Unbearable, p.19
Unbearable, page 19
Bhatt had seen white women like me, like Maggie, who had transferred from out-of-hospital births or who had come because they heard Woodhull was a good alternative to medicalized birth, something they couldn’t find at NYU where she taught because, Bhatt said, physicians had blocked the door. “But to be honest, they weren’t the ones sitting in the waiting room waiting to be seen, because you and I would not tolerate that,” she added.
As for the women who did wait there for hours, “their time isn’t valued in the same way my and your time is valued,” Bhatt said. In this starved system, they would be forced to get used to that—and worse.
MAGGIE BOYD NEW YORK CITY
It had been hard to get ahold of Maggie and Matt that spring, and it took some time to find out why. The text I’d sent asking to talk, after I’d discovered what Christine and Maggie had in common, went unanswered. At preschool drop off a few days after I’d first met Jose, Matt seemed to avoid my eyes. I wondered if I’d crossed a line somehow. Outside the school, I stepped toward him tentatively. “I just didn’t want to put it in a text,” I said. So I just blurted it out. “It’s just that I met with Christine Fields’s partner. I realized that the two of you had the same doctor.”
Matt chewed over that one. “Dr. Daniel,” he repeated slowly. He understood, he said, that now I had a real story.
They hadn’t been in touch much lately, Matt finally said, because he could tell when Maggie was finished talking about something. And he understood why.
He hesitated. “It’s not really a secret,” Matt said. “But Maggie is pregnant.”
I understood, or thought I did: I figured she was trying not to dwell too much on what had happened with her last pregnancy, to protect herself a little bit from reliving that trauma. She wanted to look forward to the future they deserved to have. That everyone deserved to have. I warmly congratulated him and decided there wasn’t much more to be said.
There was a lot more to say, as it turned out, but it wasn’t the right time. A few months later, at a quiet back table at the coffee shop, it was.
Maggie and Matt weren’t sure they ever wanted to try to have another child, they told me. One day, Maggie had said nervously that if they weren’t more careful, they might get pregnant. She wasn’t sure she was ready to be pregnant again, or to be pregnant at all at forty. But it was too late. It was around that time that she got pregnant again.
This one came after another pregnancy they hadn’t yet told me about, Maggie explained. It was in 2021, two years after their Woodhull ordeal and a month after Maggie was diagnosed with Sheehan syndrome and a thyroid disorder. Her endocrinologist had suggested putting her on human growth hormone replacement, because she was still showing a deficiency, leaving her weak and exhausted. She still had no period, and it would take five years after Tuli’s birth for her to get one. Somehow, through all this hormonal turmoil, an embryo implanted in Maggie’s uterus.
They both knew the pregnancy couldn’t go on. Maggie was so fragile. The workings of her body were already an ongoing mystery to the specialists. How could she even think about supporting a pregnancy? And who knew what impact all the hormonal cocktails she’d been given would have on a developing fetus?
It was September, and Maggie was sickened reading about how the United States Supreme Court had allowed Texas to ban abortion at six weeks, before it even officially overturned Roe v. Wade. Because pregnancies are dated from the last menstrual period, not assumed ovulation or fertilization, it really was a two-week ban, and the only people who could end a pregnancy would have had to know about it, make the decision, and find somewhere to go within, literally, days. Maggie was a testament to how elusive identifying your pregnancy could be. She didn’t even think she could ovulate, and already, she learned at an ultrasound, she was nine or ten weeks pregnant.
“Remember how mad I was about Texas?” she said to Matt at the coffee shop. “I was furious, just being like, I could have to carry this baby that I couldn’t grow. And I was like, ‘What the fuck is wrong with this place?’ ” This place being America.
Their slice of this place being New York in 2021, Maggie and Matt went to Planned Parenthood on Bleecker Street in Manhattan. A woman with a rosary waved a fake baby registry in Maggie’s face, offering her a stroller and a car seat. Maggie pushed past her.
“Obviously I understood the complexity of what I was doing,” she told me. During the ultrasound, she thought about being at this point with Tuli, how moving it had been to look at the little blob on the ultrasound. “That was my baby,” she said. This time, looking into the ultrasound, she decided this was not her baby.
There was a counseling session, for which the protocol was for Matt to leave the room so they could be sure Maggie wasn’t being coerced. She assured the counselor she wasn’t. “Okay,” said the counselor, “but you seem like you’re getting nervous.” Maggie burst into tears. “I just don’t want to die right now in this procedure,” she sobbed.
The counselor listened supportively. She walked Maggie through all the potential risks, but also the statistics that showed that abortion is much safer than giving birth. Maggie felt better, but she was still afraid of the anesthesia, of the feeling of waking up feeling immobilized and tied down that she’d had when she’d woken up in Woodhull’s ICU. They told her she could decide how much anesthesia she wanted. Maggie told them she was afraid she would die if she went completely under, so she chose the lighter option.
As it happened, a little knocked her out anyway. Rather than waking up in a terror, she woke up in a fog of pure gratitude. She told the staff that she loved them so much. It wasn’t just the drugs.
Planned Parenthood, Maggie told me, “that’s the best prenatal care I’ve had.”
* * *
LEARNING SHE was pregnant again in February 2024, “I was like, I guess it has to be fine,” Maggie said. “I mean it didn’t have to be, I could have had an abortion again.” But she didn’t want to, and it felt like now or never. They knew how Tuli, by then five years old, felt about it. He was always talking about saving items for his baby sister, or what he would someday teach his baby sister.
It was hard to disentangle how Maggie felt about the pregnancy and how she felt about everything else going on in her life around that time. The grief of her little brother dying of an accidental overdose only two weeks after learning about the pregnancy. The strokes each of their fathers soon suffered. Around that time, Maggie didn’t want to talk about the pregnancy, she didn’t want to be congratulated.
To the extent that Maggie could think of being pregnant, it was about figuring out how to get proper care for it. “I couldn’t figure out if ultimately I was just a person who had had a C-section,” Maggie said, or if the complexities of what she’d gone through and the hormone therapy meant a higher order of specialist. She had shed her gentle Canadian trust in the system and become the kind of patient who could succeed in the American way of medicine. One who didn’t instinctively defer to the first doctor she talked to, who asked a million questions, who cross-referenced with research and bugged people to get the kind of coverage of treatment she needed. She found an OB/GYN affiliated with Mount Sinai, the same hospital system as her endocrinologist, who delivered in Manhattan.
On the way to her first prenatal appointment at around eight weeks, Maggie had a panic attack on the subway. But the appointment itself went fine. The doctor told her he thought she had a decent chance of having a vaginal birth, though he told her to be prepared for another cesarean.
Around seven months, doctors suddenly noticed a cyst near Maggie’s uterus, an astonishing fourteen centimeters—the size of a burrito. Maggie panicked, but an MRI showed the cyst didn’t look cancerous. She agreed to an induction at thirty-nine weeks, but when they got to the hospital, Mount Sinai West, a resident kindly told them that if her heart was set on a vaginal birth, that was up to her, but given her risk factors—the previous hemorrhage and resulting scar tissue, the ambiguous cyst, the size of the baby, her age—he strongly recommended another surgical birth. When he had consulted more senior doctors on duty, they all agreed. (The phrase “no-brainer” was used.)
Maggie thought about the panicky dash to surgery at Woodhull, the anesthesiologist shouting at her to make the shape of a shrimp. Right there on the spot, she consented to a planned cesarean, which would helpfully also give doctors a chance to remove the cyst. It felt different from the moment each doctor came in and calmly introduced themselves, acknowledged her history, told Matt and Maggie about what what they would do next, and made sure she was okay with it.
Moments after the surgery, when Maggie and Matt’s second son was placed on her body, the gravity in the hospital room abruptly shifted. Matt noticed anxiously that once again, the room was filling with doctors, and that someone was urgently ordering blood to the floor.
The doctors explained to her what they had learned once the fetus wasn’t blocking their full view. Maggie had placenta accreta, one of the most dangerous conditions that can occur in a pregnancy. The placenta, grown each pregnancy to provide sustenance to a fetus, typically detaches from the uterine wall after birth on its own, and needs to be delivered or removed separately. On rare, potentially deadly occasions, the placenta can burrow too far into or across the uterus, essentially gluing it to the uterus. A prior cesarean is a risk factor; so is any previous uterine surgery, and during her first birth, Maggie had had two in one day.
The good news was that since Maggie had already been on the operating table, doctors had been able to act quickly. Now, after the surgery, they would monitor her to see if her uterus would contract properly around the fissure left by removing the placenta. If it didn’t, she would hemorrhage again, and if they couldn’t get the bleeding to stop, they’d have to remove her uterus—a hysterectomy—to save her life, though they would do their best to avoid it. They said the best surgeon was coming to assist.
For all the respect and calm with which the news was delivered, Matt felt a rising panic, all the fears of the past returning. Worse, when he looked over at Maggie, he saw she was convulsing and vomiting, her lips blue just like they had been before. Matt felt as if he was falling deeper into an abyss. Somehow, she barked at him to get it together, like the scolding slap of a noir film. It turned out to be a reaction to the anesthesia.
For five or six hours they waited to see how Maggie’s uterus would respond, whether it would need to be removed. Miraculously, doctors told her, she was bleeding less than they would expect at this point. She emerged with her uterus, her baby, her life. The aftercare was diligent: They sent the endocrinologist to check her hormones; they checked her iron levels and gave her an iron drip, something she learned should have happened at Woodhull after all that blood loss. A nurse at Mount Sinai told her that if she wanted to breastfeed, she needed blood. No wonder she hadn’t been able to produce more than a few drops the first time.
This time, though, was different. The day that we sat down again together, Maggie had a tiny, robust newborn nestled in a carrier, a hungry boy with dark hair who wanted to nurse all the time. She kind of missed how formula-feeding Tuli had allowed her and Matt to share responsibility equally, but she thought she might as well give this way a try. She looked as relaxed and radiant as I had ever seen someone with a new baby look.
Albi, as they’d named their second son, curled into Maggie’s chest, sighed deeply, and fell into the regular breathing of slumber.
YASHICA ROBINSON HUNTSVILLE, ALABAMA
Winning their case, at least in the short term, seemed to mean Yashica and Dalton could open the birth center with a provisional license, but no one knew exactly what that meant. Yashica and the other plaintiffs were still fighting for accreditation from a separate body that would take into account the midwifery model. For the time being, at least, it would mean a visit from the Department of Health, except without any written-out guidelines for them to follow.
In May 2024, a grim-faced inspector had walked inside the building on Sparkman Avenue. There were new white fabric couches to replace the black pleather armchairs, brightening the waiting room, and plush beds with upholstered headboards and carefully arranged throw pillows where once exam tables had been, but it didn’t take long before the inspector realized where she was.
“Oh,” she said coldly. “It’s this place.” Dalton instantly recognized her as the inspector who had been charged with overseeing the abortion clinic before abortion had been banned nearly two years earlier.
Some of the inspector’s questions made clear that she had little understanding of where she was. Where did they keep the epidurals? This was a place for the midwifery model of care, they responded, so they didn’t offer any.
“Do you allow smoking here?” A few of the staffers chuckled and said of course not. “Where are your no smoking signs?” the inspector responded, unsmiling. Someone ran to the store for a few nonsmoking signs. “It’s too late,” she said. “I already wrote it down.” She had written a few other things down about employee files and policies and procedures. Outlet covers. Most of it could be corrected before she left, but it was all too late. They had failed their first inspection.
After she left, the clinic’s new administrator, Elisabeth Nussel, was demoralized. She wanted women in northern Alabama to have what she hadn’t been able to have in her first birth, which ended in an unwanted cesarean. For her second, Kirsten Clark had been her doula, which led Nussel down a similar path of pregnancy support. She had been about to start clinic escorting—ushering patients through the protesters to safety at the abortion clinic—when Dobbs ended legal abortion in Alabama. After Nussel heard about the birth center, she was so excited that she began volunteering there nine months before she was on the payroll, staying as late as two or three in the morning to get everything done.
Elisabeth was outraged at how the inspector had questioned Yashica, who shrugged it off. The board working on formal birth center guidelines, she said, was full of people associated with Huntsville Hospital, and most of them weren’t happy about the competition. Even though there weren’t enough providers as it was.
Dalton and Yashica told the team not to worry. “We’re going to get the license,” Dalton said, “and we’re going to get it with a smile on our faces. This isn’t the end.”
In July, after a second, two-hour visit, the inspector couldn’t find any reason to deny them the provisional license. In theory, this meant the midwives on staff could start attending births. In practice, it was still complicated.
Probably the biggest reason why things were slow going in the first few months of the birth center was money. Because their license was provisional, they couldn’t yet accept insurance. The sticker price of paying out of pocket was $10,200, but Elisabeth had been able to shave off a few thousand dollars thanks to grants they’d received. Still, a home birth cost only $7,000. If prospective patients asked Elisabeth why they shouldn’t just have a home birth, she could point to the fact that if their risk profile changed and no longer made them a good candidate for the birth center, or if they had to transfer to a hospital while in labor, they could seamlessly transfer to Dr. Yashica Robinson for continuity of care. And if they were uninsured and had to transfer, what they had already paid could count toward their fee. Alabama law forbade attending a vaginal birth after cesarean, or VBAC, anywhere but a hospital, so that disqualified several would-be patients.
At least once a month, someone would ring the doorbell and ask Elisabeth if she could get an abortion there. No one was ever sure if it was a sting operation, though it seemed less likely when so many of the people at the door needed a translator from Spanish. It wasn’t clear what the clinic was allowed to tell them when the threat of prosecution from Alabama attorney general Steve Marshall still hung over anyone who helped abortion seekers go out of state. Yashica and Dalton, along with the clinic in Tuscaloosa, had already brought a lawsuit trying to block Marshall from acting on his threats. They were represented in the case by Alison Mollman and the rest of the team at the ACLU, and in April 2025, a federal district court ruled in the clinics’ favor.
There hadn’t been any abortions at the clinic in almost two years, but the protesters were still showing up every Thursday outside the birth center, intimidating anyone who wasn’t already boycotting the center because Yashica had once been an abortion provider. “I have had people cancel their consultation and lose out on the deposit after knowing that she’s connected to us,” Elisabeth told me. Yashica told Elisabeth that there were always going to be those people, and there were always going to be better people, too.
By mid-January 2025, six months into its operation, the closest the Alabama Birth Center had come to living up to its name was a patient who delivered in the car on the ninety-minute drive there, and who arrived at the center in time to deliver her placenta and be checked for any issues. (Everyone was fine.) The patient had transferred at thirty weeks after a traumatic first birth in a hospital, and told Elisabeth she preferred having her baby in a car, her son asleep in the backseat, to returning to the hospital.
That spring, a few pregnant women signed up for care at the center. One was Mercedes Bolden, a twenty-four-year-old stay-at-home mom married to a trucker for an environmental company.
Twenty weeks pregnant when we spoke, Mercedes had been looking for something different from her first two hospital births. The nurses at her eldest son’s birth had insisted she resist her own body’s urge to push because the doctor wasn’t there yet. The doctor arrived and promptly yanked out the baby—who was coming out on his own and had shown no signs of distress—breaking his collarbone in the process. “Babies are so small and fragile and I had to worry about putting clothes on him,” she told me, on top of being a first-time mom. Mercedes had a fear of needles and had skipped the epidural; the doctor’s move was probably at least partly responsible for her needing four stitches.
