Carrie Ann Lucas was killed by our failed healthcare system a week ago.
I know that lede sounds extreme or exaggerated, but it isn’t. She wasn’t an infant - I will get to infanticide in a moment - but she was a beloved activist, adoptive mother, ordained minister, and disabled woman. She was 47. Her death was not premeditated but it was entirely preventable.
The picture above came from her Facebook page. In a post there, this explanation is offered for her death:
Carrie Ann Lucas, a disability rights attorney who pioneered representation for parents with disabilities, died after an arbitrary denial from an insurance company caused a plethora of health problems, exacerbating her disabilities and eventually leading to her premature death.
A follow-up story by Forbes and an obituary in the Denver Post explore her life and legacy further, but the sad reality is that Carrie Ann didn’t have to die last week. She got a cold in January of last year. That led to a trach and lung infection. She was prescribed a specific inhaled antibiotic expected to be effective for treating the infection while avoiding complications due to her muscular dystrophy. Her insurance company refused to pay for it, covering a less effective antibiotic instead, knowing that she has a history of drug allergies. She had a bad reaction to the alternate medication, spent the past year in and out of the hospital, and died of septic shock a week ago.
Carrie Ann spoke out against physician assisted suicide, declaring that her disability did not make her unworthy of life. She aligned with the pro-life movement on that. While I am not familiar with her stance on abortion, I can confidently say that she would have opposed any concept of a child being born alive and then killed by doctors.
Last week, the Senate voted down a procedural motion to move forward with debate on the Born-Alive Abortion Survivors Protection Act, introduced by Ben Sasse (R-NE). Sasse is best known, along with Jeff Flake (R-AZ), for speaking boldly against Trump’s poor decisions but ultimately voting in favor of them. Sasse argued that babies who survive an abortion be treated rather than killed.
Carrie Ann would have agreed with that. I agree with that. In fact, Congress agreed with that when I was still in college, passing the Born-Alive Infants Protection Act of 2002. That act protects the life of an baby born alive, as defined:
the term `born alive', with respect to a member of the species homo sapiens, means the complete expulsion or extraction from his or her mother of that member, at any stage of development, who after such expulsion or extraction breathes or has a beating heart, pulsation of the umbilical cord, or definite movement of voluntary muscles, regardless of whether the umbilical cord has been cut, and regardless of whether the expulsion or extraction occurs as a result of natural or induced labor, cesarean section, or induced abortion
As made clear in the excerpt above, born alive includes babies who have survived abortions.
The legislation introduced by Sasse was political theater. The substance of it was already made law seventeen years ago. Why introduce a redundant bill then?
First, redundant legislation is nothing new. To put their position on the record, members of Congress have sponsored or introduced would-be laws that were already passed, on a range of issues from gun control to airline regulations. Not only does it make their position clear, but also it makes the position clear of anyone who opposes the measure.
Why does this matter? Well, I’m not sure if you’ve heard, but there’s an election in 2020. It’s kind of a big deal. When campaigning, it’s a lot easier to say, “my opponent wants to kill babies,” if there’s a recorded vote you can cite. Voting against something called the Born-Alive Abortion Survivors Protection Act sounds pretty damning if you don’t know what it is.
Except the Democrats in the Senate - all but three - didn’t vote in favor of killing babies.
The vote last week was procedural. Procedural votes are part of the legislative process, determining if a proposal gets voted up or down. Given the way I saw conservatives spin the issue last week, though, you might have understood the yes votes to be in favor of babies’ lives (and against infanticide) and the no votes to be against babies’ lives (and for infanticide). That’s the way it will be told by Republicans during the 2020 election cycle.
But it’s not true.
A no on a procedural vote can, of course, mean the legislator opposes the intent or content of the proposal. But it can also mean that they don’t consider the bill worthy of congressional attention because another act - in this case, the Born-Alive Infants Protection Act of 2002 - already exists to do what the proposed legislation would do.
Likewise, a yes on a procedural vote doesn’t mean the legislator supports the intent or content of the proposal. In the dramatic healthcare vote in July 2017, McCain voted no on Obamacare repeal, casting the deciding vote. The reason the moment was so uncertain, though, was that he voted yes on the procedural vote. He considered it worthy of discussion and consideration but not of passing. That’s one notable example of a procedural vote being just that, procedure, and nothing else.
If it could have electoral repercussions, though, why did only three Democrats vote for it? Wouldn’t it have been easier to let it sail through if it wouldn’t change anything?
The problem here is that the proposed Born-Alive Abortion Survivors Protection Act was unclear. For babies born alive after an abortion attempt - babies already protected under law by the Born-Alive Infants Protection Act of 2002 - doctors would have been required to offer identical care to the survivor of a failed abortion as they would to “any other child born alive at the same gestational age,” under the measure discussed last week.
At first glance, that sounds good, but it gets tricky because this provision could be interpreted two different ways. The first way is that the full range of interventions - from comfort care (that is, keeping a baby with a fatal condition comfortable without other medical intervention) to heroic attempts to sustain life no matter what. The second way is that if any other child born at that age without any complications would survive, then doctors must take all possible action for the abortion-surviving baby to survive, even if comfort care is in the best interests of the child and family.
I’ve seen well-reasoned op-eds arguing each interpretation in the past week. The interpretations generally fall along party lines, with Republicans arguing the first and Democrats the second. Whenever any issue is this strictly partisan, the facts are usually somewhere in the middle of the two stances.
In this case, neither interpretation is a given. But let’s review the branches of government real fast:
The executive branch enforces laws.
The judicial branch interpets laws.
The legislative branch should craft and pass clear laws that take all foreseeable outcomes into mind. But none of us can play out every move to the ultimate end, right? That’s where the judicial branch shows up. They don’t make the laws; they interpret them.
Right now, many courts are shifting to be more aligned with Republicans, given Trump’s nominations. I wish nothing partisan factored into judicial decisions, but we all know that’s not true. That’s why you’ll see Republicans at the state and federal level pushing laws that wouldn’t have made it through the courts before but that they hope will now. Even if the courts functioned perfectly, though, the ideal situation is one in which the law has such indisputable clarity that no judicial interpretation is needed.
In other words, legislators aren’t doing their jobs when they pass murky material into law (or, in this case, into the process of debating the actual content, as this was a procedural vote). The judicial branch is needed, but it’s meant for those issues that aren’t caught and addressed in the actual writing of the law itself.
This whole debate has turned into a shouting match about whether or not late-term abortions exist. I could weigh in on that (basically the medical definition of late-term is 40-42 weeks pregnant, so it’s not medically accurate language), but the gist is that I see pro-life friends quoting one OB saying that third trimester abortions are never needed while I watch pro-choice friends and doctors citing many more sources to say that they sometimes are. These are rare cases, yes, but given that third trimester abortions make up one percent or less of all abortions, it makes sense that these would be pregnancies that are the exception rather than the rule.
The measure voted down last week, though, wasn’t really about third trimester abortions; it was about what would happen afterward. I do consider it worthy to discuss the wisdom and act of abortion throughout all maternal stages, but this piece isn’t about that and neither was the Born-Alive Abortion Survivors Protection Act.
The other reason I consider the scenario to be political theater is simple: Mitch McConnell knew they didn’t have the votes. He knew it wasn’t going to pass. He knew no vote was needed. But he sought one anyway, so the record could show who did and didn’t vote for it.
Not only do I suspect those motives, but McConnell acknowledged them in an op-ed he wrote about the act. In his own words,
The American people deserve to know whether their senators stand with vulnerable children struggling for life.
The vote last week wasn’t about last week, and it wasn’t really about vulnerable children, who were already protected under the 2002 legislation.
No, the vote last week was about 2020.
Infanticide was already illegal. Nothing Sasse proposed, even if it had passed, would have offered any needed or lacking protections.
In the midst of Cohen’s testimony and Mueller’s continued process and the seemingly unanswerable questions about what depths of corruption must be reached before change comes, the one reliable base for Trump - white evangelical Christians, with 68% holding a favorable view of Trump, including 28% with a very favorable view - needed a reminder of why they made a deal with the devil and, in doing so, damaged their own credibility for loving neighbors already born. This redundant bill was presented as necessary and a procedural vote portrayed as positional. It worked. “But baby killing…” has been the chorus in response to anything negative about Trump this week from a certain demographic.
I used to join them. I used to champion the de-legalization and even criminalization of abortion as the best way to save lives. I would have been the first to pull a “butwhatabout abortion?” with a sweet yet patronizing smile, as if I immediately had claimed higher ground.
I did and still do consider a separate life to have begun as soon as unique DNA is created. For me, that moment - conception - is when a new person is formed. I did and still do consider abortion to be ending a life.
So why have my political stances changed? It’s not what you think. It’s not the oft-claimed view of pro-life for me but pro-choice for thee.
I used to roll my eyes hard when Hillary - in 2008 - and others touted that they wanted abortion to be safe, legal, and rare. Not safe for the baby, I would mutter to myself. But now I find myself in agreement, and the death of Carrie Ann Lucas illustrates why.
Medical professionals rather than elected politicians should be the ones who offer guidance when a women is making her choice. Doctors are best equipped to make the best decisions for the person they are treating, particularly in emergency situations and especially in outlier cases. The problem is that typical cases are generally the ones used to encode insurance policy and abortion law. For patients, like Carrie Ann, doctors need to be able to treat the patient in front of them.
When I think of rare instances in pregnancy when hard decisions must be made, I think of my friend Rebecca. She’s a sonographer at a high-risk OB clinic. She scanned her own body through three pregnancies. For two of those pregnancies, she discovered and diagnosed fatal conditions. Because she had access to equipment and knowledge in understanding the black and white images that make no sense to me, her babies - Cora and Layla - received diagnoses incompatible with life far earlier in her pregnancy than other babies would. She had options far earlier in her pregnancy than most mothers have.
And? She chose to carry both Cora and Layla as long as she could. They both were stillborn, one at 29.5 weeks and the other at 36 weeks. Some pro-life folks have tried to tell her story as a model of valuing life, but Rebecca isn’t having that. She wrote:
I chose life for two babies, knowing they would die. I do not believe that should be a choice women are forced into making.
Two of Rebecca’s three pregnancies ended with a small white casket holding a much loved baby girl. I’ve watched her navigate the grief and pain and depression of the aftermath. I hear pro-life folks talk about women grieving after having abortions, but choosing to carry a baby to term who you know will die is unimaginable for most of us.
Sometimes it’s not the baby whose life is in question, though.
When I was pregnant with Robbie, my health was a hot mess. I had raging and untreated PTSD from childhood trauma I tried to hide away in hopes that it would go away. I had been diagnosed with a thyroid disorder that was barely under control when I got pregnant. A week after receiving my diagnosis of rheumatoid arthritis, I peed on a stick and watched two lines - a positive result - slowly show up. To manage my symptoms and avoid more bone erosion in my joints, I was on high doses of prednisone for the entire pregnancy.
That was fun.
Then when I was about 30 weeks pregnant, the front of my shin began to swell, redden, and burn up. I have pictures of it somewhere, but you definitely wouldn’t want to see them. (I lived through it, and I hope I never find the images. It was that bad.) My kind and compassionate doctor explained to me, before opening, draining, and packing the infection with gauze, that it would hurt a lot because lidocaine often isn’t as effective when you’re expecting. I remember her saying something about the increased blood volume during pregnancy decreasing the efficacy, but all that is vague recollection. The sharply focused memories came immediately after, as one doctor, one physician’s assistant, and two nurses worked on my leg with sharp instruments.
When they took a swab of the wound to test which kind of bacteria was present, we all expected it to be a formality. We’d wait on the results. I would start a broad spectrum antibiotic safe for us during pregnancy.
I know that was a Friday. Early the next week, maybe Monday or Tuesday, I got a call with results. My doctor tried to sound reassuring as she told me the infection was a highly resistant strain of MRSA, but her voice cracked as she explained they didn’t have a plan yet. She had to confer with other specialists to determine if there was an antibiotic that would be safe for both me and Robbie, and she tried to keep her voice level as she explained that we had to prioritize my health.
She didn’t add “if we have to choose” to the end of that sentence, but the words hung unsaid between us nonetheless.
I had symptoms of the infection being in my bloodstream at that point. Given the positioning so close to my tibia, bone infection was a major risk too. As I started the new antibiotic, one that wasn’t ideal but they hoped would work, I was given strict instructions to come directly to the hospital if we saw any signs of sepsis. If I became septic, I could destabilize quickly, making delivery via vaginal birth or c-section medically dangerous for me but full treatment for the infection dangerous for Robbie.
I’d seen storylines like this on medical dramas, and they seemed much tidier there. I loved my baby. My pain levels were terrifyingly high. Jocie was turning two that weekend. Lee and I had been married only three and a half years. I was only 26. I hated the range of bad choices in front of me.
Thankfully, that antibiotic - the one that wasn’t ideal - worked. I got better. Robbie was fine. I delivered a few months later.
I know the medical rules set by insurance bureaucrats and untrained politicians didn’t work for Carrie Ann. I know I would have been the exception to the rule in treatment if I had become septic. I know I have been the exception to the rules in so many other medical situations.
(After all, you don’t end up as a 36-year-old woman with a spinal fusion and spinal cord stimulator if you check all the boxes for being a paradigm of health.)
Roe v. Wade allows for abortions for the health of the mother. Some cases are clear. Others aren’t.
I’ve heard pro-life friends argue that the health exception is too broad. As someone who has fought hard for my health, I now take regular medications to maintain it. If I became pregnant again, then we would have to make some painful decisions. We would also have to research inpatient psych programs that are equipped for pregnant patients, because coming off some meds could destabilize my mental health.
I’ve lost enough friends to suicide or self-medicating addiction to know that mental illness can absolutely be terminal. No lawmaker should have the authority to require a woman with potentially fatal depression to continue her pregnancy if it isn’t safe for her. I know I’ll get comments calling me a baby killer (comments on abortion blogs are so fun, y’all) but any other stance results in dead mothers and dead babies.
Death isn’t fun to talk about, but even in cases in which one adult kills another, it isn’t always murder. Sometimes it’s deemed an accident. Sometimes it’s found to be justifiable. Sometimes it’s considered self-defense.
How, then, can we not view abortion in that way as well? Some are acts of self defense, lived out by women who deserve compassion and empathy rather than judgment and condemnation.
Some of you disagree. That’s okay. We don’t have to agree, but we do share some common ground.
Your argument says as long as abortion is legal, babies will die. My argument says if legislation becomes what the pro-life movement seeks, women will die,
We aren’t that different, you and me.
This reminds me of the decision moment in Bird Box, when Sandra Bullock’s character is talking out loud about which child will look (and die). Our imperfect messy world doesn’t let us opt out of death. I’ve told God my thoughts about that, sometimes with prayers that would require an explicit label if recorded, but I haven’t found an option for life, only and always, on this side of heaven.
Will all babies live if your laws pass? No. Abortion will still happen (as will miscarriages and other fatal circumstances). The women with the most resources available will still have access to all options in healthcare while women with the least medical access will continue to struggle disproportionately. Restrictive abortion laws often backfire. I know you don’t agree, but I am convinced by facts that your path leads to more abortions than mine.
Will all women live if laws go my way? No. Here’s the thing: Pregnancy can be and is both a natural process and a medical complexity rife with risk. Pregnancy literally kills women every day, here in the USA.
I’m not here to sway you. I’m merely weary of the same shoddy arguments being recycled and lobbed at each other. I think in all our fighting, we aren’t hearing one another any more. This post is simply my way to say, here’s what I think. Take all the time and space you need to consider it.
Your focus is on the risk to the baby. Mine is too. It’s also on the risk to the mother and the right for women and their doctors to make better decisions than legislators.
I believe this about more than abortion, though. Carrie Ann Lucas is dead. She didn’t have to be. But a healthcare system that limited her choices and rejected the originally prescribed antibiotic as unnecessary killed her.
This is why I can no longer support any legislation limiting access to healthcare. Hard rules kill.
Please, try to understand that many of us who oppose so-called pro-life measures are as grieved by death as you are. We don’t all celebrate abortion, even if we support the legality of it. Plenty of us are striving for lower abortion rates.
We see different paths to that than most pro-life folks do, though. We tend to address the demand for abortion by policies focused on education, childcare, transportation, domestic violence, universal healthcare, access to birth control (including to teens along with comprehensive sex education), pay equality, and other supports. Many of us are celebrating the significant decline in abortion rates throughout Obama’s presidency with the trend continuing since then. Given the push for more restrictive abortion laws, it might surprise you to know that abortion rates are currently at the lowest recorded level ever in the US.
Increased use of birth control is the primary driver of the declines, which can largely be attributed to the Affordable Care Act’s provisions for birth control coverage and to Planned Parenthood which arguably prevents more abortions by providing birth control than it performs.
One last question must be explored when discussing Carrie Ann’s life and legacy: What about abortions performed because of disability? Both she and I adopted disabled children. But you might be surprised by what research shows with regard to abortion and disability.
It’s not okay with me that unborn babies diagnosed with Down syndrome are nearly twice as likely to be aborted as those without such a diagnosis. From the most recent comprehensive research review on the topic, however, “evidence also suggests that termination rates have decreased in recent years, which may reflect progress in medical management for individuals with Down syndrome and advances in educational, social, and financial support for their families.” He elaborated in an interview with The Atlantic,
Families have significantly more educational, social, and financial support than they had in the past. For example, from a social standpoint, women of childbearing age are from perhaps the first generation who grew up in an era where individuals with Down syndrome were in their schools or daycare centers — perhaps not the mainstream integration that we see today, but still a level of exposure that was very different than in generations prior. They grew up watching kids with Down syndrome on Sesame Street.
In other words, it isn’t laws or court rulings that are decreasing abortion rates for children with prenatally diagnosed disabilities. It’s policies and programs available – from medical care to education to social supports and more – that affirm their lives after they are born. When we show that there are places in our country in which people with disabilities are welcome and loved, expectant parents feel more confident in choosing life instead of abortion when faced with a diagnosis for their unborn child.
We might not see eye to eye. That’s okay. But we aren’t enemies. We are both loved.
I’m not evil. You aren’t either. I don’t hate babies. You don’t hate women. Reductive reasoning and straw man arguments help no one, including women and babies.
Choosing life can look like a lot of different things.
I choose my life, because it matters.
I choose the lives of my children, because they matter.
I choose the lives of all children, because there is no such thing as other people’s children.
I choose your life too, whether you agree with me or not, because you matter.
I choose to support policies that reduce abortion rates rather than ones that try (unsuccessfully) to restrict them, because unborn children matter.
We aren’t that different, you and me. And we aren’t that different from Carrie Ann Lucas either, except we’re alive and - due to inflexible policies limiting the care her doctor wanted for her - she’s not.
I want to see abortion rates continue to drop, including for babies with prenatal but survivable disability diagnoses. That’s why I don’t agree with pro-life legislative attempts. You could say that I’m arguing for infanticide here, but that wouldn’t be accurate. It isn’t true, either, to say that Democrats voted for infanticide this past week.
But I’m sure it will be said plenty during the 2020 election cycle.