Did I title this post so you would read my thoughts about the value of reproductive choice? Yes, I did.

The first day of class, after introducing myself to my students and trying to encourage conversation, I asked if they had any questions for me. “Madam, how old are you?” asked a timid young woman in the front. Wow, I thought, really going for it. “I’m thirty one,” I responded. “Any other questions?”. “Madam, may I challenge you?” asked a bolder gentleman in the back. Oh boy, here we go.. I smiled and nodded, completely unsure what might follow. “Is it not more dangerous to have children when you are older?” he asked, both smug and sincere.

After I got over the shock of being asked this question on my first day as an educator in Tanzania, I gathered myself together and answered him. “It is true there are some risks with having children when you are older and when we get to that point in class I will share my decision making of weighing the risks and benefits with you all.”

While this was the most poignant question I have received on the issue and perhaps the most inappropriate considering the circumstances, it is a question I get on the regular.

As I reflect on my 32 years, and not currently having children, my thoughts wander not to if I will have them or what that will look like but the power that reproductive choice has played in my own life. I’ve had a good 32 years. I was able to complete my master’s degree, pursue fulfilling and meaningful work both in the US, Ghana and Tanzania. I’ve partnered my life to a loving and thoughtful human being. I’ve been able to explore so many corners of the world that as a young woman I only dared to dream I might one day see. I have had the choice to do all of this without having children. That is not a reflection on the value of having children but on what it has meant in my own life. I, of course, have tons of friends, sisters and patients who have made other choices. Who have felt differently. Who would be deeply disappointed to not have children at 32. Many of them have exercised their own reproductive choice to pursue families in whatever conventional or unconventional ways they have desired and I am the happy aunt to many wonderful tiny people.

I was brought up to believe that my body is my own and that I am in charge of it. To dream about how I could contribute meaningfully to the world with both my mind and my heart. To live in love. I have always believed I have had a choice. This belief, the power of autonomy, has given me keys to open so many doors in the world.

I have cared for and loved people who have had to make really hard choices.

I cared for a woman who was beaten so badly her face was fractured and she didn’t leave the house for months, who faced another pregnancy that she feared would put her life at risk and might leave her four living children without a mother if she didn’t terminate.

I have sat beside a woman at 13 weeks of pregnancy and delivered the news that the anomalies her fetus had make it incompatible with life, who sobbed in despair as I sat beside her.

I had to tell a woman in prison that the complications of her fetus, diagnosed at 20 weeks, would make it near impossible for her fetus to survive outside the womb. Yet as a prisoner in the government system, she had no choice but to carry this child to term should it live that long.

I have patients who have had to decide if they should spend tens of thousands of dollars on assisted reproductive technology in order to conceive.

I have friends who have wanted so badly to conceive but couldn’t so considered adoption or fostering instead.

I am not sharing the outcomes of these scenarios. Knowing the outcome only allows us to make a judgement about their decisions but the judgement is not ours to make. Each woman’s reproductive choice is her own. Only she lives inside her own body, only she will bear the burdens and the joys of the decisions that she chooses to make for herself. Other people will feel them, yes. But she is the owner of them. She is the sole owner of her body.

As I am the sole owner of mine. Writing this feels personal. Just as the government becoming involved in the reproductive choices of women is personal.

I am proud to be a woman. I am proud to care for women. I am proud to stand up for women. Looks like there’s going to be a lot of standing in my 33rd rotation around the sun.