After an abortion for fetal anomalies, she hoped IVF would build her family. Now that’s in doubt.

A blanket given to Anne Angus at the Boulder Abortion Clinic in Colorado, one of the only clinics in the country that offers termination after the second trimester. Angus said a former patient makes the blankets, called Bananas for Annie, for others who had to terminate for medical reasons. (Courtesy of Anne Angus)

Editor’s note: This is the fifth installment of an occasional States Newsroom series called When and Where: Abortion Access in America, profiling individuals who have needed abortion care in the U.S. before and after Dobbs.  The first installment can be found here, the second installment is here, the third is here, and the fourth is here.

Anne Angus has been ready to start growing her family for years now.

She got pregnant on her first try and felt lucky to escape the morning sickness and extreme fatigue that often comes with the first trimester of pregnancy. She quit her job in anticipation of being a full-time mom.

“It was so exciting, I was so ready,” said Angus, who lives in Montana.

She’d bought a few items off Facebook Marketplace by the time she was close to the halfway point, including a bassinet, some toys, a bouncer — and the teddy bear onesie that she holds onto when she tells the story of her doomed pregnancy.

At her routine 19-week anatomy scan, Angus’ doctor said something didn’t look right with the abdomen. But that could mean any number of things with varying degrees of severity, according to her doctor, and they wouldn’t know more until further tests could be completed. And those tests would need to be done by a team of specialists almost 700 miles away, at a children’s hospital in Denver, Colorado. Her appointment was four weeks out from the anatomy scan.

At the end of a series of tests, she met with a team of doctors at the children’s hospital to discuss the diagnosis and next steps. It was called Eagle-Barrett Syndrome, a rare genetic defect that can cause the partial or complete absence of stomach muscles, urinary tract malformations and abnormalities of the testes.

“The little glands running from the kidney to the bladder — his were three times the size of an adult’s,” Angus said. “You’re not even supposed to be able to see them at an ultrasound, let alone have them be very obvious.”

There’s a 50-50 chance her future pregnancies would have the same mutation, which led her to decide in vitro fertilization was the safer way to get pregnant and be able to test embryos prior to implantation in the uterus. But like abortion, access to IVF treatments is becoming another political argument at the state and federal level, leaving Angus to worry that her remaining option for having a child is also at risk.

Following Dobbs decision, clinic overrun with patients

Before arriving in Denver, Angus had told her husband that even if the diagnosis was severe, she didn’t want to terminate. He understood and supported whatever decision she wanted to make, she said.

But after determining the status of the fetus’ condition, the Denver doctors started to discuss dialysis, kidney transplants, and a variety of other courses of treatment that would be needed after birth.

“All of which sounded to me like they would just be experimenting on my baby, with the experiment being, ‘How long can we keep him alive?’” Angus said. “That did not feel loving and compassionate to me.”

While talking it over with her husband, Angus said they discussed a family member who had a terminal illness.

“It has been devastating to the family to watch this person’s pain increase as they slowly fall apart over the years,” she said. “We didn’t want that for our son.”

It was at that time that they made the decision to let him go without the medical interventions and the idea that he might just slowly slip away in a neonatal intensive care unit, she said.

By that time, it was mid-October 2022, four months after the Dobbs decision that allowed states to once again regulate access to abortion and the ensuing legal and legislative chaos. One of the only places in the country where Angus could terminate at her stage of pregnancy was a clinic in Boulder, Colorado. Montana has a gestational age limit of 21 weeks for termination, so she knew she couldn’t go back home.

“That clinic (in Boulder) was overrun because all of the states that used to have access now didn’t have it, or they were being pushed until much later,” Angus said. “We had a two-week wait from when we made the decision.”

By the time she got to the intake appointment, she was at 26 weeks. There were protesters outside of the clinic, so an escort with an umbrella covered Angus and her husband as they walked inside.

“I remember feeling so much anger and rage at them. You have no idea what’s going on,” she said. “You don’t care at all about my baby’s suffering if he’s born.”

The termination was a few days later. Angus said it was difficult to face the reality of letting go of any shred of hope she had left.

“That was probably the most scared I’ve ever been. Nobody talks about what it’s like to get an abortion at the end of your second trimester. What am I supposed to feel? What’s going to happen? Who do I talk to about this?” she said.

After the procedure, the doctor told her it was a difficult process because of the amount of water retention in the fetus’ body. Angus said she could tell just by looking at him.

“I didn’t see his whole body just because of how medically fragile he was, but you could just tell that it would’ve been a really ugly death for him earthside,” she said.

Insurance didn’t cover the costs. With the travel, lodging and the price of the procedure, Angus and her husband spent $10,000 of their savings.

Frustration continues

Throughout 2023, Angus had many appointments for egg retrievals, but she said the process has been emotionally and financially draining.

“We are extremely lucky that my husband has benefits through his work, but we’re also at the end of (those benefits), which is why this is our last IVF retrieval cycle,” she said.

She has a planned embryo transfer in September, but if it’s not successful, she worries about future political decisions around IVF limiting her options. There is only one clinic that offers IVF treatment in Montana.

The Alabama Supreme Court ruled in February that embryos are “children” and several IVF clinics in the state closed their doors over liability concerns. In the months since, some states have taken steps to ensure access to the treatment, but congressional bills to protect IVF federally have failed to advance and a politically influential religious sect came out against it for ethical reasons, potentially igniting more ideological battles.

The new political fight over IVF on top of her experience getting an abortion has made Angus fearful about not having explicit protection for the treatment in her state. It has also made her passionate about telling her story, including at the Montana Legislature in early 2023, when legislators did not advance a bill that would have eased some of the remaining restrictions to abortion access in the state.

Although access is still broadly available in Montana, Republicans have tried to change that since the Dobbs decision. Gov. Greg Gianforte signed several anti-abortion bills in 2023, including a 20-week ban, but they’ve so far been blocked in the courts. Gianforte continues to use executive authority to try to limit Medicaid funding and who can perform abortions.

Republicans in the legislature have also made it clear they don’t support a November ballot initiative to amend the state constitution with a right to abortion access, and at least one candidate endorsed by a national anti-abortion group is running for a congressional seat.

“I’m so angry that politicians are inserting themselves into an extremely intimate part of my life. I am trying to grow my family in a way that I can and in a way that is loving and sustainable, and they think they know better than me, and I am so insulted by that,” she said.

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