Dr. Tiller, Beatriz, Savita, and all the others

Posted on 5.31.2013 by Lily

Note: This post is part of our collective blog remembrance for Dr. Tiller on the 4th anniversary of his murder.

About ten months ago, a 16-year-old girl in the Dominican Republic died of complications from leukemia after doctors spent three weeks withholding chemotherapy because she was pregnant.

About six months ago, Savita Halappanavar, a 31-year-old woman who was 17 weeks pregnant with a non-viable and dying fetus, died of blood poisoning when the hospital she went to in Ireland refused her a life-saving pregnancy termination.

Today, Beatriz, a 22-year-old mother with lupus and a high-risk, non-viable pregnancy lingers in an El Salvador hospital as her 26-week pregnancy endangers her life a little more every day. The Salvadorean Supreme Court decided that she would not be permitted a life-saving abortion, which essentially amounts to a death sentence, as Beatriz's doctors have assessed that continuing the pregnancy will likely kill her. They did decide she could be allowed a premature delivery by C-section - despite that the C-section is far riskier to Beatriz and, y'know, the fetus still won't survive. (You can support Beatriz's cause here.)

These are only a few stories. No doubt there are countless other women like Beatriz, Savita, and the anonymous 16-year-old who do not come into the grip of the world's attention, inspiring international frenzies and calls for justice.

Now another story. Four years ago today, Dr. George Tiller, perhaps the most well-known provider of second and third trimester abortions in the United States, was gunned down in his church in Wichita, Kansas, by a radical anti-abortion domestic terrorist.

What do these stories have in common? They are all about killing under the guise of "pro-life." None of these stories support life in any way that I understand it.

Dr. Tiller specialized in helping women no one else would. People flew to see him in Kansas from all over the country. They never expected to need his services. But pregnancies and life circumstances take unexpected twists and turns, and Dr. Tiller helped those in devastating circumstances who often found themselves needing to terminate desperately wanted pregnancies.

I imagine all but the most ardent anti-abortion folks believe that Beatriz should be "allowed" an abortion. After all, without one, both mother and fetus will likely die, which is surely a worse outcome than only the fetus dying. And they might think such a situation as is playing out in El Salvador today would never come to pass in the U.S. Of course, we would always do what needed to be done to save the patient, under circumstances so cut-and-dry.

But here's the thing. It's never cut-and-dry. There's no line dividing Beatriz from Dr. Tiller's patients. You may have your own guidelines for when an abortion is acceptable; when the patient has a 95% chance of dying, perhaps. 75%, 50%. If the fetus has this condition, or that one. If it definitely won't survive outside the womb. If it probably won't. If the woman was raped.

Who decides? Who decides how bad it has to be, how dire a woman's situation, how heart-wrenching her story, how sympathetic her character or the circumstances surrounding the conception? Who decides?

In El Salvador, a few judges decided - and took their sweet time, too, which is why Beatriz is now 26 weeks pregnant. Because that is what happens when abortion is illegal. Yes, there are varying degrees of legality, and few countries' laws are quite so harsh. But when you take the ability to handle a pregnancy out of the hands of the pregnant person and her medical team, well, a woman might very well end up wasting away as her pregnancy kills her a little more each day, waiting for some powerful people far away who don't know her to decide her fate.

Another woman might quietly languish at home, her physical health okay while she agonizes over how this child will fare when her three others already go to bed hungry. Maybe she thinks it would be more merciful to not bring this child into the suffering.

Maybe another woman's pregnancy is viable - so far - but when her husband beats her up, she fears for both her own and the baby's safety - and fears the child being born into that home even more.

Maybe another woman's physical health is okay, and she isn't being abused, and the pregnancy is healthy. But her depression grows by the day, and she may well become suicidal if the pregnancy continues.

Who decides?

Dr. Tiller famously wore a pin that said "Trust Women". With him gone, fewer women are trusted with their own bodies and lives.

It seems like every day there's another restriction on abortion in this country. Another TRAP law, another 20-week ban, a parental consent law. There are no sensationalized stories about the woman who goes bankrupt to pay for an out-of-state and later abortion because her local clinic closed for not having wide enough hallways. The pregnant teenager living in such fear and denial, unable to tell her parents as her pregnancy progresses past the point of decision, doesn't make the headlines. The patient weeping at the clinic where she found out she is two days past the 20-week cutoff, and now bewildered and lost with no idea where to go, doesn't inspire an international outcry.

All of them should.

Dr. Tiller's death left a gaping hole in American women's health care. Today, four years after his brutal assassination, it's even more crucial that we honor his memory and trust women - here and everywhere.