Ledes from the Land of Enchantment

Both of these women needed to end their pregnancies. Only one got to do it on her terms. • Source New Mexico

Jennifer Vollstedt and Ariel Cavanaugh-Okhah have never met, but they are connected by fatal chromosomal abnormalities that affected their wanted pregnancies, and the stress and heartbreak that comes with it.

Their experiences of needing to terminate their pregnancies were quite different. One took place before the Dobbs ruling overturned Roe and the federal right to abortion while the other occurred just a few months after.

The two women are separated by nearly 1,500 miles. Vollstedt lives in Wisconsin. Cavanaugh-Okhah is in southern Florida. In some states, like Wisconsin, abortion restrictions were already in place before Roe fell, but the procedure was still accessible.

After June 2022, patients and providers found themselves trying to navigate a patchwork of laws in 14 states that implemented strict or near-total abortion bans, some from any gestational age. Access suddenly became largely dependent on location, with some clinics in bordering states less than an hour away and others more than a 12-hour car ride.

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Vollstedt got pregnant for the first time at 27 in December 2014, not long after her wedding. She couldn’t wait to tell friends and family. She called her grandfather to share the news over FaceTime, just weeks before he died.

“He was really excited, he loved babies,” Vollstedt said.

Her doctor ordered standard blood work and other lab tests. But while she was on a family vacation in Florida a few days later, a geneticist called.

“They said my results from the blood test were actually very concerning,” she said.

The test indicated her fetus could have a rare condition called triploidy, which means it has 69 chromosomes instead of the normal 46, and causes many developmental issues such as heart, kidney and neural tube defects. In almost all cases, the pregnancy ends in miscarriage or stillbirth. The few babies that make it to delivery die within hours or days.

“I was just absolutely devastated, because I really wanted this pregnancy,” Vollstedt said.

To confirm the diagnosis, Vollstedt had to wait until 16 weeks for an amniocentesis because of the position of her placenta. Although Roe was still in effect, that year then-Gov. Scott Walker signed a law scaling back abortion to 20 weeks. The clock was ticking.

“I had no doubt that I would get an abortion for this pregnancy, that I did not have any interest in carrying it to term,” Vollstedt said. “I knew this baby, if she survived to term, would experience suffering and then pass away.”

Now with confirmation of the diagnosis, and the termination appointment scheduled, Vollstedt said she avoided leaving the house.

“People could see I was pregnant, and would comment on my belly, and that would just send me into instant tears,” she said. “Everything is going on with your body that you don’t want to be going on, and it’s just really frustrating and disappointing. … I wanted to not be pregnant anymore, and I didn’t have 100% control of when that happened.”

For the abortion, she returned to the same hospital where she had already been receiving care for her pregnancy, where she was already familiar with the nurses and doctors.

“I felt really cared for, and it felt really comfortable to be able to get my abortion in a hospital setting where I knew everybody,” she said. “It was just treated like regular, normal health care.”

Diagnosis came after Florida’s 15-week cutoff 

Cavanaugh-Okhah learned she was pregnant in early October 2022, when her son was about 18 months old. That was the age gap she and her husband, Zachary Okhah, had hoped for.

“We were at that time with my first child when you finally start to sleep, and thought, ‘Okay, we can try again now,’” she said.

Everything went well at her first ultrasound, and she decided to go ahead with genetic testing. Her doctor told her that following the Dobbs ruling, if the test results flagged anything that might cause her to want to terminate the pregnancy, she would have to do it by 15 weeks according to the new Florida abortion law. He wrote the details on a sheet of paper with the name of a clinic and the deadline.

“I remember thinking, ‘Thank you for the information, but that’s not a me problem,’ and just walking out the door,” Cavanaugh-Okhah said.

The test results came back with a high risk of Trisomy 21, better known as Down syndrome. It is the most common chromosomal abnormality, affecting about 1 in every 700 pregnancies, and it has a higher survival rate than several other disorders. But it can come with other severe defects that decrease those odds.

At first, Cavanaugh-Okhah was in denial that the results were accurate. Her doctor seemed to indicate it was probably wrong, she said, and her husband was convinced they were part of the small percentage of people whose babies end up being perfectly fine.

“That was a little too painful, to sit in that place of hope for weeks,” she said.

The doctor ordered an additional diagnostic test just before Cavanaugh-Okhah and her husband left on a trip overseas — her dream vacation to Switzerland at Christmas. But they received the phone call not long after arriving confirming the condition.

“I just fell into my husband, and I was weeping,” she said.

Zach Okhah is a plastic surgeon, and he called in a favor with a friend in Germany who helped them schedule an appointment with an OB-GYN who was willing to perform another ultrasound. That doctor found fluid present in the fetus’ brain, a heart defect, and a gastrointestinal tract that was so poorly developed, the doctor said termination was worth discussing for that abnormality alone.

At that point, Cavanaugh-Okhah was right around 15 weeks, so she wouldn’t be able to get an abortion at home. In Germany, they didn’t offer the type of procedure she preferred to have. And if she wanted her husband to be able to come with her, it needed to happen within the next week. So on Dec. 23, 2022, Cavanaugh-Okhah first called an abortion hotline to figure out her options, then called as many clinics as she could back in the states to find an appointment.

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Massachusetts was one of the options on the list, and since she met her husband in Boston, they still had family there who could offer support. But that meant disclosing the whole story to more people than she wanted to tell.

“We hadn’t told those family members we were pregnant, so (my husband) called them and said, ‘Hey, we’re pregnant, and we need an abortion, a place to stay, and child care,’” Cavanaugh-Okhah said.

She contacted her doctor to get all of the ultrasound images and medical documents sent to the clinic, she said, because it felt like no one back home in Florida wanted to be involved with it at that point.

There was one appointment available. They changed their flights and flew straight from Stuttgart, Germany, to Boston.

“It’s so painful getting on an airplane knowing you’re flying to end your pregnancy,” she said. “I kept on saying, ‘I don’t know that I can do this.’”

The hospital was calm and quiet the day of her appointment, and Cavanaugh-Okhah said the doctor who cared for her helped give her the emotional support she needed to make it through the procedure.

“I wanted someone to tell me how many people go through this, because I couldn’t find it anywhere,” she said. “I’ll never forget, she just rolled her little chair closer to me and said, ‘I don’t have that number, but I can tell you there’s a lot of you.’ And then I think she placed her hand on me and said, ‘I know what you’re doing today is done with absolute love and compassion for your child.’”

‘We can love that pregnancy … and still make that decision’ 

By the end of 2016, Vollstedt was pregnant again with her son, who is now 6. To process her grief and start to move forward took more than a year, she said, and she’s not sure if she ever would have wanted to get pregnant again if she had been forced to carry that pregnancy to term.

“(When Roe fell) I just thought so much about where I would’ve been had all this happened after that, what other people who are going to be in my situation or similar situations are going to experience,” Vollstedt said. If she had faced the same situation after the Dobbs decision, she would have been forced to look out of state for help, since Wisconsin had a full abortion ban in effect for more than a year.

“To have to do that many extra steps to get to Illinois or Michigan is so challenging when you’re already in this really fragile mental state,” she said.

Cavanaugh-Okhah knows she was able to get the care she needed because she had the means to book a last-minute overseas flight, but that didn’t make the experience any easier or less frightening. Even wealthy people can still lose their lives because care is too far away or otherwise inaccessible. As someone who had an ectopic pregnancy before her abortion and two miscarriages since, Cavanaugh-Okhah is all too familiar with potential complications.

The Florida Supreme Court has yet to decide whether the state’s 15-week ban should become a six-week ban after Republican Gov. Ron DeSantis signed a bill into law in 2023 to further restrict reproductive care.

“We’re in Miami, and if this thing passes and it’s a six-week ban, what’s going to happen if something goes wrong?” she said.

“I really want for people to see the humanness of us women, and that we can love that pregnancy and have so much compassion and connection, and still make that decision. Both can exist at the same time. We’re not heartless monsters.”

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