WELLS — I am a certified nurse-midwife who is now retired. Years of caring for pregnant women bring an acute awareness of what can go wrong in pregnancy. Pregnancy is biologically, emotionally, socially and economically costly to women. A developing fetus pulls the iron from the mother’s blood and the calcium from her bones. Mercifully, pregnancy-related deaths are much less common than they were 100 years ago, but according to the federal Centers for Disease Control and Prevention, approximately 700 women still die every year in the United States from complications of pregnancy or childbirth.

Women with heart conditions, hypertension, diabetes and other chronic illnesses are at high risk during pregnancy, and for some of them, pregnancy can be life-threatening. Some illnesses, like cancer and hepatitis C, can’t be treated during pregnancy because the medication would damage the fetus. Some women will choose to forgo treatment until the fetus can be safely delivered, but other women will want to end the pregnancy and be treated. This is especially true for women who have other children to consider.

The decision to end a pregnancy is heart-wrenching and should be made by the woman and her family with help from her health care providers, not by the government. Lawmakers should not be choosing between the life of any woman and the life of a fetus. Judges should not be practicing obstetrics.

One Christmas Eve I attended a woman who was carrying a fetus known to have a fatal condition, anencephaly, in which the fetal brain and skull fail to develop and there is nothing but a thin membrane covering the top of the head, usually just above the eyes. This condition was discovered by ultrasound very early in the woman’s pregnancy, and she requested a termination. That early, the procedure could have been done in the operating room under anesthesia. But since her insurance provider wouldn’t pay for a termination and she couldn’t afford to pay herself, she decided to carry the pregnancy.

At 28 weeks the fetus died, which can cause infection and severe bleeding, so it needed to be delivered. Inducing delivery at that gestational age is difficult and painful. An anencephalic fetus is especially difficult because there is no bony cranium to put pressure on the cervix. When the time finally came, I had a very difficult time trying to ease that little dead baby out of its mother without decapitating it, and eventually the pressure from the vaginal walls caused the thin membrane over the fetal head to rupture and the cranial contents to protrude through it.

I was weeping so hard I could barely see. The nurse was weeping. The family was weeping. Everyone was traumatized – and it was totally unnecessary. This fetus was diagnosed at 11 weeks. Termination of the pregnancy could have been done very easily and painlessly at diagnosis, which would have spared us all from a horrific experience and reduced the risk to this woman’s health.

Another woman who was carrying an anencephalic fetus developed a blood clot that traveled to her lungs and caused her to go into cardiac arrest. The code team couldn’t do effective CPR because chest compression in pregnancy pumps blood from the heart to the pregnant uterus and not to the brain and other vital organs.

They did an emergency cesarean but, because she had been given a blood thinner, the bleeding wouldn’t stop. After many transfusions, they were able to save her life, but she was left with significant brain injury and is no longer able to care for herself or for her other three children.

It is unreasonable to require any woman to risk her health and well-being by carrying these pregnancies after the condition is diagnosed. Our senior senator, Susan Collins, has repeatedly expressed her support for the right of women to make their own reproductive choices. Yet, Sen. Collins has so far refused to take a stand against the confirmation of Judge Brett Kavanaugh to the Supreme Court.

Donald Trump has promised many times to appoint justices who would overturn Roe v. Wade, and Judge Kavanaugh is very conservative and has not been a defender of reproductive rights. He can be expected to vote in ways that limit the ability of women to make health care decisions. As an experienced women’s health care provider, I urge your readers to contact Sen. Collins and ask her to protect the health of Maine women by voting “no” on Kavanaugh.