A few days ago, the Supreme Court entertained arguments on a case that could effectively overturn Roe V Wade.  A patient of mine taught me a lesson about what this legal decision would mean.

A mother was concerned about her young daughter who was repeatedly banging her head and pulling out her hair.  Trying to understand this upsetting behavior, we got to talking about her family.  Reluctantly, the mother told me about an older child, a son whom she had given up for adoption.  At the time, she knew that she would not be able to give this child the stable home he deserved and she couldn’t get an abortion.  Adoption was the solution; but the emotional cost was steep.  Her grief at the loss haunted her next pregnancy.  With the birth of a healthy baby – my patient — instead of joy, she felt torn.  “How could I love her,” this mom asked, “when I had given her brother away?”  Years later, the pain in her voice was still raw.

Commenting on the Supreme Court arguments, Justice Amy Coney Barrett said that mothers, denied the option of abortion, could simply choose adoption. But there is nothing simple about giving a child up for adoption.  Mothers naturally fall in love with their babies, either during the pregnancy or after. Adoption may bring relief, but often there is also grief. And if that grief cannot be resolved, it grows and spreads throughout the family.

Thinking about the pain shared by this mother and her child led me to three conclusions.

First, judges should ground their decisions in an understanding of human nature.  Laws that deny the reality of how humans actually are – that deny, for example, that mother’s love their babies — do violence to people. They break hearts.

Second, mothers need a louder voice. American justice is not just the product of abstract principles objectively applied.  Supreme Court decisions are made by people appointed through a political process.   Mothers need to be politically powerful, if the law is to respect their lived experience.

Third, in order to change the laws that injure our patients, doctors need to be led by the parents who trust us with their children.