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“One day about seven months ago, I was standing in a dark room in a hospital not far from Tel Aviv, performing an ultrasound on the taut belly of a woman well into her third trimester. She was 35 weeks pregnant, due in about a month. She and I felt the fetus kick, right under the ultrasound probe. “Strong one!” I said in Hebrew. She smiled. I managed to freeze a sweet picture of the bow-shaped fetal upper lip, and pressed “Print,” to give to her later.
Then I measured the fetal head, snug against her pelvic bone. The numbers on-screen suggested that it was too small. I measured it again. Still small. So I measured it again, and again, and again. Everything else in this pregnancy looked healthy: the volume of amniotic fluid, the general size of the fetus, the structure of the heart and brain. According to the woman’s chart, everything had been fine, all the way through.
At that point, I needed to tell her about that small head and what it might mean for her future child’s development. This is not uncommon; it’s a situation I’m used to dealing with easily. But in that room, I was overcome with a strong urge not to tell her what I’d observed, because I feared where that discussion might lead. I am an American ob-gyn. In most states in my native country, third-trimester abortions are illegal or nearly inaccessible. In practice, only a handful of facilities in the entire United States perform abortions after 26 weeks for nonlethal anomalies. But here in Israel, abortion is widely available and can be offered until delivery. A subtle abnormality, such as the one I saw in that ultrasound room outside Tel Aviv, can prompt a discussion of pregnancy termination. Even at 35 weeks.
Within the American abortion debate, I am pro-choice in a concrete way. Giving women information about their pregnancies and helping them assess their options, including termination, is part of my life’s work. When state legislatures in Georgia, Louisiana, and a host of other states have taken up bills to limit abortion rights, I have always known which side I am on.”
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