Then I measured the fetal head, snug against her pelvic bone. The numbers on-screen suggested that it was too small. I measured it again. Still small. So I measured it again, and again, and again. Everything else in this pregnancy looked healthy: the volume of amniotic fluid, the general size of the fetus, the structure of the heart and brain. According to the woman’s chart, everything had been fine, all the way through.

At that point, I needed to tell her about that small head and what it might mean for her future child’s development. This is not uncommon; it’s a situation I’m used to dealing with easily. But in that room, I was overcome with a strong urge not to tell her what I’d observed, because I feared where that discussion might lead. I am an American ob-gyn. In most states in my native country, third-trimester abortions are illegal or nearly inaccessible. In practice, only a handful of facilities in the entire United States perform abortions after 26 weeks for nonlethal anomalies. But here in Israel, abortion is widely available and can be offered until delivery. A subtle abnormality, such as the one I saw in that ultrasound room outside Tel Aviv, can prompt a discussion of pregnancy termination. Even at 35 weeks…

But in that dark room so far from home, I was deeply uncomfortable discussing abortion with a woman 35 weeks into her pregnancy, when that fetus had no clearly lethal or debilitating problem. By then, I’d been living in Israel for about a year, and practicing medicine at a local hospital for about six months. In Israel, everything was different—perhaps including me. In that dark room, I felt lost, as I confronted the outer borders of my pro-choice beliefs.