Living in Texas Forced Me to Spend Over $7,000 to End My Ectopic Pregnancy
In this post-Roe world, a doctor's visit in Texas seemed risky. Why does health care need to rest on luck?
Last September, I thought I might be pregnant. I had a copper IUD, one of the most efficient forms of birth control. It was long odds, but my period was late, and I had had a serious boyfriend up to three weeks prior. The first pregnancy test came back positive. And then the second, third, fourth, and fifth (I wanted to be absolutely sure).
I was 23 and had been a college graduate for only nine months and held my adult job for less than six months before getting pregnant. I felt like I was a stumbling idiot baby in the real world—was I about to have one too?
I already knew that an IUD made becoming pregnant unlikely—the gynecologist at my IUD consult made that clear. He said I should get care immediately if I became pregnant, because having an IUD and getting pregnant increases the risk of miscarriage or the pregnancy could become ectopic—when the fertilized egg implants outside of the uterus, usually in a fallopian tube. If an ectopic pregnancy continues, there is a high risk of the fallopian tube rupturing. All ectopic pregnancies are ended with either the fetal matter’s removal or the death of the pregnant person.
I live in Texas, so because of the overturn of Roe v. Wade, a doctor’s visit in my state seemed risky. If I had a viable and healthy pregnancy, I worried my doctor or friends could be sued and fined a lot of money if I tried to get abortion care in a state where abortion is still legal. I had seen news reports of doctors scrambling to get legal aid to provide care to miscarrying women. I had read articles of pain and misfortune for pregnant Texans. I didn’t know what to do.
I went to the closest Planned Parenthood in Austin for more clarity, but that location didn’t offer ultrasounds. They said the nearest office that could provide one was closed, and the best they could do was a urine test to confirm my pregnancy. I already knew I was pregnant, but I had cramping and pain. Could it be ectopic?
I told three people about my condition: my roommate in Texas, my best friend in Georgia, and my ex-boyfriend who had a place in Washington state. Even though I was sure conception happened within the month, the first day of my last period was just over the six-week period. This random day of bleeding is a legal benchmark. I had to go elsewhere. I called my ex, knowing he had a place I could stay in Seattle, that he wanted to help support me—and that Washington would not punish me for going to a doctor.
After days of panic and an uncomfortable call with my ex, I made an appointment with Planned Parenthood in Seattle (on an incognito browser, in case Texas was watching).
I booked an in-person abortion procedure for $610. It was another $530 to fly to Washington. On the plane, I texted my best friend that I loved her in case I exploded from the pressure in the air. I didn’t. My ex picked me up from the airport. We both cried.
Getting care in Seattle
My appointment was several days later. At the clinic, the medical staff told me they couldn’t see a pregnancy in the uterus using the abdominal ultrasound. They also said my IUD was positioned correctly, and I was just unlucky. The nurse removed the IUD, took some blood and urine, and performed a vacuum aspiration on my uterus. The blood and urine tests confirmed I was pregnant, but there was no fetal tissue found. I was still sent to the UW Medical Center emergency room in case I had an ectopic pregnancy. I spent four hours there and had a transvaginal ultrasound.
The UW doctors still couldn’t find a fetus—they guessed it may have been removed during the vacuum aspiration, and I returned to Planned Parenthood a few days later. That week at Planned Parenthood, I had blood tests every other day to monitor my HCG level, a hormone produced in the body during pregnancy. It hadn’t properly dropped by the end of the week. I was told I was one in a million, and my pregnancy was likely ectopic. On a Friday afternoon, I was given methotrexate, a chemotherapy drug used to stop fetal cells from multiplying. I had a concert to attend in Austin on Saturday night and wanted to fly home. Did this shot mean I was done?
The Planned Parenthood doctor who administered the shot called the director of the Seattle Planned Parenthood (my case had been shared up the ladder—I was a micro-celebrity). It was recommended I rebook my return flight and rest. I had already been in Seattle for two weeks, more than 2,000 miles from my Texas apartment. I was lying to my work, family, and friends about where I was, what I was doing, and how I was doing. It was embarrassing. I wanted to go home. I wanted to curl up. I wanted to be done. I rebooked my flight for Tuesday.
On the morning of Saturday, October 1, my fallopian tube ruptured. It was the worst pain of my life. I was crying so hard I could not communicate and I was hurting so badly I could not walk. My ex helped carry me to an Uber and we went back to the UW ER. The pain medicine brought down my pain level to a three, and the doctors discussed my pregnancy with me. I also had blood tests done. For several hours, I had to wait to hear what was going on.
But then I used the bathroom to pee—big mistake. After this hobble, my pain shot back up to a nine, even ten. I was writhing in pain. Something felt very wrong. My ex could do nothing but watch me and cry as I cried. It took 40 minutes for a physician to see me and another half-hour to get pain meds. It was horrible.
After that, I got a toilet in my room, and I was sent to get a transvaginal ultrasound. It showed my right fallopian tube did have an ectopic pregnancy in it. I needed immediate surgery.
At that point, the family rule “always call when they get the saw” applied, and so I called my Catholic, conservative mother in Georgia to tell her I was pregnant, had been lying for the past four weeks, and that I might be losing an organ or two in 30 minutes. This was also horrible.
I woke up after surgery to learn my fallopian tube had ruptured due to the ectopic pregnancy. The doctors had cut out the organ, removed the fetal tissue, and sewed me up. The life-saving surgery cost me $6,290 after insurance. I didn’t get to keep my broken tube. They did let me keep a pair of sweatpants.
I moved my flight for the third time and remained in Seattle for five more days to recuperate. I was very thankful I was able to work remotely and had someone to stay with for my three weeks in Washington. It cost $400 to get back to Austin.
Health care shouldn’t rest on luck
A lot of circumstances are the luck of the draw. I had some shit luck. A perfectly placed IUD failing? Unlucky. Getting pregnant in Texas? Unlucky. Having to find more than $7,000 as an early-career 23-year-old before collections came calling? Unlucky.
I also had some great luck in this tale. A remote job that allowed me to flee the state without having to tell coworkers? Lucky. Being able to pay all my medical bills interest-free with banked internship money from college? Having friends who were there to help me? Having a place to stay in Seattle? Rescheduling my flight so that my fallopian tube ruptured on the ground instead of in an airplane? Lucky, lucky, lucky, lucky.
But that’s the thing: Health care shouldn’t be dependent on luck. No one should die in Texas because they don’t have a free place to stay in a better state. No one should lose an organ because they are in a state that punishes you for an unplanned and unsanctioned pregnancy. Health care shouldn’t pit neighbor against neighbor. No one should have to wonder if there’s a tattler in a doctor’s office. No one should have to book flights on a private tab on the off-chance that traveling to Seattle automatically registers you as suspicious.
I had the money to travel for treatment. Even if I had had a healthy, viable pregnancy, I probably would have gotten a legal abortion in Washington, anyway. The nullification of Roe v. Wade doesn’t prevent abortions from happening—it only endangers pregnant people’s lives. It punishes people who can become pregnant and those who can’t flee to find lifesaving care. It weighs down the state with unwanted children and dead pregnant people.
If I had stayed and received care in Texas, I might have been able to keep my fallopian tube. It also could have turned out the same way—but I would have loved to be in my own bed and keep my savings.
Instead, Texas terrified me and pushed me away. The conservative-controlled legislature prioritizes cells over its community and cares more about the fetus than the children in its underfunded systems. Their laws attack and kill pregnant people. The men in charge do not care that the Texas abortion ban is deadly and ineffective. Please realize this ban hurts Texas and Texans more than it could ever help my nonviable ectopic fetal cells. Please let me control my own body from my own home.