Women who took abortion pills in states where abortion is banned described experiencing deep anxiety and uncertainty about doing something they assumed was illegal.
By Caroline Kitchener, The Washington PostAngel at her home in Oklahoma. Her deepest fears and anxieties took over.to end her pregnancy, worried about how they might interact with medication she took for her heart condition.The pain kicked in after about an hour, around midnight on a Sunday in January, eventually becoming sharp enough that the 23-year-old said she struggled to stand.
But the experience can feel very different in states where abortion is illegal. As more women in states Meanwhile, many abortion rights advocates describe the experience as straightforward and easy to handle on your own, a characterization that some women say glosses over what can be a more complicated reality of ending a pregnancy alone in your bathroom.
The complex legal landscape can be hard to understand. Abortion bans do not allow people seeking abortions to be prosecuted, targeting only doctors and others involved in facilitating the abortion. But people have been charged under other laws for self-managing their abortions, especially later in pregnancy.
With her heart condition, she said, she was supposed to seek medical attention if her heart rate got that high. “There’s nothing in there that’s traceable back to you,” she said. “As long as you don’t tell anybody.”“You are doing what’s right for you and your future family,” she added, her voice firm.The Miscarriage and Abortion Hotline is staffed by over 50 U.S.-based medical providers, a mix of doctors, midwives, nurse practitioners and physician assistants with experience in abortion care.
“They’ll say, ‘I’m in a state where this is illegal, so I can’t go get medical care. I want to check in and make sure everything is going okay,’” Prine said.She and her colleagues hear the same questions again and again: Am I bleeding too much? Am I not bleeding enough? Is it normal to have this much pain? People call to see if they can drink alcohol or smoke marijuana after taking the pills. One woman asked whether it was safe to walk up the stairs.
For those who choose to self-manage their abortions, Prine said, she is there to offer reassurance that their experiences are nothing out of the ordinary, and that they almost certainly don’t need to go to the emergency room. A medication abortion is just like a miscarriage, she’ll tell them, with hundreds of women going through the same process every day.
“Your uterus knows what to do,” Prine told a woman who called that January morning with reports of unexpectedly heavy bleeding. “It’s going to take care of itself.”On the infrequent occasions when a patient calls with concerns about their medication abortion, Clayton Alfonso, an OB/GYN at Duke University, said he’ll try to evaluate how much she is bleeding and how her body is tolerating the blood loss. But he said it can sometimes be difficult to make those assessments over the phone.
“They’re passing these babies into the toilet,” said Johnson, founder of the antiabortion group And Then There Were None. “Then these women have to make a decision: What do I do with this fully formed baby?... Do I flush my child down the toilet?” When the pills first arrived in the mail a few days earlier, in April 2023, Briana had expected her experience would be more difficult than most. The doctors who administered the medication through Aid Access cautioned Briana that they “do not like to recommend medical abortions” as far into pregnancy as she would be when the pills reached her, according to emails reviewed by The Post.
“If we think people might be longer than that, they get an email to make sure they can navigate the situation,” said Gomperts, who personally prescribed Briana’s medication, according to documentation reviewed by The Post. “Women have agency. They are perfectly capable of making these choices about their own health, and we are there to support them the best we can.”
Finally, Briana decided to call the number for the Miscarriage and Abortion Hotline she’d seen in an email from Aid Access. One doctor in the group insisted that the woman had to go straight to the ER, but Prine and others disagreed. Worried the woman could face prosecution or mistreatment if she went to the hospital, Prine said, they walked her through her abortion at home, instructing her to take more abortion pills and gently massage her stomach until the placenta came free — the same advice Briana said she received.
As difficult as the situation was, Briana says she is extremely grateful that Aid Access was willing to send her the pills — and that someone on the hotline was available to talk her through taking them.“The lady ... stayed talking to me for hours,” Briana added. “I wish I knew her name.” “Are you ready?” Glenda Lima, the sonographer, asked on a Tuesday morning in mid-February. “There will be a little cold and just a little pressure, okay?”
She decided that she needed to talk to someone. Not a disembodied voice on the phone or an anonymous commenter in an online forum — but a real, live person she could actually meet. “I was like, ‘Oh my God, I feel like I have been searching for this,’” Ashley said. For the first time since finding out she was pregnant, she said, “I just felt safe.”As other Texas clinics moved to New Mexico and Illinois after Roe
and offers no health services other than ultrasounds — is somewhat controversial in the abortion rights community. With abortion rights advocates arguing vehemently that in-person consultations and ultrasounds are entirely unnecessary for a medication abortion, Kleinfeld said, some likely see her clinic as an impediment to women accessing the care they need.
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