the Court may have done more harm than good here, by impatiently stepping out of the judicial lane and into the legislative one, at a time when progress was slowly but surely being made in various States.

        Did you know that in Roe the Court asserted that a woman’s right to an abortion is “fundamental”, but only for the first three months of a pregnancy and only in consultation with a physician? After that the State has its own rights to intervene with or outright deny this fundamental right, due to competing interests. Later, in Planned Parenthood v. Casey, the court discarded the medically outdated trimester framework and introduced a dynamic “viability” concept, bolstering the power of States to interfere with a woman’s fundamental right to an abortion, as long as no “undue burden” is imposed on the woman. Neither Roe nor Casey are giving women full rights to terminate a pregnancy whenever and however they see fit. Both Roe and Casey grant States the right to curtail reproductive autonomy of women, if they so choose.

        In 1973 the Court decided Roe with a clear 7 to 2 majority. Ten years later, in Casey, the Court splintered into multiple plurality opinions with only one narrow 5 to 4 majority decision to uphold Roewith adjustments in favor of the States. I can’t even begin to guess how the lines will be drawn if an abortion case comes before the Court today. We share this country with one third of a billion other people. Societal consensus on important issues is rare, difficult, and takes decades if not centuries of patient and serious discourse to build. That’s why we have fifty States. We either relearn how to meaningfully communicate and compromise with each other or we will perish in most unnecessary and painful ways.

Leave a Reply