STRING OF PEARLS | Elizabeth Ryder
This morning, I came in early, as I had a personal medical appointment before work. The floor where my office is, along with the floor above me, hold several OB-GYN clinics, including the one where I go for primary care. I recently started dating again, and so I chose to have an IUD placed for birth control—you know, “just in case.” My family’s curse (or should I say “one” of my family curses) is getting pregnant out of wedlock. It’s happened for all the generations I know of, and I won’t let it happen to me. My maternal grandmother was raped by a farmhand and became pregnant at age 15. My mom got pregnant four times throughout her non-marital partnership with my dad, despite being on the pill. And both of my brothers’ children are from their baby mamas. I personally haven’t been on any birth control for nearly ten years since my husband left and we got divorced. The one partner I’ve had since was snipped, so that took care of that.
But now there’s a little copper T nesting in my uterus. A few weeks after they place it, my clinic’s practice is to confirm location via ultrasound. The only other time I’ve had a pelvic ultrasound (the one where they put what is essentially a dildo with a camera on it up inside the vagina to look around) was before I was to be married. I was being responsible and having an annual exam, just to make sure I was healthy and because, I supposed, I would soon be having sex. (For the record, we never had much sex, and it was never any good.)
To my surprise, that exam led to being diagnosed with PCOS: polycystic ovarian syndrome. I had shared my menstrual history with the gyno. Given that I didn’t have menses until age 18 or had ever menstruated “regularly,” she thought it pertinent to investigate with imaging. So at age 28, two months before getting married, I learned my ovaries didn’t work normally—they didn’t release an egg monthly like most women’s do. Instead, the eggs got trapped in the ovarian wall itself, creating little follicles that could be seen on imaging. I recall reclining in that dark room, having just felt violated by a piece of technology. Still sitting spread-eagle on the exam table, an unreasonably attractive male OB-GYN popped his head in, surprised me, looked at the screen and said, “You know, PCOS—I…I think you have that…” He pointed out the little circles edging the oval-shaped ovary. “You see—the strings of pearls. That’s classic PCOS.” And then he walked out. He didn’t exactly have the most elegant bedside manner. The string of pearls, I thought. “Don’t cast your pearls before swine,” I thought again.
There’s never been a more hostile time to be a woman in our country and particularly in Idaho. Since the Dobbs decision in 2022, 25 percent of the OB-GYN’s, and 55 percent of the MFM's (maternal fetal medicine) have left the state. There are other areas where these physicians can still use their skills and knowledge to attend to women’s health and safely care for pregnant people. But maternity wards are closing in rural communities throughout Idaho as hospitals can either no longer staff them or take on the liability of delivering babies in their facilities. Idaho has a virtual abortion ban—no abortions after six weeks of pregnancy. Most women do not know they are pregnant until well after six weeks of not having a period. By the time they find out they are expecting, abortion is not an option. For my recent annual exam, I got bumped from my doctor’s panel and was asked to start seeing her PA. I can only imagine how busy and stressed my doctor and her colleagues must be. Too many women, too many pregnancies, too many babies to deliver, and not enough rights—for anyone.
Since I am not an obstetrics patient, I am to see the PA. I feel less important: as a patient, a woman, a non-pregnant person. It’s not my doctor’s fault, though. I love her, and I hope she knows that. She has been hugely supportive of me throughout the past twelve years as her patient, and I believe she would still treat me if she were not so overburdened and under-supported. Various OB-GYNs pass by me in the halls every day, running back and forth between their clinics and the hospital. I whisper little prayers for their well-being: may they be at peace; may they be happy and free.
So as I lay on that exam table this morning, I thought of the irony of the moment. Instead of excitedly awaiting the first glimpse of a fetus who would become my child, I watch as the tech securely identifies the device that will prevent me from conceiving. It’s supposed to last eight years. I’ll be 49 then, and likely perimenopausal. Who knows if birth control will even be available in eight years? But I have mine now, and I’m grateful for it.
Several years ago, I desperately wanted to have a baby with someone I loved very much. He was divorced and had two kids already, but for a few months I allowed myself to feel the desire of us having a child together. I am not a woman who has wanted to be a mom my whole life, but I came to experience the excitement and hope of loving someone so much that I would want to create a new life with them. Long story short, he wasn’t up for that, and I wasn’t ready to let go of the option. We broke up, a year later the pandemic started, and I’ve been single ever since.
A New York Times article I read a few years ago emphasized that the demographic affected most significantly by the pandemic was mine: single women in their mid-30s who hadn’t yet had kids. I know other women who somehow dated successfully during Covid, got married, got pregnant and now have a baby (if not two). But none of that happened for me, and now it won’t. I know that if it was really important to me, I could make other choices.
But it’s just not anymore. The world is on fire and only getting hotter. The looming election, mixed with current geopolitical conflicts, makes me fear we are on the brink of World War III. There is no way I want to bring a perfect new baby into this broken world, and so I won’t.
The tech said everything looks good, and the PA will call me later today to confirm. I had her print out a copy of the 3-D ultrasound picture, like all the moms-to-be do. There it is, and I’m so proud: the IUD resting snugly in my slightly arcuate uterus, surrounded by darkness, and shaped like a little heart.
Elizabeth Ryder serves as a chaplain in the outpatient oncology setting in Boise, Idaho. She enjoys all things outdoors, along with writing, gardening and exploring through travel and adventure. Connect on IG: @lizryder217