It shouldn’t be this hard to find a birthday cake in a college town in suburban Maryland, even on short notice.
That’s what Emma Giglio thought as she walked up and down the busy streets, a bleak January air whipping her face. There were fast food joints, sports bars, casual restaurants offering every cuisine you could imagine. Just nowhere, seemingly, to buy a birthday cake.
Emma and her husband, Zach, kept going. Because they had to, even though at 24 weeks of pregnancy, Emma’s gait had changed. She was so much bigger with this baby than she’d been with her older sons, but that’s how it goes when it’s your third.
Emma Giglio
They found a Trader Joe’s. But nothing. How could it be that there was nowhere in this freezing-cold and unfamiliar town to buy a birthday cake?
They were running out of time. At this point they just needed something. So Emma and Zach walked back the way they came and went to Starbucks. Inside they ordered a cake pop. It was so small. Was it too insignificant to celebrate a birthday with? To honor a life with?
It would have to do. Emma got herself a chai tea latte. She had consumed so much chai tea this pregnancy, it felt fitting. She grasped the latte and the cake pop, clad in its waxy little envelope.
Then Emma walked back to the clinic, where she would get a shot in her abdomen that would stop her baby’s heart.
On June 24, 2022, the US Supreme Court ruled in Dobbs v. Jackson Women’s Health Organization that after nearly 50 years, pregnant people in America no longer had full rights over their own bodies—overturning the seminal 1973 Roe v. Wade that made abortion a Constitutional right.
Pro-life campaigners had spent years, decades even, preparing, and more than a dozen states had so-called trigger laws in place to ban abortion entirely, with limited exceptions, if Roe were overturned. As of summer 2024, 21 states either ban the procedure entirely with limited exceptions or have bans in place that begin as early as 6 weeks of pregnancy, according to a New York Times tracker.
South Carolina, where Emma and Zach live, had passed a law restricting abortion in 2021, but it could not be enforced until the fall of Roe. This legislation banned abortion from around six weeks of pregnancy, when proponents claim a “fetal heartbeat” can be detected (though this is a characterization many reproductive care physicians have pushed back against). It allowed for exceptions if terminating the pregnancy would save the pregnant person’s life or prevent them from grave physical harm; if the fetus was not expected to survive after birth; or if the pregnancy was the result of rape or incest (but only with law enforcement notification). Prior to then, abortion in South Carolina had been allowed up until 20 weeks of pregnancy, with limited exceptions.
Almost immediately after the Dobbs decision, South Carolina became somewhat of an abortion battleground—a legal challenge from Planned Parenthood temporarily reverted the law back to what it had been before the ruling, and the state’s Supreme Court then ruled in January 2023 that the six-week ban was unconstitutional. A group of five women “sister senators”—Democrat and Republican—banded together to fight to protect abortion rights. However, in May 2023, despite their best efforts, a new bill banning abortion after about six weeks passed the State Senate and was signed by the governor. And in August 2023, a newly all-male South Carolina Supreme Court reversed course, upholding that six-week abortion ban, nearly identical to the one that had been struck down earlier that year.
That same month Emma Giglio got pregnant with her third child. By June 2024, all three of the GOP sister senators had been voted out of office.
All of Emma’s pregnancies were different. She and Zach never wanted to find out the sex of their babies before birth; it is one of life’s last true surprises. But that didn’t mean she couldn’t guess for fun. She followed all the old wives’ tales: what she craved, her morning sickness level, how she carried. It never worked. Her symptoms were all over the place and had no correlation from one baby to the next.
During this pregnancy she craved orange juice. She drank a ton of it, something she’d never done with her two older sons. Any other differences, though, were unremarkable. She was probably more tired, sure. She and Zach already had two sons at home. But after having their first during the height of the pandemic in 2020 and their second less than two years later—the infamous “two under two”—they were used to a little bit of craziness, and they’d always wanted three kids.
Plus, that’s how the Giglios rolled. They were adventurous; they took risks. It’s how they had found each other, built successful careers as entrepreneurs, and decided to move to South Carolina, where they felt it was the place to build a life.
The way Emma tells it, Zach told her that he once experienced a moment of absolute clarity. He had been a recent college graduate originally from New York’s Long Island and had taken a job in Ningbo, China, a three-hour drive from Shanghai, to teach English. When he arrived in February 2010, he walked into the school and saw a mural where photos of all the foreign teachers were displayed on the wall.
“He saw my picture and was like, There she is,” says Emma with a smile. Then she jokes, “And then, yeah, my reaction wasn’t quite the same when I saw him.”
But soon she was similarly head over heels. Born and raised in Cape Town, South Africa, Emma had always been curious about the world beyond its borders. A formative experience came in high school, when she traveled with an exchange program to India. That led her to the study of Mandarin, then to China, and then to Zach. The next year they were engaged.
Emma and Zach searched a long time for a physical place to plant roots. After China they did stints in Zach’s hometown, did long distance as Emma figured out her visa, then moved to Washington, DC, so Zach could work in political communications. In 2014 they moved to Johannesburg for two years, but Emma had decided she wanted to raise a family in the States, and so they moved back to Long Island in 2016.
But then, after months of searching for a house they could afford and in the middle of a brutal Northeast February, they went on a weekend trip to Charleston and made one of those decisions that changes the course of your life. Sitting among the palmetto trees and the candy-colored houses, wearing shorts and T-shirts, they looked at each other and thought, What if we moved here?
Now, many of us have done the thing where you visit a new city, hop on Zillow, and begin to dream. But Emma and Zach were serious. They were working toward their own marketing and communications business by then, and they reached out to the local Chamber of Commerce to get a gauge of the local small-business community. They stayed in Airbnbs in different areas to get a feel for various neighborhoods. When they realized they could buy a beautiful house in the charming suburb of Summerville, best known for being the “birthplace of sweet tea,” for about a third of what they would pay on Long Island, they were sold.
Amid all the considerations Emma and Zach pondered as they weighed their move south, politics never crossed their minds. It was 2018, so it was the Trump administration, but Emma said the possible politics of their neighbors, or their state legislators, didn’t factor into their decision. And once they arrived, they found themselves in a neighborhood chock-full of fellow East Coast transplants.
“It’s very rare for us to meet someone who’s actually from here,” she says. “That’s like a joke in Charleston: Wait, you’re from here?”
As for abortion rights, Emma never gave them much thought. In South Africa abortion has been legal since 1996 (although not quite as unrestricted as in other countries), so the issue wasn’t on her radar for most of her life. “I’ve always been pro-choice, but I never knew that termination after 20 weeks was even a thing,” she says. “I was very naive. I didn’t pass judgment on a week deadline or anything. I felt like it should just be up to a person to choose what they want to do.”
She pauses. “So I don’t know. I was never really following it closely. It wasn’t really a big part of my life until it had to be, I guess. Until it affected me.”
Emma wasn’t sure why she felt a little anxious going in for her anatomy scan in December 2023, the ultrasound at 20 weeks of pregnancy in which a technician checks every part of the fetus to ensure it’s growing normally. Maybe she just had normal pregnancy nerves.
The technician started the scan, and then a senior tech came in. Then she kept going. And kept going.
“I was like, This is taking very long. This is the longest scan I’ve ever had,” Emma recalls.
The technician left, consulted with the doctor. She came back in. The doctor wanted her to rescan a few areas, she said. At this point they had been there two hours. Zach started to google, comparing the numbers on the screen to whatever “normal ranges” the search engine spat out. Emma thought it was okay, but Zach just had a feeling.
Then five people walked into the room. The junior technician, the senior technician, a genetic counselor, a doctor, and a nurse practitioner.
They told Emma that they saw multiple anomalies in her baby.
On the screen the doctors had seen two abnormalities in the fetus’s brain, problems with his heart, blood filling his kidneys. The medical team asked the Giglios to come back in two weeks for another scan when everything would be a bit more developed, and in the meantime they ran blood tests for a host of genetic diseases and infections.
As the results of the testing began to come back—negative—Emma began to feel slightly more hopeful. “We were still cautiously optimistic,” she said, clinging to the idea that they would go back for the upcoming scan and it would turn out that everything was actually fine.
The day before Christmas a batch of new results came into the online portal. Emma looked, and within a sea of reassuring negatives, she saw one line. The sex of the fetus: male. The baby was to be their third boy. It was the only bit of clarity they had while they sat through an agonizing two weeks of waiting, trying to parse the endless results of tests that came in and hoping each result would bring them one step closer to finding out their baby was healthy.
“It was good news in that everything was negative,” she says. Because some of the results were confusing, they went down a Google rabbit hole. “We were like, ‘We need a doctor to explain these to us. What does this mean? Is this a good thing? Is it not?’”
Then, finally, the day of the scan came. Everything was not fine. Everything looked worse. The same organs impacted, plus now the liver and extremely low levels of amniotic fluid. The baby might not make it to term with so little fluid to breathe.
The prognosis was grim, and confounding. All those tests led nowhere. There were no genetic diseases to explain what had ravaged their little boy’s body, no clear answer. There was no treatment they could try, no expected outcome or other kids they could look to for answers to see what kind of life their boy would have. The best theory doctors had was that Emma had contracted an infection that had made its way to her baby, destroying the life growing inside.
“We’ll never know what happened to him,” she says. “They equated it to us being struck by lightning.”
Emma and Zach had a choice to make, one they agonized over. They consulted Emma’s ob-gyn and saw specialists. They had two options. They could wait and see if the baby would be born alive, and if he was, how long he would survive, and if he did, what his life would look like.
Doctors they consulted had brought up the alternative.
“The other option, which they brought up very cautiously, would be to terminate the pregnancy,” Emma says. “And they said, “If that was an option for you, you can’t do that here. You wouldn’t be able to do that here.’”
Emma remembers sitting in the office of one of the specialists, where they went to assess the baby’s prognosis. They couldn’t stop asking questions. Some were more practical. Would their baby walk? Would he talk? How many surgeries would he need after birth?
Internally the couple were grappling with more existential questions. How could they best parent this baby? What quality of life would he have? Was the life he would live be a life worth living? What was the best thing for him? They asked one doctor, “If your daughter or son were going through this, what would you tell them?”
“Eventually, at the end, the doctor told us to read between the lines,” Emma recalls. It was clarifying. They knew the right thing to do would be to terminate.
At this point Emma was 22 weeks pregnant. If she had lived in a more liberal state, she would have been able to terminate the pregnancy in her own town, be seen by her own doctors, recover in her own bed. But because she couldn’t get an abortion in South Carolina, she had to travel hundreds of miles away for the procedure. It was a cold reality hitting both the Giglios and their physicians.
“If you’re a doctor, you have to have a heart for your patients,” she says. “That’s why you’re practicing medicine. And so to not be able to do that to the full extent is…I can’t imagine what that must be like. And also for me, knowing that I’m talking to a doctor who is trained and capable of performing that procedure, is sitting right in front of me and they can’t even do that, just adds that extra sting to it all. You could do it and you could help me through this immediately, but I was forced away.”
Emma had been through a life’s worth of trauma the past few weeks. And now she saw how much more she would be forced to endure.
Two more weeks. Emma had to endure two more weeks in a pregnant body, one that kept growing. It was agony.
They really shouldn’t, but people just can’t help commenting on a baby bump. Emma would be at the gym and people would stop her to ask her when she was due. Another reminder that her baby wouldn’t live.
“Where do you want to go?” Emma says her ob-gyn had asked her when they first discussed termination as an option. They started searching in New York and Maryland, two states where Zach’s family lives. They found two clinics, both in the DC metro area; one, Partners in Abortion Care, could see Emma when she was 24 weeks.
What happened next Emma describes as “logistical trauma.” It was all the normal headaches and stress of arranging a complex medical procedure—transferring medical records, connecting doctors to one another, talking to billing departments—all coated in a layer of agony. Every step felt like a knife to the gut. Having to call and say the words “I want an abortion.” When Emma wanted to scream, “I want this baby. I want him.”
The procedure itself cost $7,500, and it’s not covered by health insurance. Emma and Zach planned to put it on a credit card, but then a week before they were scheduled to leave, they got a call. A clinic social worker had connected them with The Brigid Alliance, a nonprofit that provides logistical and financial support for pregnant people to travel to get abortions. Over the next week representatives from the organization arranged the procedure, booked Emma and Zach’s flights and hotels, even gave them money for their Uber to the airport.
“They just came in and said, ‘We’ll take care of this. We’ve got this. You just focus on yourself and your family. We are holding you and we’ve got you,’” Emma says, through tears. “So it was amazing…when it was extremely isolating and lonely saying, ‘You can’t do this in your home, you’ve got to go away from your home,’ they were there for us.”
Emma was blown away by the fund, and their generosity. But the fact that nonprofits have been created to help people in her position didn’t take away from the sense of injustice she felt deep in her bones.
Every step felt like another slap. The fact that she had to leave her two boys, fly away from them when she needed them the most. The fact that she had to worry about childcare for them for multiple days, when she could have snuggled with them in bed after the procedure. The fact that in the hours before she left to experience one of the hardest things she would ever go through, she was writing out instructions for her mother-in-law, who flew in to help. She was stacking meals in her fridge, making lunches, writing down her boys’ nap times.
Then there was packing for herself. Never had packing a hospital bag, an activity that has become an Instagrammable milestone for moms-to-be, felt so horrible. Because she was packing a suitcase. For a different climate, going and buying winter gear she’d long since discarded, and shoving it into her bag.
“I also was like, ‘I’m going to be bleeding, and I’m traveling. I don’t want to be wearing white,’” she says.
Emma wouldn’t be having a normal recovery, being monitored and checked on in a hospital postpartum ward. Once the baby was out, she was on her own. What should she wear to leave the hospital? With her older sons, Emma had fun picking out floral dresses, cute enough for photos but stretchy enough to be comfortable on her postpartum body. She couldn’t wear a dress in Maryland in January, and besides, it just felt wrong. She settled on a sweatsuit, in black. For the baby Emma picked out a blanket and cap with little cars on it, a display of gender she couldn’t do before for her surprise babies.
Emma and Zach left on a Wednesday. For the 30-minute drive to the airport, the driver was chatty, engaging with Zach about nothing, really. Emma just sat in the back, staring out the window.
“Even when I think back on it now, it feels like an out-of-body experience,” she remembers. “I still sometimes feel like, How did this happen to us? It doesn’t feel real.”
At the airport Zach remarked that this was the first trip they had ever taken together that he wasn’t excited about. They boarded the plane. When Emma handed her ticket to the agent, the woman looked at her obvious baby bump, then her name on her ticket, and smiled.
“Is a little Emma coming soon?” she asked.
Partners in Abortion Care is located in a sprawling yet understated office park made up of Colonial-style red brick buildings. Diane Horvath, MD, an ob-gyn who specializes in abortion care, cofounded the clinic and opened it just months after Dobbs; since then she’s treated patients from all over the country, ranging in ages from 11 to 53. She tells me it’s the only women-owned clinic in the country that offers abortions at up to 34 weeks of gestation, one of a handful to do so that late in pregnancy.
“We knew there was a need for later care,” she says. “And we knew that there were only a few places that saw people beyond 30 weeks.”
On the first day of the two-day procedure, Emma and Zach decided to walk from the hotel to the clinic. It was freezing, but it felt almost nice, she thought, to have the cold air sting her cheeks. They walked through the parking lot, down a long outdoor hallway with signs for every type of medical office you could imagine, until they reached a door that simply read “Partners.” The outside of the clinic was nondescript, save for a cheery rainbow-colored welcome mat reading “Safe Space.”
It wasn’t until Emma had sat down in the waiting room that she felt it. Despite the plush chairs and feminist artwork and creature comforts like a Keurig, water, and snacks, she felt alone. The whole situation at that moment felt incredibly unfair.
It’s cold outside, she remembers thinking; this is not the environment that we’re used to—I’m away from my children and my home and the comforts of my bedroom. “It just all hit me, that weight, how unfair this is…it just was like, This isn’t where we should be right now.”
Emma had spent a lot of time on the internet over the previous few months, and had found support groups, where other parents who’d had to terminate for medical reasons gave advice. Emma was drawn to the tips for how to celebrate your baby’s life. Because they knew his sex, they could choose a name. Emma had always liked Siya, after the South African rugby star Siya Kolisi, who Emma admired for his strength and perseverance. They had batted the name around before, but this time it felt right. He was their Siya.
Emma wanted to honor Siya and celebrate him just like any other baby. Her doctors back home in South Carolina had recorded his heartbeat and placed it into two stuffed animals for his big brothers. And she had clung to one idea that another mom who’d lost her baby had told her about: to have a birthday party for him the night before. Buy a cake and sing to him. Tell him about his brothers, how much they loved him, and how much they would miss him.
But when Emma was finally seen, she learned they didn’t have one more night. The last thing they would do at the appointment that day was give her the injection to stop Siya’s heart.
“But they said, ‘All of the rooms right now are full, so you have a couple hours if you want to go out and do something,’” she says.
Emma and Zach went out into the cold, feeling numb. There wouldn’t be a birthday party after all. They would have to change their plans. Emma was heartened to spot a Nando’s, a popular South African chicken franchise, just down the road. It felt like a sign from home. They got lunch, searched for a cake, and bought the cake pop. And then it was time.
“We went back to the clinic and they gave us the room to ourselves so that we could talk to him,” says Emma. “And we just told him how much we loved him and we sang and we didn’t eat the cake pop. It was cut short, I guess. Then they asked if we were ready…and we said yes. And I don’t know how I did it, but I sang him to sleep. I sang, ‘You Are My Sunshine,’ which is the same song I sing to my boys every night. And then they’re done. And they say, ‘Sorry for your loss.’”
It’s hard not to view the entire, awful experience through the lens of what-ifs. What if they were in Summerville? For one, Emma and Zach would have gone home after saying goodbye to Siya, home to their boys, to their own space. Instead, they went back to a hotel room and ate takeout. Emma spent the night lying there, the effects of the drugs she had been given to induce labor slowly working their way through her body.
In the morning she went back to the clinic and prepared to deliver Siya. It would be her first vaginal delivery, something special, she thought. Both her other boys were C-sections, and had her pregnancy progressed much further Siya would have had to be a C-section too. As it was, he was just young enough gestationally.
Partners in Abortion Care provides a space for patients to labor together as the drugs begin to take hold. It’s a narrow room on the smaller side, with a row of big lounge chairs. There are medicine balls and peanut balls for laboring, books and magazines, and a TV. There are also notebooks, which the staff replaces when they get full. In them patients write notes of encouragement to one another, and to those who may come after them, like I felt so alone but if I can do it you can, you’re stronger than you think, keep going. Some sign their first name, others just their initial. Some draw pictures.
Emma sat in there all day, not incredibly uncomfortable but noticing as the medication began to take effect. Dr. Horvath says that the goal is pain management and making the patients as comfortable as possible; there’s no need to restrict any medication that could harm a fetus, as there is in an average labor. Around 4 p.m. Emma started bleeding. The contractions grew strong. She went into the room where she would deliver and then, nothing. For the actual birth she was sedated.
When she woke up, she and Zach made their way to a recovery room. And then they got to meet Siya. He was in a Moses basket, clad in the hat and blanket with cars that Emma had picked out (in her spare time Dr. Horvath also crochets hats for the babies whose mothers would like to see them).
“It was not easy, but we had the time that we had with him,” says Emma.
They held him, snuggled him. They took photos with him. But their time was short. They were the last patients of the day, and there was a snowstorm coming. The staff had to go home. They had to say goodbye.
The nurse brought Siya’s blankets to Emma and Zach to keep. As she clutched them, she felt the wrongness of it. If she had his blankets, where was he?
“I think as a mother, your role is to protect your children and you just want them to be warm and safe. And the thought of ‘I have the blankets and he was not swaddled…,’” she trails off.
“And now we had to leave him behind,” she continues. “And then we had to get on an airplane and leave him behind.”
It was the final what-if. The final, unbearably barbaric cruelty. Because Emma not only had to face leaving her infant in that office; she had to get up in the morning, get on an airplane, and fly away. She thinks she blocked a lot of that night out of her mind. It was too painful.
“What I do remember is just feeling empty,” she says. “A hotel room, I think sometimes can feel empty, and my body was feeling empty. I didn’t have my baby.”
All Emma wanted to do was crawl into bed and not get up for a while. But in the morning, less than 24 hours after giving birth to her son, she was in a car, headed for the airport.
“I was forced to have to get out of bed and get dressed and go to an airport and be in public and sit there amongst everybody else as if I didn’t just give birth the day before,” she says.
Sitting there, in an airplane seat, bleeding and bleeding and bleeding into her heavy pads, her body aching, she could only think of Siya. But with hindsight, she reflects on the situation she was forced into. She thinks of everything she went through. How can anyone think that it was just?
“I don’t think people understand the level of trauma that can have on a family,” she says. “If people can think through the journey we had to take and understand the gravity of that. Especially being as far along as I was. You actually are going through the process of giving birth; you labor an entire day. You’re exhausted, you’re going through contractions, you’re eating Popsicles all day, you’re going through the process of labor, and then you are actually physically giving birth. Sedated or not, your body is still working and doing all that stuff. Then having to leave and get on a flight, when usually in any other birthing situation, you are in a hospital recovering for at least 24 hours. I don’t know if people really get that.”
It’s been nine months. Emma is still grieving, but she’s getting by. Telling her older son the baby had died was hard. Her due date coming and going was hard. When iPhone memories pop up of her older sons as infants, she thinks to herself, Siya should be doing that now, or, Siya should be using that swing.
Emma has had a lot of time to think about what to do now, as Siya’s mom. She can no longer parent him physically. How does she parent his legacy?
One idea she has is sharing his story. Siya is always with her, and she wants him to be an ever-present member of the family. She doesn’t want to stop talking about him, or put him away. She wants to tell people about him, let them know what happened, and hopefully his life could help someone else.
“A lot of people have said I’m very brave for sharing my story, and I feel like brave means that I am telling my story in fear of judgment, so that’s why I’m brave,” she says. “But I feel like there’s so much stigma around termination for medical reasons, infertility, miscarriages, that people don’t talk about it. And I think it would be great if we lived in a world where these things can get spoken about and we can just be parents sharing stories about our children who didn’t make it.”
She’d also like to think that for those who implemented the laws that caused her so much added grief and trauma, the cruelty isn’t actually the point. If she shares Siya’s story, the people who are doing this may realize how misguided these restrictions are.
“I want to share my story so that people can have a greater understanding around the complexities of reproductive health,” she says. “It’s not getting a pregnancy test that’s positive and the outcome is a happy, healthy baby at the end. That’s not how it works. Unfortunately, we had an experience where that wasn’t the outcome for us. And we suffered a tremendous amount of trauma having to fly away from our home and have this procedure done with doctors we didn’t know in a place we didn’t know…. This is not a black-and-white, easy issue. This is very complex.”
Now Emma thinks about Siya all the time. So many things remind her of him. Inevitably, she can’t go to an airport without thinking about the trip she made to say goodbye to her baby boy. For the rest of her life, being on an airplane will remind her.
So Emma and Zach have embraced it. They get to the airport, find a corner bar or place a drink order once onboard. They order mimosas, because Emma couldn’t stop drinking orange juice when she was pregnant. They drink and they toast to their baby boy. To Siya.
Photography by Lindsey Shorter
Licensed images: Abortion clinic by Maggie Shannon; Maternity photos by Amber Joy
Video: Anatasia Sanger