Knowing Her Unborn Baby Will Die, Mother Choose Life Pro-Life Infonet 9/5/01 Philadelphia, PA — Marcie Macolino is carrying a baby she knows will die. Maybe in childbirth, more likely in the first week, almost certainly within three months. The baby is due Thanksgiving. Marcie knew early in her pregnancy that this baby — whom she and her husband have already named Abigail — would die. Yet Marcie always planned to carry this baby to term, to give Abigail what life she could. The mother of three lovely children, Marcie has already lost three pregnancies — all for different reasons. And all different still from the chromosome disorder Trisomy 18 that will kill Abigail. Marcie also happens to be Dr. Marcie E. Macolino, a much–loved pediatrician who daily treats and nurtures thriving newborns, all the time knowing the baby inside her will struggle and perhaps suffer from the first breath. Marcie, 35, thinks of her work, as well as her mothering, as a calling from Jesus. Though she weeps at home and mourns for the baby yet to be born and has become too well acquainted with grief, she does not question God or lose her faith. "My whole life has been turned over to God," she said Wednesday afternoon at the kitchen table in her Germantown home. "He's the one that made me, that saved me. I consider it a privilege, whatever it is He wants me to do. This underlines not only why I'm a pediatrician, but this pregnancy as well." Marcie's mother and father were missionaries, first in Kenya, then in American cities, settling in Philadelphia. Her father died when she was 12. By ninth grade, she knew God's plan for her. "I really felt called to be a pediatrician," she said. She met her husband, Jerry, at church. They consider themselves Disciples of Jesus, a form of evangelical Christians. They really got to know one another in 1988, working together on a house in West Philadelphia for Habitat for Humanity. She works two and a half days a week as one of four physicians with Mount Airy Pediatrics. He works the other two and a half days as a computer consultant. They school their children at home. Their first child is Sarah, now 8, and beautiful, who can play Beethoven's Ode To Joy on the piano and who consoled her father, even cooked him dinner the other day when he collapsed in tears over Abigail. Their second child is Thomas, now 6, a concrete thinker who recently said to his mother, as she tucked him into bed, "So, this kid's going to die?" After Thomas, she became pregnant with twins who were in the same embryo sac and died at 13 weeks. Next came a boy who died when her placenta separated from the uterus. She went into labor and delivered him at 17 weeks. Jerry held his son in his palm. He was perfect, seven inches long, seven ounces in weight. Third came a boy who had Down syndrome whose heart stopped beating in utero at 17 weeks. Marcie asked friends and family, she prayed to God: "Am I crazy to keep having children?" The answer she heard and felt was: "No." Soon she became pregnant again, this time with Peter, now an adorable one–year–old with curly blond hair. Peter, they believed, was a gift from God. Marcie and Jerry thought the heartache was past, at last. "There's really a sense of moving on," Marcie said, "when you have a healthy baby after these three losses." They wanted to have one last child, maybe another girl. This spring, Marcie became pregnant with Abigail. Ten weeks into her pregnancy, Marcie was bleeding. In an ultrasound test, doctors saw a big pocket of fluid under the skin around the baby's neck. That suggested a chromosome defect. Doctors wanted to give Marcie tests to determine exactly what was wrong. She declined. "We decided whatever the information was, we weren't going to do anything," she said. "So no further testing." Over the next several weeks, the situation became more grave. Marcie never doubted she would keep the baby, but decided that as a physician and a mother, she needed to prepare for what was to come. Doctors did an amniocentesis, a check for chromosomal defects. On July 13, at 21 weeks, a doctor called Marcie at home. "It's Trisomy 18," the doctor said. ""Is it a boy or girl?" Marcie asked. "It's a female," the doctor said. According to a medical textbook in Dr. Macolino's office, "Babies with the Trisomy 18 syndrome are usually feeble and have a limited capacity for survival. Fifty percent die within the first week and many of the remaining die in the next 12 months. Only five to 10 percent survive the first year as severely mentally defective individuals." From the very instant her specialists determined the baby had a fatal disorder, she said, "their words became incredibly dehumanizing." "I was appalled because he was still offering me the option to terminate my baby," she said of her doctor. "My calling is to children whether my own or others. I consider that to include unborn children. I knew that ending the life of any child was not an option for me." Her midwife supported her. "You can give your baby the gift of carrying it," she told Marcie. In her Mount Airy office, Dr. Macolino has an obvious rapport and devotion to children. She switches seamlessly between baby talk with a 3–year–old, "Hey pumpkin! Big breaths! Big. Big. Big," and adult conversation with the parent: "She's got some stuff going on in her lungs. I hear some wheezing now." At work, she shows no hint of her grief. Her focus is entirely on her patients. "When I'm at the office, my mission is to provide medical care for them," she said. "When I'm home, that's when I cry and cry and cry." She is now 28 weeks along. "It feels like forever," she said. "This is the eternal pregnancy." Two weeks ago, at her request, a letter from Mount Airy Pediatrics was sent to hundreds of families. "Dr. Macolino will be out on indefinite maternity leave after Thanksgiving," it said. "Unfortunately, her little girl has Trisomy 18, a genetic disorder, and is not expected to live long after birth. We hope you will support her with your thoughts and prayers." Dr. Macolino couldn't bear the idea of parents' asking every day, "Aren't you excited?" "I did it for me and for them," she said. Parents have responded in many ways. One asked to pray for her, right in the examination room. "I was devastated," said Iris Carter of Collegeville, mother of Ashleigh, 3, and Jordyn, 1, in the office Wednesday for checkups. "I think she's very brave. A lot of people probably would have aborted. Knowing the baby's going to be born and not live very long, a lot of people wouldn't continue the pregnancy. I admire her for doing so." Marcie's colleagues at Mount Airy Pediatrics respect her decision and feel sad for her. "You don't want to see it happen to anybody, but to Marcie even less," said Jennifer Louis-Jadotte, the office receptionist and a good friend. "She loves children so much and what she does so much." Abigail has been vigorous in the womb. "Sometimes I enjoy that," Marcie says. "And sometimes it makes me feel sad about what we're going to lose." She is familiar with grief and has been since she lost her father when she was just a girl. She knows it will come in waves, and when the waves come, it will devastate her. Being a doctor, she also knows — more than her husband can imagine — the demands and pains of a severely disabled, special–needs baby. "I know," she says. I've seen them — at all hours." Jerry knows he can never feel exactly as his wife does. "I don't carry her," he says of Abigail. "I don't feel her kicking." He said he had tried to imagine losing one of his three children to anticipate what it might feel like to lose Abigail. "We pray for her to have limited amount of pain and discomfort," he says. "My first goal is to make her comfortable. The second goal would be to make her last as long as she can, but not at the expense of the first goal. "I've wanted this baby as much as any," he said. "I'm already starting to miss her — which may sound funny — even though I haven't met her yet." Marcie chose the baby's name. It means "my father's joy."