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June 27, 2007

I Was Betrayed by a Pill

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He didn't need any convincing. The next question was how to abort. There was the surgical option, of course. I'd had one in college (so you'd think I would have learned this lesson already), and I dreaded the needle that would be used to numb my cervix. In the years since college, another option had emerged: A pill called mifepristone (formerly RU-486, now sold under the brand name Mifeprex) could trigger what experts call a "medical abortion." Mifepristone isn't to be confused with Plan B, the "morning after" pill that can prevent pregnancy if you take it within 72 hours of unprotected sex.

This one (also called the "early option" or the "abortion pill") is used together with the synthetic hormone misoprostol to abort when you're already pregnant. First, mifepristone blocks the action of progesterone, the hormone that's needed to sustain pregnancy. Then, misoprostol empties the uterus. The Mifeprex literature described some cramping and bleeding, "similar to or greater than a normal, heavy period." This sounded far more appealing than surgical abortion. A few pills, a couple of cramps, and it would all be over. We could move on with our lives.

But as it turned out, things weren't quite that simple.

For starters, the abortion pill is not always easy to get. In Nevada, where the state constitution guarantees the right to abortion, my own gynecologist refused to administer the pill-not because he's antiabortion, but, he explained, somewhat apologetically, just as he didn't do surgical abortions because he feared becoming a target of abortion foes, he didn't do medical abortions, either. Nor would he simply write me a prescription and let me do it myself. "They watch what I prescribe at the pharmacy," he told me. So much for discretion and accessibility.

Fortunately, after searching online, I was able to find a cooperative local clinic. The initial procedure was simple enough. I had an ultrasound to confirm that the pregnancy wasn't lodged in the fallopian tubes (a case where Mifeprex can't be used). I signed a release stating that I understood how the drug worked and all the risks involved. Then I downed the Mifeprex and went home. Two days later, it was time for the misoprostol. This part I could do at home. Clinic staffers had directed me to insert the tablets into my vagina in the morning so I'd have the day to recover. I envisioned recuperating on the couch with some uncomfortable but bearable cramps and soothing myself with bad daytime TV. I kissed Stewart good-bye. He said he'd call later. I went to insert the tablets.

I never made it to the couch.


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