A true story - Pregnant Autistic Woman

[Sola]

Autism Spectrum Disorders are not hereditary. This baby could easily be neurotypical.

Autistic Spectrum Disorders ARE hereditary. There is a very high chance that this baby will be on the spectrum, particularly as both parents are not NT.

To the OP;

My work is with special educational needs which includes carrying out and arranging placements for teen mums, I've been involved in a situation like this a couple of times. The first one was a few years ago with a 16 year old girl who had aspergers syndrome and had a baby. It was very difficult for all involved. This girl had issues with wanting to be accepted and had gone from boyfriend to boyfriend, sleeping with them as to her it seemed a way to be accepted by them. She got pregnant, I have no idea if it was by accident or not, she was supposed to be on the pill, but I do wonder if 'forgot' to take it in the hope the BF would stay, plus she also had an obsession with babies.

She was in no shape or form capable of being a mother at that age. By the time I was working on her case she was 16, leaving school and I was working in liaison with Connexions (post 16 edu/careers service in the UK). Social services were involved as she had decided that she wanted to live alone with her son - by this time the BF was out of the picture. Her parents were against it as she was incapable of looking after heself let alone the baby. She had no clue as to the child's needs whatsoever, cues from the baby had no meaning to her at all and the baby would be hungry, sore from a dirty nappy and she didn't realise that crying was because of that. There was little interaction with her and the baby either and she would frequently leave the baby crying in the cot in another room while she would be sat listening to music through earphones as she couldn't cope with the crying.

She did go through parenting classes and while she could recite the 'rules' like the best of them; feeding, changing, burping etc, she couldn't generalise and apply them to herself. She had absolutely no theory of mind, her executive functioning was very delayed and by the time the child was a year old she couldn't be left alone with him as on one occasion she had left some heated hair straightening irons within reach of the toddler and he had burned his hand. Her critical thinking skills were under developed and she couldn't project her thoughts to the future at all.

The pregnancy was hard on her as she found the changes very hard to cope with. She found it hard to cope with being touched due to sensory issues and that was an issue whenever she had examinations by the midwife. At the birth it was decided for her to have a general anaesthetic and a c-section as she was so distressed.

I don't know what happened in the end as she transferred to adult services. Social services did approach adoption with her (she had flat out refused an abortion when she found out she was pregnant) but she refused. The baby was a 'Child in Need' and her cases manager at SS was considering putting him on the 'At Risk' register.

Another case is one I am currently involved in. The girl is 16, nearly 17 and again is transferring to adult services soon. She has no diagnosis but her brother is profoundly autistic and already known to my dept and SS. She is of low average intelligence, socially and emotionally very immature and again is obsessed with babies. She spoke for a very long time - from the age of around 12 - that she wanted a baby. She came up as at risk of teen pregnancy and measures were put in place such as giving her the baby doll (turned up to extremely cranky!) for the weekend. When she was 15 she got pregnant by one BF but miscarried, she is now 7 months pregnant by a different BF. The pregnancy was an 'accident' and the feeling is that the pregnancy was planned by her. She is still in the relationship with the BF but the feeling is that she wont be for much longer as it seems as though the BF is now surplus to requirements.

She again hasn't a clue how to take care of a child. She loves dolls and played with them right up to getting pregnant. She would bring a reborn doll to appointments with a pram and the whole caboodle for it. For her the baby is a real live doll. We're now trying to liaise with other services to get her a supported placement somewhere where she can learn (she has a very low educational attainment), which will have childcare and support for her. SS are involved with her but the fear is that she wont be able to care for the baby.

[thinkforyourself]

In my work with developmentally disabled adults I have not yet had to deal with a pregnancy. Reproductive rights and sexuality, however, we deal with all the time. For many of our higher functioning girls, the Depo shot has been a great choice. It is a choice THEY get to make, but they often like this option when it is explained to them. The advantage is, they don't have to take a pill every day and can't suddenly decide they want a baby and stop taking their pills. For those without the capacity to decide, it gets much more complicated. It's not ethical to mandate birth control or abortions. We can think that a person wouldn't make a good parent, but it's just not up to us. Being able to make those decisions would start a huge slippery slope. Most of us wish the Duggers would quit, but who gets to decide the maximum number of children? Then maybe we decide that you have to have a set amount of $ in order to keep you child. Or maybe you had 1 disabled child and you can't risk the odds that you'll have another. There are cases where birth control has been mandated, but it's a very long process that involves a human rights committee.

[browngrl]

The one question this story raises, if the girl is not able to take care of a child. Why wasn't she put on a form of birh control that she had no choice over, i.e. an injection or coil.

This story is quite personal because I have AS but i'm fortunate that is high function enough for me to be in control of sexuality and maybe one day if i'm lucky have children.

The girl should have an abortion but it should be made clear that this is her choice and the best solution.

I agree that these may be options but the trouble comes in obtaining consent to do the medical procedure to insert the implant/IUD. What if the woman/girl refuses to allow the doctor to perform the procedure? This is slippery ethical territory.

[J-Watcher]

At discharge, the topic of making her father guardian did come up, but the decision has been thus far to allow her to remain her own agent.

. . .

If this girl decides to maintain custody of the child, should she be entitled to government assistance? She and the boy both have parents who currently support them. Should they foot the bill and go through the emotional roller coaster (again) with this new little person?

. . . Dad has been unemployed for 5 years and has had a very difficult time getting a job. He suffers severe depression. Mom is bipolar (untreated) from observation.

. . .

My personal belief is that the government cannot know what is best or what situations arise. It does not belong in the decision at all. Ultimately, this girl deserves support for whatever she chooses to do with her own body. I am certain that her parents favor terminating the pregnancy. But it is not their choice either. And it should not be, even though the burden will most likely fall on them.

Issues that are controversial are so for a reason. THis story underlines the reason. This is a private decision. The ramifications will have public prepercussions. There are no easy answers.

It sounds like the court is avoiding the responsibility of appointing a guardian because it would have to be a court-appointed professional guardian rather than either of the girl's parents. That will cost the taxpayers a lot of money, because it doesn't sound lke the parents have the resources to pay for it. And of course, the taxpayers are going to get socked with the bill for raising the child too. Which is why pregnancies like this need to be prevented, and why the government *should* be involved in preventing them. The time to make a legal determination that a mentally impaired teenager or young adult needs passive contraception or sterilization is *before* a pregnancy. Yes, it costs the taxpayers money to take legal control of an incompetent teen/adult, but not as much as is costs to raise the children resulting from failure to take control of the incompetent teen/adult. This young lady needs an abortion quickly, whether she wants one or not. Just like my schizophrenic sister needed to be taken off the streets, whether she wanted that or not. It's absurd to talk about "her choice", when she's incapable of comprehending the implications of having a baby. Makes no more sense than talking about letting a young child make their own "choice" about whether to chase a ball into a busy street or to refuse to learn to read.

[Guest Anonymous]

It sounds like the court is avoiding the responsibility of appointing a guardian because it would have to be a court-appointed professional guardian rather than either of the girl's parents. That will cost the taxpayers a lot of money, because it doesn't sound lke the parents have the resources to pay for it. And of course, the taxpayers are going to get socked with the bill for raising the child too. Which is why pregnancies like this need to be prevented, and why the government *should* be involved in preventing them. The time to make a legal determination that a mentally impaired teenager or young adult needs passive contraception or sterilization is *before* a pregnancy. Yes, it costs the taxpayers money to take legal control of an incompetent teen/adult, but not as much as is costs to raise the children resulting from failure to take control of the incompetent teen/adult. This young lady needs an abortion quickly, whether she wants one or not. Just like my schizophrenic sister needed to be taken off the streets, whether she wanted that or not. It's absurd to talk about "her choice", when she's incapable of comprehending the implications of having a baby. Makes no more sense than talking about letting a young child make their own "choice" about whether to chase a ball into a busy street or to refuse to learn to read.

No. You're a horrible person troll.

**Edited for clarification.

[Deleted03]

I agree that these may be options but the trouble comes in obtaining consent to do the medical procedure to insert the implant/IUD. What if the woman/girl refuses to allow the doctor to perform the procedure? This is slippery ethical territory.

it's still her body/her choice... And there are always risks of malfunctionning, so yeah no I find that ethically debatable.

[J-Watcher]

This young lady needs a legal guardian. Her parents failed her badly by not getting an IUD into her while she was still a minor, and ensuring she would remain under guardianship after turning 18. A court should look into appointing a professional guardian. Someone whose mental function is so impaired that she can't function in a normal high school, should not be making her own decisions about contraception (or sex for that matter -- it sounds like she's impulsive enough that she'd go ahead a sleep with a guy even if she knew he had AIDS, or with a much younger boy without regard to legality or to the fact that he wouldn't be responsible for child support for a child resulting from statutory rape). She needs passive contraception or sterilization, since she's obviously not responsible enough to take pills regularly or mentally competent to have custody of a child. And if she's still at school, the school should be sued out of existence for allowing this to happen.

This is a tragic situation, but it's not the fault of religious right political activists. If anything, it's the fault of the left-wing political activists, who have pushed into law the notion that people who have severe mental impairments should have virtually no restrictions on their "freedom" (as if anyone can actually be "free" while their severely malfunctioning brain is controlling their actions). My schizophrenic sister is dead because of these laws -- she said she wanted to keep living on the streets, and the court wouldn't force her into treatment because it would violate her "rights", so she got murdered on the streets.

[Guest Anonymous]

My head is spinning with questions on this one.

If she is legally an adult, but involved with social services because she is deemed incapable of taking her own decisions, won't the court appoint an impartial guardian to assist in decision-making?

Second question: I agree that the whole issue of 'forced' anything is a tricky one, but for vulnerable young people, the depot injection or contraceptive implant seems to be recommended quite a lot in my area of the UK. Is that a widely offered form of contraception in the USA?

Obviously the young person has to give as informed consent as possible, and of course it is not 100% reliable. But it is a method that is more 'resistant' to unwanted pregnancy that can come about through impulsive/unstable behaviour. I guess it is more likely to be accepted by a young person when talking with a health professional in the cold light of day, and is not something that can be stopped on a whim during a vulnerable moment with a sexual partner.

[J-Watcher]

At the birth it was decided for her to have a general anaesthetic and a c-section as she was so distressed.

Yikes! That's really dangerous for the baby, even if it wasn't technically a "general anesthetic" but rather heavy sedation like propofol.

[Sola]

Yikes! That's really dangerous for the baby, even if it wasn't technically a "general anesthetic" but rather heavy sedation like propofol.

I have no idea whether it was heavy sedation or full GA, I just remember what was in her records. Apparently she was very aggressive during labour and the decision was taken for her own safety and that of the staff.

[Sola]

It sounds like the court is avoiding the responsibility of appointing a guardian because it would have to be a court-appointed professional guardian rather than either of the girl's parents. That will cost the taxpayers a lot of money, because it doesn't sound lke the parents have the resources to pay for it. And of course, the taxpayers are going to get socked with the bill for raising the child too. Which is why pregnancies like this need to be prevented, and why the government *should* be involved in preventing them. The time to make a legal determination that a mentally impaired teenager or young adult needs passive contraception or sterilization is *before* a pregnancy. Yes, it costs the taxpayers money to take legal control of an incompetent teen/adult, but not as much as is costs to raise the children resulting from failure to take control of the incompetent teen/adult. This young lady needs an abortion quickly, whether she wants one or not. Just like my schizophrenic sister needed to be taken off the streets, whether she wanted that or not. It's absurd to talk about "her choice", when she's incapable of comprehending the implications of having a baby. Makes no more sense than talking about letting a young child make their own "choice" about whether to chase a ball into a busy street or to refuse to learn to read.

No, it is not absurd to talk about choice. Everyone should have the choice, even if they have issues making choices.

Sounds like this girl falls down the gap between services, much like what happened to the girl I mentioned. Many services for vulnerable young adults use, either officially or unofficially, an IQ level as a cut off point. The girl might well have a normal or high IQ but what needs to be taken into account is how much 'useful intelligence' she has. She may well be able to recite the entire periodic table from memory or pi to 21 places but if she cannot plan, execute or function in daily life then she is going to have problems.

[shesinsane]

I usually use "making an adoption plan".

Thanks! I like that phrase and will use it. Much like "giving up one's virginity", the term "giving up for adoption" just bothers me with its negativity, making an adoption plan is both neutral and factual.

[helloemi]

"The time to make a legal determination that a mentally impaired teenager or young adult needs passive contraception or sterilization is *before* a pregnancy. Yes, it costs the taxpayers money to take legal control of an incompetent teen/adult, but not as much as is costs to raise the children resulting from failure to take control of the incompetent teen/adult. This young lady needs an abortion quickly, whether she wants one or not."

The OP did say the girl was high functioning right?

I'm sickened that we have someone on here advocating the forced sterilizations of those that they deem inferior.

Eeek!

IUDs have their own risks, especially for women that haven't given birth before. As a parent you can only do so much, and regardless of the mental capacity of the child, they are going to make their own decisions. What are you supposed to do, drag the girl to the doctors kicking and screaming and strap her down on the table as they stick a piece of copper up her uterus? She may be autistic, but let her have her dignity.

*Edited to include quote and ease my wording

[Terrasola]

I am not so sure that this is an issue of reproductive rights so much as it is one of control ... the desire of some people to control the lives of others that they fear aren't "doing it right" and the concomitant need to let go of those desires and respect the right of legally competent individuals to live their own lives.

I had a mentally ill (BPD), addicted teen-aged daughter who behaved very similarly to the girl we are talking about. She did scary and stupid things and became pregnant at 17. She will be 26 next month, is in recovery and has 3 children under the age of 8. Those first years were tough and Child #1 was not raised well. DH and I struggled with the issues we are discussing.

What I thought of at the time as reproductive/legal rights questions were really control-related issues: my lack of control over my child and desire to "get her life back on track", lack of influence with "the authorities", lack of control over the direction of my grandchild's life, etc. I learned over time that I am not supposed to have that control over another person. As long as persons are deemed competent they have a right to live their lives as they want, to make stupid decisions, to fuck up royally and make messes of their lives. TPTB exist for when those decisions go horribly wrong and others get hurt (like the little boy who burned his hand). It is not my job (or anyone else's) to fix or control those things, unless it really is your job. We have established certain organizations as checks and balances to our freedoms and hopefully these will work as they should for this girl and her future baby.

Trying to force an outcome won't work. You cannot control another person; you can only control yourself.

[FlorenceHamilton]

I have really appreciated this discussion. This is tough stuff. The girl is falling between the cracks because her deficits are multiple, but mild, leaving her with a "high functioning" overall appearance.

My purpose has been to illustrate that issues are controversial for a reason. This girl had access to birth control and her parents saw to it that they were made available. They even picked the pills up at the pharmacy and reminded her to take the meds. She is not medically a candidate for an IUD as she had not had any prior pregnancies. She refused Depo shots because she heard they make you gain weight. (Which is true). She is body dysmorphic although she has never been overweight. Both of her parents have been overweight and there is good evidence that the mother has similar issues.

Often, life cannot be tied up into nice net little packages of "right" and "wrong".

Bringing things full circle, it seems to me that the lure of the fundamentalist lifestyle is the desire to put things in convenient packages. All children are blessings....yes....but they are mixed blessings. They are burdens as well. Burdens are not always bad things. In the troubled economic times that we live, it is tempting to simply assign responsibility to individuals or to government (depending on which way you lean). The truth is that it is a shared responsibility. We carry as much as we can on our own. And we all sometimes need to rely on the herd to carry us a bit. Particularly in the issue of the creation or not of new human beings, this is the case.

It is interesting to see which contributors to this discussion have tried to make a clear cut answer and those who simply undertand that it is a difficult situation with many nuances.

[kb2]

It is hard to decide what to do when someone gets pregnant on purpose because they want to, but for whatever reasons the pregnancy is inopportune. I think that there are always going to be children who come into the world as burdens, who will need to be raised by people who did not choose to create them. And we should provide a lot of social support for that.

J-Watcher, I'm sorry for what your family has gone through. I can understand that you'd rather your sister be hospitalized than dead, and there are plenty of problems with our current system of dealing with mentally ill people. But always choosing the thermonuclear options--permanent sterilization, mandatory institutionalization--we've already done that as a society, and that didn't work either. It's easy to play Monday morning quarterback after she's proven herself to be impulsive enough to get pregnant because she's already done it, it's harder to guarantee what the right thing to do for someone like that beforehand is.

[helloemi]

J-Watchers comments upset me because I have bipolar disorder (in addition to other health issues) and at certain times in my life when I have been "out of balance" I have made some pretty stupid decisions, so I understand what it is like to have sex without understanding the consequences or completely knowing what you are doing at the time. Unlike the OP's situation, I am stabilized 95% of the time now thanks to years of therapy, understanding my triggers and being on medicine at various times. I consider myself very lucky for this.

I was on the Depo shot for 6 months. It is not recommended for those with emotional disorders because it can cause severe depression and I have found studies that say the surge of hormones in the shot can trigger major health issues. For me that was lupus. I would NEVER want anyone I care about to go through what I have because of the depo shot. And yes, I did gain 30 pounds on it.

Someone suggesting forced sterilization (which is eugenics, something I thought was universally considered wrong) is no better than forced abortion, or forced pregnancy. There seems to be a forgetfulness about the fact that people with disabilities are in fact people, with rights and dignity.

Getting off my soapbox now :-) Ever have one of those emotional days?

[Elle]

The girl should have an abortion but it should be made clear that this is her choice and the best solution.

So basically tell her it's up to her. While pressuring her toward abortion. How would you feel if you were pressured to abort a baby you wanted because you fall somewhere on the AS spectrum? Because it's presumed you are incapable? It's hypocritical of you to say you are fine to make your own decisions but someone else who is also on the spectrum and also of average intelligence should be pressured to abort.

[Elle]

There seems to be a forgetfulness about the fact that people with disabilities are in fact people, with rights and dignity.

This times a million. I'm disgusted and shocked at the supposedly pro-choice people here who think she should be pressured to get an abortion rather than supporting her choice. Even people who aren't on the spectrum can be extremely immature and incapable of parenting - where is the outrage against the idiots on Teen Mom and those other teen pregnancy shows? And even worse is the mere suggestion of forcefully sterilizing people for mental disorders or conditions.

Do you know part of why I'm against forcing abortions on people who aren't completely neurotypical? Aside from being pro-life, that is. I'm against it because across the board the babies of non-neurotypical people are likely to be aborted both out of "concern" that the person couldn't handle it (newsflash, many neurotypical people can't handily it, and there's something being referred to as "prego-rexia going on among women who can't handle the chances and stop eating to limit weight gain), and out of "concern" that the baby has a higher than average chance of having a disability. You know, eugenics. Once we start deciding that some people should be put through abortions because they or their babies may somehow be less than "desirable" we get into the problem of whether or not people with other conditions should be determined unable to properly decide to have a baby. What about people with depression? A history of postpartum? Someone with epilepsy? We can claim to be "concerned" they couldn't handle it, or that we are "concerned" for their babies. We can claim that these people aren't neurotypical, therefore their decisions should be removed and it's off to a table to have their wanted babies sucked out of them. Forcing someone into a surgical procedure to remove something front heir bodies that poses no imminent danger is WRONG and a severe violation of human rights. The process of labor and delivery falls into a grey area and in THAT situation it may often, but probably not always, be better to have a c-section under general anesthesia. For those with moderate to severe disabilities, it may be very difficult for them to comprehend that much happening all in a matter of hours while expecting them to participate. Pregnancy changes tend to be gradual over a period of months.

All of you claiming to be pro-choice while hedging toward thinking that babies of non-neurotypical people should be aborted without any imminent danger to the mother's life need to shut the fuck up. You're not pro-choice if you'll only support someone for making the choice you'd make for that person. Simply being pregnant isn't an imminent danger.

[Guest Anonymous]

I didn't read it the same way as you, Elle. Yes, there are a few bigots on the board, but aside from those who want compulsory sterilisation, most were acknowledging the difficulty of the situation, with some disagreeing that carrying the pregnancy to term should necessarily be the default position.

[Witsec1]

I don't think anybody is reading the thread the same way as Elle. There is only one person arguing for forcing anyone to do get an abortion/get sterilized, and that 's J-Watcher the troll.

[Witsec1]

The whole point of this post as far as I'm concerned is that life often presents us with messy situations where equally compelling values are in conflict and there are no magic answers. Anyone who thinks there is an answer to this situation that does not itself cause other problems is in denial.

[Witsec1]

Someone suggesting forced sterilization (which is eugenics, something I thought was universally considered wrong) is no better than forced abortion, or forced pregnancy.

I think no one mentioned this except J-Watcher, though I could have missed something

[FlorenceHamilton]

The whole point of this post as far as I'm concerned is that life often presents us with messy situations where equally compelling values are in conflict and there are no magic answers. Anyone who thinks there is an answer to this situation that does not itself cause other problems is in denial.

Precisely.

[Guest Anonymous]

The whole point of this post as far as I'm concerned is that life often presents us with messy situations where equally compelling values are in conflict and there are no magic answers. Anyone who thinks there is an answer to this situation that does not itself cause other problems is in denial.