iPhone app iPad app Android phone app Android tablet app More

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors
Tamara Mann

GET UPDATES FROM Tamara Mann
 

Heartbeat: My Involuntary Miscarriage and 'Voluntary Abortion' in Ohio

Posted: 11/01/2012 11:30 am

On June 19, the state of Ohio declared that I had a voluntary abortion. My rabbi and my doctors disagreed. I simply wanted to be pregnant.

The ordeal began two weeks earlier; I was in stirrups. The sonogram technician needed more images. When she got them she looked ashen. "You should see a doctor today," she emphasized as she handed me the printed image of my 13-week-old baby or fetus, I still don't know what word to use. "But there is a heartbeat. Thank god there is a heartbeat," I mumbled. I had been here before. But last time, during my first pregnancy, there was no heartbeat.

I waited. I overheard the technician as she looked at the screen with the doctor, "this is bad, this is really bad." He wasn't my doctor, but he had a soft voice with a southern kick that I liked. He saw me, gestured for me to come to his office, and referred to the ailing life in my belly as a baby. "This isn't good," he whispered. "It's really not. Let me show you." He was kind but clear. "The organs are not inside the baby's body. The hands and feet are curled, actually one limb seems to be stunted or missing. The neck isn't right. This really doesn't look good." I looked at the expanded sonogram on his desk. I saw the hands turned in, the area that he referred to as the organs, the dead space where there should be a limb. Minutes ago, I had looked at this same image and smiled. "I don't understand," I replied. "What do I do now?" "Why don't you wait a week," he offered. "I don't understand," I repeated, "can the baby survive? Can these problems be solved? I don't understand exactly what you are telling me." "No, I don't think so," he said finally, "but there are always miracles."

I was withered, but functional. I knew this could happen and knew that I could recover. I had been blessed with a healthy child in between and felt, in my Nana's words, "Why should this be easy?" I decided to wait out the week. Looking pregnant, I returned to work, still hoping that maybe with more quiet time, with more love, next week the baby would be better. As I sat down at my desk, my own doctor called. To him, it was a fetus. "Tamara, I have looked at the scans and I have shown the scans to doctors in my office. I want to tell you that we all agree that this fetus is not compatible with life. It will not survive the pregnancy. You should get it removed immediately. The longer you wait the more risks are involved." I hung up the phone.

The idea of "removing" my baby, my fetus, while its heart was still beating was simply unbearable. Was it living? Was it still growing? Would I be stopping the heartbeat, cutting short its life? And what do I do after the operation? Do I bury it? I didn't understand what I had inside of me and I didn't understand what I should do. I called a dear friend, an Orthodox rabbi, who I knew would be both compassionate and firm. After consulting with his rabbi, he said the case was clear. In situations where the mother's health is at risk and the fetus (he explicitly said fetus) is not viable, Jewish law errs on the side of the mother's health. I should have the operation and I should not bury the fetus -- it is not a life.

The next morning I got the following message, "Because your fetus still has a heartbeat, it has been our experience that insurance companies in Ohio will not cover the costs of the operation. They consider it an optional abortion. Our office suggests that you go to Planned Parenthood, which will only run you $800. If you go to the hospital it will be over $10,000." I was stunned. What did my insurance company want, for me to have a dangerous late-stage miscarriage or go through the risks of labor to give birth to a stillborn? And why this obsession with the heartbeat as the sole marker of life? What about organ and brain function, what about viability? At that moment, I was extremely grateful for Planned Parenthood. But I still didn't want to go there. I wanted to support them, but I didn't want to have an abortion. I didn't even want to have anything that seemed like an abortion. I wanted to be pregnant. I wanted to have a baby.

My home morphed into a crazy lair of pencil scribbling, tissues and phone numbers. For three days we fought. My husband, my parents and my doctors made phone calls, wrote letters and tried every avenue possible to get the insurance company to change their mind. Finally, three days later, we got the news. Because of my doctor's carefully crafted letter, my insurance company would cover the procedure.

I thought the political nightmare was over. I thought I could start the process of mourning. I was wrong.

Another phone call, this time from the office of the OBGYN performing the procedure. You must come in 24 hours in advance. "Why?" "To sign a consent form." "What consent form?" Silence. "Well, you only don't have to sign it if you were raped." I was still completely confused. "I wasn't raped. I don't understand. What are you talking about?" "You are having an optional abortion right?" "No. I am having a therapeutic D&C (dilation and curettage operation to remove the fetus and womb lining) to remove a non-viable fetus." "But the baby is alive?" "Well, according to my religious faith, that is not so." "Is there a heartbeat?" "Yes." "Then, I am sorry to say, you are having an elective abortion and you must sign an informed consent 24 hours before the operation."

Roe v. Wade gave states the right to regulate abortion. State laws can mandate that doctors describe the risks of abortion and receive the informed consent of a woman before proceeding. In Ohio, a physician must meet with the pregnant woman 24 hours before the operation to explain the procedure, give the state sponsored materials on alternatives to abortion and receive a signed form stating that the pregnant woman "consents to the particular abortion voluntarily, knowingly, intelligently, and without coercion by any person...." There are "medical necessity" exceptions to this ruling, but due to custom more than statute, the sign of a heartbeat trumps other prognoses.

While Ohio is not the only state preoccupied with the heartbeat, it seems to be one of the most committed. On March 3, 2011, two pregnant women received ultrasounds in a state committee hearing. As Charles Lewis of the National Post reported, "The lobbying effort to end abortion in the United States moved into strange new territory Wednesday as two fetuses were presented via ultrasound to a packed committee room of the Ohio state legislature." State legislatures looked on as "a technician used a probe to show images of each woman's fetus on a portable screen. A heart monitor was used to project the sound of the beating heart of each fetus, nine and 15 weeks." This display was in service of the Heartbeat Bill, a piece of legislation that would make abortion illegal once a heartbeat could be detected. The bill passed the House but not the Senate.

In the vice presidential debate, Paul Ryan continued in this tradition, explaining his pro-life decision as a matter of "reason and science." He continued, "You know, I think about 10 ½ years ago, my wife Janna and I went to Mercy Hospital in Janesville where I was born, for our seven week ultrasound for our firstborn child, and we saw that heartbeat." What is going on here? Why have so many people settled on the heartbeat as the best marker of life in-utero? This is not science. It is the tyranny of a metaphor.

There is little consensus among biologists, doctors and ethicists on when life begins. The language here can be tricky. There all sorts of things they agree are alive -- from cells, to animals, to people. But that is not what they mean when they discuss life in utero. In this case, they mean life as something endowed with humanness, and worthy of rights, something closer to personhood. A brief look at the literature reveals a litany of standards for determining personhood: conception (day 1), implantation (day 6-7), detectable heartbeat (approximately week 6), detectable brain activity (approximately week 8), quickening (when the mother can feel the fetus moving), development of the cerebral cortex (at the end of the first trimester), viability outside the mother's body (now as early as 24 weeks with medical support), when the head is visible during labor, and when the baby takes its first breath. Smart, thoughtful people genuinely disagree. Even the Supreme Court had this to say about the issue in 1973: "We need not resolve the difficult question of when life begins. When those trained in the respective disciples of medicine, philosophy, and theology are unable to arrive at any consensus...."

In Judaism, the dominant metaphor for life is not the heartbeat -- it is the breath. In Genesis 2:7, God breathes life into man: "Then the Lord God formed man of the dust of the ground, and breathed into his nostrils the breath of life; and man become a living soul." Even that final word, soul, nefesh, can be translated as breath. My own rabbi's rabbi, Dov Linzer, explained it to me in this way. The definition of life can also be understood through our definition of death. At the end of life, the Talmud speaks almost exclusively about breathing. Breath was used as an indicator for life. The Shulchan Aruch says to test for a dying person's breath to know whether or not they are alive. So, if death is the absence of breath, life is the presence of breath. Life, personhood, is marked when the baby takes its first breath.

While a fetus is not considered actual life, Jewish law does acknowledge a continuum between potential and actual life, which guides, among other considerations, including the health of the mother, abortion rulings. According to Rabbi Linzer, the presence of a heartbeat, in itself, is not an important Jewish legal marker in determining the viability of life in utero. Even in the strictest ruling, he related to me, the fetus has to be able to live for a day outside of the mother's womb to be considered a viable life. The definition of potential life, he said, "is fully dependent on it being able to be born."

Life is not instantaneous. It is an arduous, miraculous, process. So many steps have to align -- so much has to go exactly right for a baby to take its first breath. When we start to think of life this way, the pro-choice/pro-life debates seem to me almost cruel. Neither accurately explains the moral nuance of each individual's situation or honors the complexity of creation. I wish we could reframe the debate and talk more about what it would mean to honor the sanctity of life. To honor the actual lives of pregnant women and the potential lives they hold within them.

On June 19, I sat down in another doctor's office and, as was required of me, read the pamphlet, "Fetal Development and Family Planning." I looked at pictures of fetuses at 12 and 14 weeks. I learned that at 12 weeks "a doctor may be able tell if it is a boy or a girl," and at 14 weeks "the head is erect and the legs are developed." The doctor was kind and she didn't make me watch the sonogram. She told me how lucky I was that my insurance would cover this and that she had a patient just a few months ago with my prognosis that had to give birth to a stillborn.

The next day, I had the operation. In the hospital, nurses, many of whom told me that they leaned toward pro-life, sympathized with my situation. Together, we chatted about the D&C, about how complicated it can be to have a child, and about how difficult this kind of a miscarriage can be. In those hours the debate between pro-choice and pro-life dissolved into one much more subtle and specific, one between the health of a mother and the viability of a fetus. One that felt like it was just about me.

When the anesthesia wore off, my two friends, who had traveled to be with me for the operation, told me that the doctor had come in. What did she say? She said the operation went very well. She also said that they did a sonogram before the operation. Tamara, she said, the heartbeat had already stopped.

 
FOLLOW RELIGION
On June 19, the state of Ohio declared that I had a voluntary abortion. My rabbi and my doctors disagreed. I simply wanted to be pregnant. The ordeal began two weeks earlier; I was in stirrups. The...
On June 19, the state of Ohio declared that I had a voluntary abortion. My rabbi and my doctors disagreed. I simply wanted to be pregnant. The ordeal began two weeks earlier; I was in stirrups. The...
 
 
  • Comments
  • 2,380
  • Pending Comments
  • 0
  • View FAQ
Comments are closed for this entry
View All
Favorites
Highlights
Bloggers
Recency  | 
Popularity
Page: 1 2 3 4 5  Next ›  Last »  (38 total)
05:55 AM on 12/29/2012
Powerful and thought provoking.
04:32 PM on 11/14/2012
Thank you for sharing your story with me. God bless you!
09:38 AM on 11/14/2012
What an emotional piece! Thank you for sharing, and may God bless you in your journey of life.
03:06 PM on 11/12/2012
To Continue:

In all of this, am I suggesting that you should have suffered a potentially life-threatening miscarriage, or gone through a dangerous delivery of a stilllborn? By no means. The surgical procedure of removing the baby was necessary - though it was not necessary while the fetus was still alive (note that "fetus" is simply a biological term for a certain stage in human development, like "newborn," "toddler," and "adult"). It would be medically possible to wait until to fetus had passed away, and then surgically remove it. It was neither necessary to have an abortion, nor to deliver a stillborn. Thankfully, in your case, the fetus had already died, though you were not aware of that at the time.

Again, I would like to make it clear that I am not trying to diminish the pain you experienced, the difficulty of the decisions you made, or the religious reasons behind your conclusions. I am only trying to present some basic scientific and medical realities so that we can all better understand what it means to protect the life of the unborn and its mother.
02:02 PM on 11/21/2012
oh, so medically possible, huh? How about the woman in Ireland who just passed away because the doctors would not give her a life saving abortion until the heartbeat stopped? Savita Halappanavar died of sceptic shock because they felt the life of the fetus was more important than the life of that woman.
04:51 PM on 11/22/2012
I was not aware of this case until now - thank you for mentioning it.
I read as much as I could about Savita's death, and found a statement by a number of OB/GYNs saying that a direct abortion was not necessary to save her life. These were the key sentences for me: “In current obstetrical practice, rare complications can arise where therapeutic interventions (including termination of a pregnancy) is required at a stage when, due to extreme immaturity of the baby, there may be little or no hope of the baby surviving. In these exceptional circumstances, it may be necessary to intervene to terminate the pregnancy to protect the mother, while making every effort to preserve the life of the baby.” In other words, the baby's and the mother's lives must be treated as equal; however, if the baby has little or no chance of surviving, the pregnancy can be ended to save the life of the mother without directly killing the baby. For example, inducing labor immediately probably would have saved Savita's life, but the baby probably would have died during or after birth because it was so young. ://www.lifenews.com/2012/11/21/doctors-no-reason-to-ok-abortion-after-savita-halappanavars-death/
I also found an article that says that under Ireland's current laws, there was no reason for doctors to refuse to induce labor. http://www.c-fam.org/fridayfax/volume-15/worldwide-abortion-campaigns-exploit-tragic-death-in-ireland.html
03:05 PM on 11/12/2012
Before the moment of conception, there is only "potential life," if we are to use that term correctly - a sperm and an egg which, remaining separate, will never become anything other than a sperm and an egg; but which, when joined, are no longer simply cells belonging to a man's and a woman's bodies. At that moment, a brand-new DNA is created, all 46 chromosomes are present, and a separate organism is formed which has every single piece of information necessary for normal human development. Biologically speaking, this is the moment when human life begins. Personhood is simply a synonym for human life - it has nothing to do with level of development. If we look at the only four characteristics that separate that organism present at conception from a newborn: size, level of development, environment, and degree of dependency - we recognize that these are the same characteristics that separate a child from an adult, a down syndrome person from a person without that disorder, the elderly from the middle-age. Yet in these pairs, one is no less "human" than the other; one does not have less dignity than the other.

"Why have so many people settled on the heartbeat as the best marker of life in-utero? This is not science." I agree. The heartbeat does not determine when a human life is present. As noted above, conception kickstarts the beginning of human development. The heartbeat is simply a visible indicator that human life is present.
This user has chosen to opt out of the Badges program
photo
thomasina 1
The Truth; and all that it en-Tails.
05:42 PM on 11/12/2012
None of that matters. Not "personhood", heart beat, ect. The only thing that matters, is what the woman wants to do with a pregnancy, and the well being of her body, and her control over that. After a baby is delivered, and is viable, after the umbilical cord is cut, then you have two human lives to consider. But not until. If It is a thing, in a woman's womb, then it is none of your or my business.
Concentrate on something else, in your own life, to control. I am sure there is some room for improvement.
11:06 PM on 11/15/2012
In light of the thoughtfulness of the article, I'm surprised by this comment. As radical as you likely consider the position that a life worthy of human rights begins at conception, your position is just as radical (if not more).

Human beings in a society constantly become involved in the behavior of others, because we recognize a social interest in that behavior. That includes what happens to a life that hasn't come out of the vagina and been cut from the mother's cord, but that has developed for nine months into a sentient human being (despite it being, you know, "just a thing"). And it also includes the health and welfare of women. Abortion debates must be about both rights, and unfortunately people like you are what embolden people like Todd Akin and his ilk. I'd be curious whether you were ever a parent, or whether you have ever known anyone who has been involved in an abortion procedure, or have ever been present at a birth, or seen a premature baby. Perhaps then you might realize this is a complex and nuanced issue.
photo
HUFFPOST COMMUNITY MODERATOR
LiberalLee
Yes I am a witch. Deal with it.
10:39 PM on 11/15/2012
New DNA isn't 'created'.
It's recombined from the nuclei of the generative sex cells of the two parents.
And btw? Your last two statements completely contradict each other.
01:29 AM on 11/16/2012
Hi LiberalLee,
I believe your first point is simply semantics. My point was that there is new DNA at the moment of conception - but thanks for giving us all extra info about the biological processes involved.
I'm sorry - my last two statements may have been poorly worded. I agree that the heartbeat isn't THE scientific proof of human life. However, the fact that a heartbeat is present is a very tangible piece of evidence that human life is, in fact, present. I hope that was clearer.
04:52 PM on 11/11/2012
What an ordeal! I feel for you. My wife and I lost a very-much-wanted child about 10 weeks into her pregnancy. Luckily, we were able to go on and have two wonderful children, now 19 and 24--but there weren't a lot of sympathetic ears or resources at the time. So often, the law with its absolutes can be an insensitive partner when things are not so black-and-white. I am sorry you had to go through the additional trauma of this very weird state intervention.
photo
HUFFPOST SUPER USER
Cecelia Nunn Haack
Art saves lives
12:42 AM on 11/10/2012
I am greatly sorry for your loss and ordeal. No woman should ever have to go though this kind of drama for a medical procedure. Thank you for having the courage to share your story. Peace be with you and your family.
photo
HUFFPOST SUPER USER
wbthacker
Can YOU pass the Turing Test?
09:56 AM on 11/09/2012
Thank you, Tamara, for sharing this painful experience and for illustrating how the maze of abortion restrictions makes tragic situations like this even more painful.
10:01 PM on 11/06/2012
I am sorry for the hardship you had to endure, I can begin to inderstand a womans point of view on this subject. Thank you for sharing. My opinion has no place in reponce to your story. Ill save it for later. Blessings to you.
05:11 PM on 11/06/2012
How absolutely beautiful. Thank you for sharing your heart wrenching story. These are troubled times in the insurance and health care business, just to name a few. I hope no one else has to be put through what you did. Kindly, Susan
01:04 PM on 11/06/2012
Here's the thing. I truly feel for the writer. Having lost a child at 39 weeks, it's a horrible thing to go through. And I support the law being made to stipulate that medically necessary (especially involving a non-viable fetus) abortions should be included. No one is that heartless or insensitive. But the data show that this type of abortion is in the EXTREME minority of the reasons for abortions.

http://141plus.files.wordpress.com/2012/10/abortion-reasons.png


There's a chart. Here's the article:
http://www.johnstonsarchive.net/policy/abortion/abreasons.html

To the rabbi who believes life begins at breath. How did God know Jeremiah while he was in the womb? Why would God have formed David if his life didn't begin until breath?
03:26 PM on 11/06/2012
"To the rabbi who believes life begins at breath. How did God know Jeremiah while he was in the womb? Why would God have formed David if his life didn't begin until breath?"

Why should your religion dictate my (or any one elses') reproductive and medical choices?
09:59 PM on 11/06/2012
Agreed. I was interested to read about a Jewish perspective, but no religion has a role in this issue other than to counsel INDIVIDUALS seeking their advice. (Sorry about the caps - wish I could bold or italicize instead.)
11:28 AM on 11/07/2012
At what point in my comment did I suggest that religion should? I shared that I thought that the rabbi's belief conflicted with Scripture. And my religion isn't even Judaism. So I'm not sure why you made this comment.

Clearly; this next question doesn't reflect on the article at hand; but considering a non-medical-need abortion. Why should the mother's decision/beliefs effect the child? At what point does a child have rights?

If an abortion is needed for a medical reason; if the child just isn't viable (though I have a niece that was "non-viable" that plays soccer with the best of them); then yes, by all means, it's extremely logical and perhaps compassionate to allow abortions. What are my feelings on those resulting from rape and incest? I don't know. Part of me wants to say that the child could/would be a blessing to a couple that can't have children, or even to that mother herself. But i can't make that call. I don't know. Statistical data shows that the grand majority of abortions aren't for medical reasons/rape/incest. That's a statistic, not my opinion.
This user has chosen to opt out of the Badges program
photo
10:15 PM on 11/07/2012
Well, if you believe is omniscient, then he would know everything. But the recognition of a potential life or the precognition of a life that will be is not necessarily exclusive of "life" beginning with the first breath. (I have also heard this called "ensoulment"--meaning the soul enters the body with the first breath. So, where are those souls prior to that first breath?)
11:24 AM on 11/06/2012
I believe the breath is when life begins.
11:17 AM on 11/06/2012
Not counting health issues, incest and rape, I think, most of the drama are the pro-choicer's who see the fetus as an object to discard, rather than a "living being" with its own "blood beating" heart.

Such as the case with 'casual sex,' each partner sees the other as "an object" to exchange body fluids with; however, totally disregarding the health risks of abortion or giving birth.

And I think most casual sex could be merely a pleasurable rebellion against religious teachings--good verses evil-- and how devilish it can feel to "get it on" in the church parking lot or in the closet just outside a church filled sanctuary.
This user has chosen to opt out of the Badges program
07:55 AM on 11/12/2012
"totally disregarding the health risks of abortion or giving birth"

Some do. The vast majority, especially those who have been offered and have had the time to go through proper sex ed, don't disregard it. But there's always a risk. Eating is a risk. Even if it's the most perfectly healthy food, you can end up choking and die that way.

You won't be able to eliminate risk, or eliminate people exposing themselves to risks because they seek something other than what they risk. What you can do, is find the optimal solutions, where people can do the most of what they want, with the least amount of risk.
01:21 PM on 11/12/2012
I think the "optimal solution" is men and women need to value each other as "emotional feeling" human beings more, much more, than sexual objects.

I think also "proper sex education" needs to happen during a child's most formative years with proper emotional bonding with parents. And I think this is not happening to the "vast majority" due to the billions of dollars being made by therapists and psychiatrists.
10:38 AM on 11/13/2012
Actually, statistically, married women are more likely than single women to seek abortions. You're being incredibly reductive to pretend that abortion is an issue that only affects those who engage in "casual sex." Oddly, by deciding that women who seek out abortions see everything as an "object," YOU'RE being incredibly objectifying and ignoring complexities to make it an easier moral issue for yourself.
photo
HUFFPOST SUPER USER
Rob Ferris
05:43 AM on 11/06/2012
Part of the reason this keeps coming up is this concern with "life". The issue itself is phrased badly.
Bacteria are alive, but we have no qualms about killing them. If I were to chop off my hand it would still be alive, for a while at least.

Personally I think we should be less concerned with whether or not something is alive, and more concerned with whether it is capable of suffering. Bacteria have no nerves; they have no idea that they're being killed. My severed hand has pain receptors, but without a brain it can't actually feel pain.

I would adopt the same position when it comes to a foetus. A foetus has typically formed a central nervous system, and the thalamic connections to receive sensory input to the brain, at about 24-25 weeks (thought it can be earlier). I would suggest this as a cut-off point, with room for exceptions when it comes to individuals who have developed early.
This user has chosen to opt out of the Badges program
08:30 AM on 11/12/2012
I see several aspects here.

If it can't suffer, it doesn't matter. No one should be concerned with the wellbeing of something incapable of wellbeing. Other than if you're looking into the future, and your concern is with what the state of it now, will have to say for its future state.

While, if our "life" concern is for the more refined human life capable of suffering, emotions, desires, etc., then we definitely have one such being present throughout, regardless of the state of the embryo/zygote/fetus. Personally, I don't really consider people to be pro-choice, if they want to take away the ability for people to choose what happens with their body, as soon as they see someone else being dependent on that body. Only one of them matters, and you're neither pro-life nor pro-choice, because you take away choice from the one capable of choosing. You decide which life takes precedence. And somehow it's the one that's occupying the other.

Pro-choice is about people deciding over their own body. If someone else depends on it, their future is at their host's mercy. If we had the technology to sustain and grow a healthy fetus outside of the womb, we could go on to discuss if we should in the event of abortions, mandate that they be grown by such technology, when we can do it without impeding bodily autonomy. Other than the fetus's, which we never ask if it wants to become.
This user has chosen to opt out of the Badges program
08:44 AM on 11/12/2012
Further there are various population concerns, where we might find that the best life is that which is welcomed, so we only want the future babies that are wanted. Not because we care about people being able to control their own bodies, but because we want the better results. Or you might find there to be too many babies being born, too many people around for the limited resources that we have to abide by, and abortion is preferable to letting babies or older individuals suffer.

But ahead of it all, contraceptives are superior, ethically and economically. If you don't want a pregnancy, don't let it even start. If you don't want to use resources (whether you're the individual or the collective) on abortions, or babies, use them on contraceptives, use them on educating people about the superiority of contraceptives. Of course, some people want sex to result in pregnancy (for everyone) for various reasons, and they're neither pro-life nor pro-choice. They're pro-pregnancy. Or possibly anti-sex, and pregnancy, along with the threat of STIs that they don't want people to learn how or be able to avoid, is what they use to fight sex.
11:34 PM on 11/05/2012
so what, your insurance should not be forced to pay for the abortion
09:14 AM on 11/06/2012
Well, then. I'm an insurance company, and I'd like to refuse payment for your CABG surgery. Your unhealthy diet and sedentary lifestyle caused this to happen to you, and I don't think I should have to subsidize that.
HUFFPOST SUPER USER
Wrenn NYC
'Cause I'm a smof...
11:29 AM on 11/06/2012
Your insurance pays for elective surgeries all the time. So that doesn't support your view.

Your insurance is part of your pay package, like your salary, and you can do anything with your salary, your employer has no say.

Most if not all, now) employees pay part of the premiums (out of payroll deductions) for their health insurance. But you want the employer alone to make the decision as to what that covers? The employer - who pays part - has no say? Again. this is a problem.
02:38 AM on 11/07/2012
really i have no say over what you do with your pay........try rolling in with a car not made by an american car producer......you will be parking in the far parking lot....and it is still a gravel lot.......try spending it on piercing and tattoos that are visible you maybe fired

so you're correct you can spend it how you want.......but no without backlash

but thanks for playing