They could have been worse

by Jessie

March 27, 2023

I was a college student in Scotland, a country with free healthcare, when the condom that my boyfriend was wearing broke. Early the next morning I procured and swallowed the beautifully named morning after pill. When I didn’t start bleeding, I waited a month and returned to the pharmacy for a pregnancy test, which was, as I suspected, positive. My boyfriend at the time was willing to drop out of college to get a job and support us, but this wasn’t at all the life I had imagined for myself, and although he wasn’t a bad person, he wasn’t someone I had wanted to spend the rest of my life with. His family was fairly strongly Catholic, as were, coincidentally, most of my university friends at the time, and yet everyone was supportive of, if not enthusiastic about, my decision.

Then the timing broke down a little bit. There weren’t any more appointments available for medical abortions (the NHS is free, but not fast), so I had to schedule a surgical abortion for the first available slot after I got back from visiting my family in the United States for Christmas. I hadn’t planned to tell anyone in my family about the pregnancy, but my mom’s pretty smart, and when I inexplicably started throwing up in the morning, she cornered me at the dining room table and asked if I had anything to share. I did, and when I was done, she gathered me into an enormous bear hug and let me weep onto her shoulder. She asked if I wanted to get the abortion done over Christmas, in the States, and when I sniffled that I already had an appointment, she insisted on accompanying me back to Scotland so that she could be there from the moment I got out of the operating room. I learned that she had had what amounted to an upscale back alley abortion when she was on her international exchange program in India, and she was determined that her daughter would not experience an abortion scared and alone, as she had, at approximately the same age.

And true to her word, she drove with me to the hospital and hovered in the waiting room during my abortion, of which I only remember the countdown to sedation. She sat with me while I groggily ate what I thought was the most delicious buttered toast of all times, my appetite whetted by fasting. She drove me home from the hospital and sat with me in bed for a week, binge-watching the UK version of The Office and eating air-popped popcorn, pausing only for real meals and pad changes. She even did a pub crawl with me, a hallowed St Andrews tradition, once I was off the opioids.

My second abortion was less controversial but more exotic, and therefore more complicated. I was working in rural Madagascar and having an affair with my boss. One of the most interesting parts of my job was to travel to remote rural clinics and teach bedside ultrasound to the midwives. We had just completed the theoretical portion of the teaching, a bit early, such that our scheduled pregnant patients hadn’t shown up yet. I offered myself as a volunteer ultrasound patient, because I had a uterus, and an IUD, so at least there would be something to see on ultrasound. But when my students placed the probe just above my pelvic bone, as I had taught them, they all wondered aloud what that large fluid sac in my uterus was. They mused aloud that it looked like the images that I had drawn for them of an early pregnancy, but of course, as an unattached female living alone, this was impossible. Indeed, I improvised (read: lied) and informed them that I understood their mistake, but that in fact it was a uterine cyst, which can look very similar to an early pregnancy. I quickly hopped back off the table and elicited other volunteers until the “true” pregnancy patients arrived, and thus we passed the rest of the day and the rest of the weekend. As soon as the motorcycle dropped me back off at the referral hospital where I worked when I wasn’t traveling, I locked myself in my shared office with the portable ultrasound. Indeed, there was my IUD, and right next to it, a fairly large gestational sac, but interestingly, a barely perceptible fetus, and certainly no heartbeat. I took a few measurements, consulted with google, and confirmed that it was an anembryonic pregnancy, which was only a relief because it would mean that whatever happened, I wouldn’t stay pregnant, and there would be no significant legal barriers to getting an abortion. This was an important detail in Madagascar, where abortions were illegal, albeit eminently obtainable with enough connections, which I supposed I had, even if I didn’t know it.

In a coincidence of timing, I had an upcoming flight to the States for my sister’s wedding. Not wanting to risk a miscarriage on the flight, I invented a postpartum hemorrhage for one of my patient’s, and prescribed misoprostol for myself from the hospital pharmacy (mifepristone was not available). The next day, a Sunday, I lay in bed and sequentially took all three doses of the misoprostol, but while I suffered all the flu-like side effects, I never had any bleeding beyond minimal spotting. So I got on my flight still (barely) pregnant, and immediately scheduled an appointment with an obstetrician in Ohio. I explained to the intake staff that I had self-diagnosed myself with an anembryonic pregnancy, and self-prescribed three unsuccessful rounds of misoprostol, and that I now needed a procedure. This caused no small amount of confusion, and engendered unnecessary, repetitive and expensive imaging, but eventually I got my second abortion, this time, in the States, just in time to be able to go to my sister’s wedding without worrying about an untimely miscarriage.

I am now a family physician and an abortion provider. I understand better than many, on a visceral level, how important an abortion can be to someone’s future, and the multiple unexpected roadblocks that can delay access to abortion care. I like to think that I would have arrived at this point without passing through my own personal experiences, but I can’t help but be grateful for these experiences, however tumultuous they seemed at the time, and how they formed me into the provider I am today.


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