What it’s like to take the abortion pill


One woman’s experience with RU-486.

Woman looking through window at home. sad introspective alone thinking reflective moody depression abortion

My period wasn’t due for another few days, but I knew I was pregnant. The three previous pregnancies that blessed my husband and I with our cherished, healthy children began with the same symptoms: a creeping nausea, bleeding gums when I brushed my teeth, a sudden aversion to my morning cup of tea.

But there was no question of continuing this pregnancy. For personal reasons – health, family, employment – I knew it with unwavering certainty.

Living in regional South Australia, my local area health service was my only option. My GP was empathetic. Apologetically, he explained that before I could access a termination of pregnancy I would need to have a blood test and an ultrasound – the ultrasound to confirm gestation, and to ensure that it was within my uterus. It was the law, I had no right to informed refusal. More positively, a medical abortion was now available to me, an option less invasive or risky than surgical dilation and curettage.

However, for the ultrasound to be definitive I would need to be five to six weeks pregnant. And that day, at my GP’s office, I was merely three weeks and four days pregnant.


During that long fortnight’s wait I became increasingly symptomatic, and swung between pragmatism, frustration and quiet sadness. I cared for my children, tried to keep busy, and tried not to think about what ticked inside my body.

Getting the blood test, the nurse remarked over the baby’s due date – close to Christmas. When I politely informed her I was having a termination she coloured and stuttered. When I made an appointment for the ultrasound, the receptionist asked, How many weeks? And then eventually, lying on the bed in the dimly-lit room at the imaging clinic, the sonographer turned the screen away as she inserted the transducer into my vagina. Everything is where it needs to be, she told me.

Finally, sitting in a consultation room at my local women’s health clinic with the licensed doctor and a nurse, I signed forms and consented to risks. The procedure, its side effects, and how it might feel were explained to me. I was given painkillers and antinauseants to take home and then, at last, I was handed a small, square foil blister pack containing a single, large, round tablet.

A medical abortion is essentially a forced miscarriage. Two drugs are used to induce menstruation: the first, mifepristone, more commonly known as the abortion pill or RU-486, is an anti-hormone that blocks progesterone, the hormone essential for a pregnancy to continue. Two days later a second drug named misoprostol is given that induces uterine contractions to expel the products of conception.

After taking the mifepristone I went home, flooded with sad, grateful relief. No side effects presented themselves after taking the medicine, although I still experienced strong morning sickness.

Two days later, on the morning of my second appointment, I lost a clump of blood-stained mucous. It was almost over. Returning to the clinic I was given four misoprostol tablets, tiny and hexagonal-shaped. The nurse helped me insert them buccally – between my cheek and lower jaw, two on each side, where they would dissolve over an hour and be absorbed into my bloodstream. The pills were tasteless, and I could talk and even drink water whilst they gradually disintegrated.

On the way home I felt apprehensive. I’d been told to expect anything from mild discomfort to excruciating, labour-like pain, but I only trembled with adrenaline. About an hour later, I went to the toilet and noticed I was bleeding. A smear of bright red blood upon wiping.

It was sixteen days late, but my period had arrived.

Other than some initial cramping, my menstruation is rarely uncomfortable. This was the same. Mild, painless cramps, no vomiting or nausea except for the lingering morning sickness. And six hours later, my nausea disappeared. For the first time in two weeks I ate dinner with my family. I was able to smile and laugh with them.

For six days I had moderate, period-like bleeding, and on the seventh day I lost the pregnancy tissue – a lump of reddish tissue, about the size of a fifty cent piece. At first I thought it was a blood clot; there was nothing discernibly foetal about the shape or appearance. But it was firmer than a blood clot, and lighter in colour. I felt a sense of intense closure, a gratitude of sorts. After this, the bleeding slowed to light spotting for about another ten days.

My menstrual cycle returned, as normal, one month later, almost like clockwork.

Despite the regular use of mifepristone for over two decades in 46 other countries–including China, New Zealand, the United States, Canada, and the United Kingdom–medical abortion has only been available in Australian since 2012. Appearing on the WHO Model List of Essential Medicines, in some countries the abortion pill is available over the counter.

For as long as women have been fertile, women have experienced undesired pregnancy. The safe availability of medical abortion for early pregnancy is a progressive, positive step for Australian women. However, abortion still remains on the criminal code in most Australian states and territories. Even in ACT and Victoria where termination of pregnancy is entirely legal, the abortion pill is only available from specialist clinics and practitioners and only after an ultrasound.

Each woman’s experience of medical abortion will be different. It can be unpleasant or painful, and not all women will feel comfortable experiencing a miscarriage at home. It can take days, there is blood, and involves passing foetal tissue. But I found the experience cathartic. I was able to grieve, and I was able to nurture my body and what it was going through. And despite Australia remaining decades behind other countries in its availability of abortion, I’m grateful to live in a time where I have safe and legal access to this vital procedure.

Like most women who have had an abortion, I feel regretful it had to happen, but no regret that it did happen. Although I hope I never have to, if I found myself unexpectedly pregnant again, I would choose another medical abortion.

*Not the author’s real name. Some details changed to protect identity.



The cancer that was Musharraf’s regime

The cancer that was Musharraf’s regime

Like any illegitimate ruler, Musharraf’s core aims were survival and gaining legitimacy, and his every decision was a manifestation of these vulnerabilities
With the assault of the Pakistan Tehreek-e-Insaaf (PTI) and Pakistan Awami Tehreek (PAT) on the capital, doubts have been raised against democracy and the constitutional process once again. In the heat of it, voices are rising in quite a few circles for a military takeover in the county. The rationale they present is the glory of the Musharraf regime. Notwithstanding how the ‘glorious’ regime actually fell, even the record of that regime was abysmal to say the least. It is a fallacy labelling Musharraf’s regime a regime of stability, progress and prosperity. On the political front, the Musharraf’s regime’s failures outshine those of Ziaul Haq’s. It was the regime that pushed Balochistan to the brink of secession. An army operation there, confrontation with the pro-state Bugtis and alienation of all mainstream political forces in the province pushed the province away from the Pakistani federation. Had it not been for the political initiatives of Asif Ali Zardari and then Nawaz Sharif to engage the political leadership of the province, fully supported by the armed forces, we may have seen secession by now.
If Balochistan was not enough, his policy in the war on terror was enough to cripple the state. That he played a vicious double game in the war on terror with both internal and external stakeholders is no secret now. Those who portray him as the ultimate saviour of Pakistan against the Taliban and al Qaeda militants must remember that it was under his watch that the state of Pakistan ceded control of seven tribal areas and Swat to the terrorists. It is only in regimes after him, through the bravery and courage of our armed forces, that the state of Pakistan has gradually regained control of the ground lost there. His policy of harbouring the Taliban led to alienation of the people in the tribal areas and made them targets for drone strikes in later years. It was under him that Karachi became a hub for the Taliban and al Qaeda, and though Sharif’s provincial government cannot be absolved of its fair share of responsibility, the network of Punjabi Taliban expanded and consolidated in Punjab during Musharraf’s regime. If this was not enough, his double game policy compromised the Pakistan army the most. Do we forget that in the twilight of the Musharraf regime, because of his hypocritical double game to stay in power, he had pushed things to a level where confusion led people to refuse leading and attending the funeral prayers of soldiers martyred in the war on terror? If this is your de Gaulle, I salute your wisdom.
The ultimate defence of Musharraf is his economic performance. However, as far as the economic growth rate goes, it was only in 2003-2004 and 2004-2005 that the growth rate was higher than six percent, otherwise it was largely under six percent, which is hardly glorious. More importantly, the abundance of capital that we saw during the Musharraf regime had nothing to do with the policies of the regime but was a result of a global zero-interest rate environment. Unfortunately for Pakistan, thanks to the ineptness of Musharraf’s regime, this abundance of capital did not result in an enhanced industrialisation and production base. Industrial production as a percentage of GDP declined rapidly under the regime. Ironically, this global zero-interest rate regime was used effectively by our neighbours India and China to enhance the production base of their respective economies. Just when India and China were busy using abundant capital to enhance productivity, the Musharraf regime was using the abundance of capital to inflate the real estate and stock market, leading to an asset price bubble. Those who admire Musharraf’s economic marvels are the beneficiaries of this urban centric asset-inflation driven economic bubble that went bust during the last years of his regime.
Musharraf’s regime was a cancer from which Pakistani society, our brave armed forces and state institutions will take years to recover. Like any illegitimate ruler, Musharraf’s core aims were survival and gaining legitimacy, and his every decision was a manifestation of these vulnerabilities. He allowed the real estate and stock market bubble to appease the urban elite of Pakistan. Like his predecessors, Musharraf knew that regimes in Pakistan fall when the cities of Lahore and Karachi rise against them. Thus, they go the extra mile to appease them through artificial prosperity. Ayub did it, Zia did it and so did Musharraf. The problem is these policies are a stopgap arrangement and when the effect fades, everything crumbles. Similarly, to gain international legitimacy, Musharraf had to keep the threat of the Taliban alive while showing action against it at the same time, leading to a destructive double game. As they say, you can fool some of the people some of the time but not all of the people all the time; eventually the game had to fail.
There is a lesson to be learnt by us as a nation from the Musharraf saga. For one, those who are political players must acknowledge and respect the army’s role and strategic concerns in decision making, and should not push matters to a point where the army is sucked into the political space. For their part, the armed forces must realise that it is not in their interest to come to the fore as it only undermines their stature and power. It is in everyone’s interest that the system continues. For this, everyone needs to play by the rules of the game. It may sound a little Machiavellian but the system needs to be built so that it has institutional mechanisms to eject corrupt or illegitimate players. Another piece of adventurism like Musharraf’s will destroy it for all. In these vulnerable times, let us stay composed and say a prayer for Pakistan and for us all.

The author can be reached on twitter at @aalimalik