Women who took abortion pills in states where abortion is banned described experiencing deep anxiety and uncertainty about doing something they assumed was illegal.
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. While Angel would be fine by the next morning, she
with abortion bans choose to end their pregnancies on their own, without directly interacting with a medical professional, they are thrust into a largely ad hoc, unregulated system of online and grass-roots abortion pill distributors — an experience that, while deemed generallywas overturned — with women in antiabortion states obtaining pills through several distinct channels.
“I wish I would have known that it wasn’t just blood clots. … I was really confused and shocked,” said Briana, a 34-year-old in Alabama who took pills she ordered online when she was In Oklahoma, Angel ordered her pills from Aid Access, according to emails reviewed by The Post, and took them five to six weeks into her pregnancy. She’d told doctors at the online clinic about her heart medication when she filled out its online form, she said, but no one ever reached out about it — a silence easily explained, Prine said, because Angel’s medication is not one that would raise concerns.Sitting on the toilet, she could hear her heart pounding in her ears.
The voice Prine heard was quiet and scared — belonging to a 15-year-old with an area code in a state with an abortion ban who had taken pills and passed a fetus larger than she’d expected.Prine cradled the phone in both hands and leaned in, trying to channel every ounce of reassurance and understanding she could muster through the phone line.
“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. in the United States who took mifepristone — the first drug in a two-step medication abortion regimen — between its 2000 approval and December 2022, just 32 died,. Those cases, the agency says, “cannot with certainty be causally attributed to mifepristone.” Major adverse events — in which a blood transfusion, major surgery or overnight hospital stay is required
A tiny fraction of patients who take abortion pills have a serious adverse event such as a blood transfusion, major surgery or overnight hospital stay.an indication of a safety issue, but leading medical experts say they instead highlight the confusion and fear that many women experience after taking the pills. Patients often go for a gut check, doctors and medical researchers said, wanting to confirm that they’re not bleeding too much, or that the pills worked and they are no longer pregnant.
“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.
These kinds of incendiary attacks make it hard for abortion rights advocates to discuss the details of a medication abortion later in pregnancy, said Prine and Gomperts —At her home in Alabama, Briana waited to take the pills until she’d put all of her children to sleep. Briana felt she had no choice. By the time she found out she was pregnant, she was already 11 or 12 weeks along. The abortion clinic she’d called in a different state, more than a six-hour drive from her home in Alabama, where abortion is banned, was booked for surgical procedures for over a month, busy treating patients from other antiabortion states across the South. She spent nearly two weeks researching her other options, then the pills she ordered took two weeks to arrive.
Still, Prine said, she has fielded far more of these calls from women later in pregnancy than she would like — averaging one a day on the hotline in the months after the Supreme Court decision. Some of the callers had no idea how far along they were until they passed the pregnancy, she said. Others knew, but chose to go ahead anyway.“We hear the trauma when we talk to people,” Prine said. “It’s an image you can’t get out of your head.
Her boyfriend was sleeping in the next room. Even if she woke him up, she wondered, what could he do? If she went to the emergency room, she said, she felt sure she’d be prosecuted. When the Miscarriage and Abortion Hotline received its first call from a woman who was unable to pass her placenta — at least five weeks further into her pregnancy than the FDA’s 10-week limit — a group of hotline doctors started messaging one another, trying to decide what to say to her, Prine said.
“Whenever there is something inside the uterus that is trying to come out and won’t come out, the risk of bleeding and infection gets higher with every passing moment,” said Keri Garel, an OB/GYN at Boston Medical Center, adding that she would advise someone in Briana’s situation to go to the hospital immediately. “At that point, your life is the most important thing.
It was Ashley’s fourth visit in two months to Houston Women’s Reproductive Services, one of a handful of former abortion clinics that have remained open in states with near-total abortion bans. While the staff originally imagined a new version of the clinic that offered ultrasounds and referrals to patients planning to travel out of state for medication and procedures, a large share of the women they serve are now self-managing their abortions with pills they got online.
Ashley struggled to come up with the right terms to Google, she said, wondering if it was even possible to get advice on abortions in a state where abortion is banned. She came across contact information for Houston Women’s Reproductive Services only after first messaging a crisis pregnancy center — an email thread she abandoned when she realized it was actually an antiabortion organization designed to dissuade women from ending their pregnancies.
There are major challenges to providing this kind of care in a state where abortion is illegal. Perhaps the biggest, Lima said, is that women assume there are no abortion resources left in Texas. Those that find them often do so by chance.Lima said she regularly gets frantic calls and texts from Spanish-speaking patients she’s never met before on her cellphone, a number she gives out only to patients she sees in the clinic.“I need to know I’m going to be okay.
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