I don't want to be in a position where starting a family could end in my death because of a bad law.

For me, the debate about the right to abortion services in Iowa isn't an abstract principle. It's something that might actually impact whether I live or die, and whether I am able to become a mother.

I'm 31 and married to a wonderful man. I work in social services and he works with conservation programs. We were fortunate to buy a house in the country outside Decorah, where we have a big garden, chickens, and a border collie. We would love to start a family. We've been trying for two years now, and it's been incredibly challenging. I have had three very difficult first-trimester miscarriages that have resulted in a lot of blood, fainting, trauma, and depression.

It has become clear to us that if we want to continue to try to have a family, we need every medical option available to us, including options that would be classified as abortion procedures. Otherwise, it increases the chances that I could die, or come close to it, in the process of losing a fetus. I'm also worried that not getting immediate, appropriate care for a miscarriage could damage my reproductive system, forcing us to give up our dream of a family altogether.

I'm also at risk for an ectopic pregnancy, which is an extremely dangerous pregnancy that develops in a Fallopian tube instead of the uterus. If the pregnancy isn't terminated, the tube can rupture and cause internal bleeding that can be fatal for the woman if not treated immediately.

Right now in Iowa, abortion is legal until about 22 weeks with very limited exceptions, including not just the life but also the health of the mother. If the 6-week abortion ban that is now being considered for a second time by the Iowa Supreme Court goes into effect, I'm not sure what we're going to do.

My doctors have emphasized that I should consider in vitro fertilization, or IVF, if I have further miscarriages. The Iowa House of Representatives this month passed a fetal personhood bill that puts access to IVF in our state at risk. State senators say the bill is dead for this year, but I still can’t believe that, after all I’ve been through, Iowa legislators would consider taking away what could be my best option for having a child.

My husband and I have talked about moving out of state. I'm glad I live 15 minutes from the state border (Yup. I've timed it.) We use the Mayo Clinic in Minnesota, which is an hour and a half away. If I need abortion services during another pregnancy emergency, that might be an option.  But if I have a true emergency where minutes count, I would have to go to our local hospital here in Decorah, where doctors might not be able to legally give me the care I'd need. I am so afraid that I might die at the hospital because of Iowa law.

I don't want any of this. I just want to be a mother. Having to endure miscarriages of much-wanted pregnancies is bad enough. I don't also want to be in a position where starting a family could end in my death because of a bad law. I want important, urgent medical decisions to be made by me, my husband, and my medical team—not politicians in Des Moines.

Sarah Fleming lives in Decorah. She and her husband have had three miscarriages while trying for their first child.