My boyfriend and I were both pre-med students, about five years after the Roe v. Wade decision. We were studying for the MCAT. I was using a diaphragm for contraception.

I was, admittedly, a knucklehead, but boys can be knuckleheads in this arena without much in the way of consequences, while girls cannot afford to take chances. Right around the time that I realized that my boyfriend didn’t really love me, my period was late.

I was a high school sophomore when the Roe v. Wade decision was announced. Throughout high school, college and medical school, I was a feminist and supported a woman’s right to bodily autonomy, but I only knew one story. That story involved a young woman who knew that she was not mature enough to parent a child or a woman who needed to finish her education in order to have a future livable wage.

Before I decided to apply to medical school, my father said, “Pam, you should become a doctor. You’ll have a lifelong skill, help people, and be your own boss. Hang out your shingle, and then you’re in business.” I nodded, trying to envision the words on my potential shingle.

Prior to going to medical school, I worked part-time as a nurse practitioner for Planned Parenthood with a kind, caring, and responsible group of women. We provided counseling and classes on various contraceptive methods, basic gynecologic care, pregnancy and STD testing, and private counseling for abortions.

Even in the best of circumstances—having access to good healthcare, financial stability, and a committed spouse to share in parenting responsibilities—bringing a child into the world can seem overwhelming. And only the woman bears the physical discomfort and pain of nine months of pregnancy and a painful delivery and recovery. Oh, and did I mention the shifting hormones, postpartum depression, and breastfeeding? Childbirth is not for the faint of heart.

Twenty years ago, I became pregnant after having a condom break during sex with my then-boyfriend. This, despite also taking the morning-after pill. I learned about the unwanted pregnancy two weeks after graduating from college and three months before I was scheduled to leave the country for work as a Peace Corps Volunteer.

Decades ago, an acquaintance gave birth to a son I will call Sam. Despite his handsome appearance, Sam suffered from multiple challenges: he was blind, deaf, mute, and incapable of walking or of self-care, and he lacked any brain activity or emotional connections. Sam spent his life—which lasted into adolescence—in a wheelchair, oblivious to the hours, dedication, and money his supportive parents spent on him. While I know that his three siblings felt sadness for Sam, they also demonstrated signs of resentment, because the attention he needed deprived them of much-desired one-on-one interactions with their parents.