Rachel Brown was diagnosed with an aggressive form of breast cancer at the age of 36. She found out she was pregnant after nearly a year of trying to have a baby.
She said she wouldn't have an abortion. She facedwrenching choices. She could hurt her baby if she had the cancer-fighting drugs. She could die from the cancer if she didn't have it. She had two children who could lose their mom.
The Supreme Court decision in June ending the constitutional right to an abortion can be seen as a slap in the face by women like Ms. Brown. A woman can't get effective treatment for her cancer if she's pregnant. Thousands of women are facing a serious and possibly fatal disease while they are expecting a baby, because one in a thousand women who gets pregnant each year is diagnosed with cancer.
The American Society of Clinical Oncology's chief executive officer said before the Supreme Court decision that a pregnant woman with cancer was entering a world with tremendous unknowns. Patients as well as the doctors and hospitals that treat them are caught up in the consequences of abortion bans.
Is it possible for a doctor to give a drug without fear of damaging a fetus? The doctor asked. The world is a whole new place.
There are cancer drugs that can be dangerous for pregnant women. Doctors are hesitant to give newer and more effective drugs to pregnant women because of the unknown safety of the newer drugs.
Forty percent of women who are pregnant and have cancer do so. There are many other cancers that occur in pregnant women.
If the cancer is diagnosed in the first few weeks of the baby's life, the woman can't continue with the child. The drugs needed to treat them are toxic to a fetus.
The director of the Yale Cancer Center believes that the only acceptable option is to end a pregnant woman's life.
If a woman lives in a state that has criminalized most abortions but allows them to save the life of the mother, some oncologists don't know what's allowed. Is leukemia a reason for an abortion?
Dr. N. Lynn Henry said that they don't know the answer yet. We can't prove that the drugs caused a problem for the baby, and we can't prove that withholding the drugs would hurt the baby.
If a woman with cancer does not take the drugs, there can be problems with a pregnant woman, such as a premature birth, birth defects or death. Even if she had been given the cancer drugs, she could have died if she hadn't been treated.
The administrators of the University of Michigan's medical system said that medical decision making and management is between doctors and patients.
I Glenn Cohen is gravely concerned.
Mr. Cohen said that physicians were in a bad situation. Signing up to be a doctor shouldn't mean you'll be sentenced to jail.
Mr. Cohen said that doctors who treat cancer in states that don't allow abortions can face additional difficulties. He asked what the risks the hospital system was going to face.
Mr. Cohen said that oncologists never thought this day would come for them.
The stories of women like Ms. Brown are behind the confusion.
The cancer had a positive result. Without treatment, these cancers can spread very fast. About 15 years ago, women with HER2 positive cancer had a worse chance of survival. The picture was completely changed by a targeted treatment. Women with HER2 tumors are more likely to have good prognoses.
It's not possible to give trastuzumab during pregnancies.
Ms. Brown said that her life would be in danger if she continued her pregnancies because she wouldn't be able to be treated until the second trimester. She was told by him that if she waited for those months she would die from her cancer.
She would have had a mastectomy in the second trimester if she had it, as it would have raised her risk of lymphedema. She wasn't able to have trastuzumab or radiation during her second trimester.
She was told by Dr. Lisa Carey, a breast cancer specialist at the University of North Carolina, that while she could have a mastectomy in the first trimester, it wasn't optimal. Normally, oncologists would give cancer drugs before a mastectomy to shrink the tumors. A more aggressive drug treatment would be tried after the operation if the treatment didn't eradicate the tumors.
It wouldn't be possible to know if the treatment was helping if she had a Masti. What if the drugs didn't work? She worried that she wouldn't know that her cancer was terminal.
She worried that if she tried to keep her baby, she would lose her life and ruin the lives of her kids. She didn't want the fetus to feel pain if she had an abortion later in the pregnancy.
They talked about her options. He would be the father of a baby.
They decided that she would have an abortion. She cried all day after taking the pills when she was six weeks pregnant. She wrote a memorial for the baby. She thought the baby would be a girl and named her Hope. Hope had a heartbeat.
Ms. Brown doesn't take that life lightly.
Ms. Brown was able to begin treatment with trastuzumab after she terminated her pregnancies. There was no evidence of cancer at the time of her surgery. She didn't have to have all of her Lymph nodes removed.
It took a lot of courage for Ms. Brown to do what she did. Mother's first instinct is to protect the baby.
She wondered how she could have coped with having a newborn baby and her two other children.
I felt my bones ached. I couldn't walk more than a few steps. She said it was hard to get food because of the nausea.
She was hurt by the Supreme Court decision.
She said that the reason she did what she did didn't matter. My life and my children's lives weren't important.
She said that she didn't care if she died because she was being forced to be pregnant.
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