The Abortion Pill Experience
Please Note: Views expressed by patients of Early Options and their companions are their own and do not necessarily reflect the views and opinions of Early Options. This transcript has been edited for clarity and readability.
Content Warning: This post contains an image of a gestational sac at 6 weeks of pregnancy.
0:00 | The Abortion Pill
Doctor Joan Fleischman: I wanted to ask you a couple of questions because on the internet there’s a lot of misinformation about the abortion pill and while my experience is that there is a wide range of experiences, there really isn’t enough information on good experiences with the abortion pill.
I usually recommend it for women that are under 7 weeks without much hesitation because it usually goes well, so I just wanted to ask you a couple of questions so that women would have a better understanding of what it can be like to take the abortion pill.
First of all, you took one pill in the office and then how much later did you take the second set of pills? And you took those at home right?
0:41 | A Patient’s Personal Abortion Pill Experience
Early Options Patient: Yes, so the second set of pills was exactly six hours after on the same day. I went home, took those pills and knew I was kind of just going to relax for the rest of the night. Then about probably 4-6 hours after I took the second set of pills, I started to feel the cramps. I went to sleep so it woke me up but not an aggressive wake-up. I just started to feel something happening and it happened over the course of the night. I would get up and go to the restroom but I was sleeping kind of in-between.
D: When you went to the bathroom did you start to bleed?
P: Yes, I would go in to change the pad and I would take a little bit of a break and sit down on the toilet, make sure everything seemed okay. I wasn’t gushing blood. It was a very kind of steady flow, heavier than a period, your regular period but really on par with a heavier period. I don’t experience super heavy periods.
D: Okay, so that was Tuesday night. Then you went to work on Wednesday?
P: I worked from home on Wednesday only because I didn’t know truly what to expect so I didn’t want to be sitting in my office in case I was feeling very cramped, I have the luxury to work from home so I did work from home that day but I was working throughout the day. I woke up at a regular time. I sat with my computer. It was really more of a precaution for me to work from home.
D: Could you have gone into work?
P: Yes, absolutely. I could’ve gone into work and been absolutely fine. It happened kind of while I was sleeping. I just wanted to make sure that I wasn’t going to start falling asleep at work but I could’ve gone into work. I was completely fine.
You feel that something is happening. You’re going through some cramps but nothing that’s debilitating or I had to sit down and take many deep breaths. More just resting, knowing that your body is going through something and taking it a little bit slower than you normally would.
I drank a ton of water. I drank a ton of tea. I ate very light. I had toast and had soups throughout the day.
And then on Thursday it really started to slow down. On Wednesday, a small piece of mucus came out and I knew that’s what I was expecting. It was a small thing in the toilet bowl and that was really kind of the end of my experience. Now, it’s a week later and I feel completely fine. My bleeding has stopped. I’m not really experiencing any after-effects.
D: Great and we just did the follow-up visit and everything looked perfect just one week later. It doesn’t look like you were pregnant. There’s a lot on the internet with images that are disturbing about what actually passes and I just showed you sort of the equivalent of the stage of pregnancy it was at. Is there anything that could possibly be disturbing about looking at the tissue?
P: Not to me personally. I really wouldn’t think to anybody. I don’t even think you’d be able to differentiate between a regular period blood clot and this piece of mucus at 4-6 weeks. Truthfully, if you can, you have to be a doctor, I would think. I wouldn’t even be able to.
D: Or a microscope.
Gestational Sac at 5 Weeks
P: Or a microscope. There was nothing disturbing to me. I knew my body was experiencing something so I wasn’t going to push myself. I took it slow. I wasn’t planning on working out or being out or being really active on those days. It was two days of taking it slow and really taking care of your body and taking care of yourself.
4:37 | Her Decision
Beyond that, it was a very easy decision for me personally to make, after I was finished with taking the pill and the bleeding and all that I wasn’t disturbed. Nothing visibly upset me. It didn’t make me question my decision. It made me feel like I did the right thing and I moved passed it healthfully, positively, truthfully.
D: I’m always more an advocate of the procedure personally but I think the advantage of the abortion pill is often emotional because it helps women I think to feel like it’s more like getting your period or having a very early miscarriage, it’s not that much of a difference. Is that how you feel?
P: Yes, I would say that’s pretty accurate. I also feel like it’s almost a little bit cleansing in a way, like a very natural way. It almost feels like I experienced a release kind of, I made a decision and I wanted to kind of see it through. It makes it sound weird but it felt very natural.
It felt like cleansing. It felt like when I was over the bleeding and those two days of a little bit of cramping and feeling like I was going through something. It felt better the next couple of days to work through it and it was nice to be able to be at home to kind of take that time for yourself to think through it and to physically go through it.
6:07 | Abortion Pill
D: You know, a lot of women are still being put to sleep to go through something like this and for me, I feel that either the procedure or the pill, the way we provide these services allows you to go through the process of letting go and going through the process of ending the pregnancy.
It’s a difficult thing and it’s an emotional thing. There is something I like about the word release or cleanse.
P: I know it’s a medical procedure but it’s also certainly an emotional decision. I think it’s also a very personal decision for your own life, for the life that you were thinking about bringing in or not. It really is incredibly important to be present, I would not want to be put to sleep because I feel like, you go to sleep, you wake up and then it’s over. I would feel like, oh no, maybe I’d regret it a little bit.
This way I kind of processed it that whole day I was in the office, we spoke about it. I went home, thought about it more. I took the pills many hours after and the process happened a couple of hours after that.
You’re kind of able to prepare yourself mentally and physically for it. In a way that if I were just put to sleep, a procedure happened and then woken up and being like ok everything is all done. I don’t know if you have that same process and understanding.
D: Yes. I often compare it to midwifery. We’re kind of the midwifery of ending pregnancy. Midwifery believes in supporting our natural process to go through delivering a baby. That’s what I chose personally and our role as health providers in these situations as caregivers is to support women to go through the process they need to go through. That can be very different for different women.
What I always say, the medical aspect of this is so simple, the way we do it. The procedure is a couple of minutes and the pill is fairly simple to implement, so for me, a lot of what we’re doing is being by your side, providing you the right expectations and then really being here to support you emotionally. Also, helping you to figure out what you need to go through that. Do you feel that that happened?
8:35 | Why Early Options?
P: Oh yes, absolutely. I also feel that when I first learned about you guys it was actually from my eldest sister. If you do need an option, you go to this place because you won’t walk in and feel uncomfortable. No one is going to make you question your decision or going to have a conversation with you about it. They’re going to ask a few questions but nobody is going to…
Even though I understand it is a difficult thing to decide. It’s also an emotionally difficult thing to go through. It is a decision at the end of the day that has to do with my body and my body alone.
If you want to come into a place that you’re making a decision for your body and your life and yourself and somebody’s going to support you and aid you in making those decisions, I would say come here or a place like here.
I know it’s a debate a lot of people have but at the end of the day it’s my life, it’s my body and I and I alone have to go through it. If I’m not ready to do that, I’m not ready to do that and I don’t really feel sorry that I had to make this decision. I wish I was smarter previous to it but I don’t feel overly sad where I need to come in and be apologetic and sad for making the decision. It’s your decision and again it’s yours alone.
Here I felt supported in my decision. You and your entire staff, down to everyone that answers the phone is kind and generous and willing to let you know [you’re supported] even without saying it, this is your decision and we’re here to help you with what you decide. It’s an incredibly important part of it.
I obviously don’t know medicine but if it was just administering a pill but going through that. You guys just walking me through it and giving me endless amounts of information on… ‘if this happens call us, if this happens call us, if this happens, it’s normal.’ All those things are very important for when you’re sitting [at home and] it’s occurring to you, to be able to read and be like “Oh, somebody else had this moment of nervousness and called them but this is normal.”
I think it’s very important to have this support as opposed to just being like “Yeah, you had a procedure now you can leave our clinic or leave our doctor’s office.” It’s more than that.
D: I was on a national site at one point where I was answering, all experts, answering women’s questions and so many of them were about the abortion pill.
The problem with a lot of places that provide it is they don’t provide follow-up or they charge for follow-up. That’s exactly when you need help with the abortion pill. You need to know you can call somebody at any point to see how it’s going. That’s why we organize it the way we do, all your care is included, even if you need 10 follow-ups.
In your situation, it was very straightforward, but I loved what you said about the decision. I usually just say your pregnancy test is positive. I assume you’ve come here to end your pregnancy or are you still making your decision?
I always look at women in the eye and I can tell whether they have or not and I feel that my job is to make sure women have made their decision but it’s funny how a lot of women feel like in that moment they have to justify it to me. I don’t ask the question but right after I ask it for the next 10 minutes they tell me their life story and why they have to. It’s like we get on the defensive because of the topic.
P: It really frustrates me. I’m not advocating people go out and be irresponsible with their sex lives and then say “Oops, now I have to make this…”
I don’t think it’s an overly life-altering decision. I feel like I’m saying “I feel bad to say that” because I’ve been conditioned to say that. I don’t really feel that bad saying that.
[Did] it make me sad in the moment? Of course, but every person grows up and as a woman, you think about when you’re going to bring life into the world and all those things. You’re connected to your mom, you think about it.
I have a bunch of sisters, so we’re a very woman-centric household. It’s going to be a decision that I have to make but I don’t think it’s altering my life, but I have to go to work after this. You have to make decisions sometimes that aren’t incredibly easy but they’re decisions that you have to make and you have to make them for yourself.
D: I sometimes feel that’s who we are as women. We make hard decisions. We have to make these incredibly hard decisions and here is such an example of that.
The whole world has opinions about what you’re doing and you have to stand up and look in the mirror and say what’s right for you and execute it. You have the hormones involved and you have all your own personal stuff involved. I think that’s why I still love this work after 20 years.
I mean never have I come in for a day that I haven’t felt so rewarded by my work and it’s this, I think if I have to say what it is, it’s this. I just have so much respect for women and the way we have to live our lives. Especially, in these days of what we want to accomplish and achieve and we have so much we want to do.
I think most of the women who come to me are moms and that’s an even more difficult situation but because our lives are so rich and we’re doing so much. We’re so involved in so many things and at the end of the day, you have to look in the mirror and say where am I at right now? Is this what I want right now?
The other thing I love about what you’re saying is–and this, I agree with you. What you said is shared by most women who come here but everybody is so afraid of saying it including myself… I don’t feel like we’re doing anything wrong. I don’t think anything is being hurt.
P: I feel like the reason I’m prefacing it saying that I feel bad or that I feel almost conflicted to say it is not because I’m conflicted in my feelings or my brain it’s because we’ve been conditioned to feel that way.
We’ve been told that it’s [abortion] a wrong thing, and I think if any male had to carry a child or go through the things you have to go through – when you’re pregnant your body changes, your mind changes, your whole priorities change and if you’re not ready to do that it’s nobody else’s decision but your own.
This is my second procedure and this is very honest but I’ve had the same partner for 6 years. We met when I was a freshman in college and it’s the same person that I’ve gone through this with and it’s…I want to do it personally.
When I made the appointment we were away. I was away for work and he actually joined me for the last couple of days of the trip and I had to tell him on a work trip because that’s when you have time to talk about these things. We don’t have time. He’s working like crazy, I’m working like crazy.
We’ve been together for 6 years and we could probably do it. I’m sure we could. We both have good jobs. We live in New York City. We both have amazing families that would provide us support and all those things. It’s really that I don’t want to do it. It’s actually the first time I’ve ever said it out loud, to be honest other than to him. I don’t want to do it right now. It’s so sad, it’s even making me emotional but I don’t.
D: Why is that so hard to say? You don’t want to do this right now, not every moment in life is a time to have a baby. It is the rest of your life. My son is now 26 and it is not over, I can tell you. It’s for the rest of your life.
17:12 | Pregnancy and the Political Environment
P: He’s [my boyfriend] a great person and I know everything would be about our child together. We both have so much more that we want to do. It was at a work event trip when I had to tell him.
It’s so weird because we had to have this whole long conversation and we were having a very emotional conversation. Then we went to a large staff dinner with my entire team where I was awarded an award. He was so excited and so proud and he was like “this I feel is almost a good sign, these are things you would have to give up and these are the things you love to do.”
I would love my child and I’m sure it would be a happy time but right now at 24, I want to be happy and successful in those ways.
When I read all the abortion stuff it makes me go insane, and it’s really topical, that article about Donald Trump’s comments and the new FDA regulations. It came out on Thursday, I was in Starbucks and I saw it on the cover of the New York Times and I was like, “how strangely weird and topical.” If I didn’t have this option, I would not be the same person. I would have 2 children at 24, I can’t even fathom.
I went to a good college. I enjoy working. I have a lot more things to do and we can’t, unfortunately, as women, we can’t really do it all. We have to give something up and I’m not willing to do that. It may sound selfish but it’s not what I want.
D: That’s another crazy thing. How in the world is that selfish? It’s the opposite, that’s what I say to these moms. The moms are the ones that feel selfish and I just say “Why is that selfish? You want to give the child you have what you can and not drain yourself.”
P: Again, I’ve had the same boyfriend for 6 years, when we have a child together I want it to be for when we’re super excited. Not, “Oh God, throw out the pregnancy test we have to go to a work dinner right now. We can’t say anything to anybody”.
It’s tough to say that out loud because other than him I haven’t said that to anybody. It’s about what you want and what you want out of your life before you’re ready to bring another life into it. I feel like people don’t consider the next…
Yes, having a baby would be awesome. I’m sure they’re fun to hang out with and they’re cute and they’re sweet and they smell good and all those things but…
D: It’s going to be the best moment of your life when you have a baby. It’s the greatest thing and you should cherish it and be excited. If you don’t want to do it now, that’s okay.
To me, nothing’s getting hurt and I think that’s what the biggest cultural impact that people with political motives who feel that we’re such bad people doing this have had. I find that women, accomplished women, professional women, feminist women are coming in here and somehow it’s infiltrated into our soul that we’re hurting something.
P: I would feel terrible. Like I said, I have a family filled with women and I would have a hard time and I’m very close with my mom, we talk about it a lot. I would have a hard time telling her that because I just think it’s literally ingrained in us. Ingrained in this older generation that this [abortion] is bad and women stay home and take care of children. If you get pregnant that’s what you do. It’s kind of baloney. I don’t want to do that.
It is crazy how even when you make the decision and you don’t really have regret or guilt or any of those things you still see it creeping in. You then start to question yourself. Am I crazy for not being regretful? Then I was like “No, don’t go down that path because then you’ll start questioning everything.”
D: That’s surprisingly what I see day in and day out. Women are clear usually the moment they see the pregnancy test but then they spend weeks going through this cycle of questioning themselves that comes not from themselves but from the culture that’s been created. It’s really quite astounding when you think about it.
P: Or that at the end of the day for as much as it’s really great if you have a partner, if you have a husband, or boyfriend, or anybody, a friend that says “It’s your decision.” That’s a really great person and partner to have in your life, but it’s also really difficult because it really is then your decision and you don’t want to make a decision that really affects two people and do something that both really wouldn’t want.
It really comes down to what you can do, because even though yes, your husband, boyfriend, partner, friend may have a child as well, [but] they’re not going to be carrying this child. They’re not going to be the primary caretaker, so…
D: Thank you so much!
P: You’re welcome.