Kate Cox wanted to be a mom of three. Instead, she's a reluctant abortion advocate

IN THE TIDY BACKYARD OF KATE COX’S DALLAS-AREA home, there are two child-size lawn chairs alongside two toddler bicycles.

- CHARLOTTE ALTER

Cox at home with her two young children

There are two red-and-white stuffed horses in the playroom, and two sippy cups sitting in the sink. Everywhere you look, there are two of everything. The only problem is, there should be three.

Last year, Cox and her husband Justin were thrilled to learn that she was pregnant again. They had always planned to have a large family—three, maybe even four kids. When Cox saw the positive pregnancy test in August, she ran into the playroom to tell Justin, who was wrestling on the floor with their 3-year-old daughter and 18-month-old son. Justin immediately started considering whether they would need a bigger car; Kate was just excited.

But a few more weeks into her pregnancy, Cox got a phone call from her doctor. “She asked me if I was driving,” she recalls. “So I pulled the car over into an empty parking lot.” The doctor told her that the results of early screening tests indicated a risk of trisomy 18, a life-threatening genetic condition. “I cried for a while in the car,” Cox says. “In the same phone call, she told us that we were having a girl.”

It took weeks of additional testing and waiting before doctors confirmed the diagnosis. “Each time we had an ultrasound, there was more bad news,” Cox recalls, during an interview in her living room in early March. “By the end, sometimes I couldn’t look at the screen.”

Trisomy 18 is almost always a fatal condition. In rare cases, babies with milder forms of the disease can survive for years, but there were so many malformations to the fetus’s brain, spine, and neural tube that Cox’s doctor said the baby would probably die in utero. If she did survive birth, she would be placed directly into hospice care.