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.