I stared down at the plastic stick in my hand, my mind still unwilling to truly process what that tiny pink cross really meant. And yet, the symptoms all made perfect sense. My period had been conspicuously absent for days, despite my normal PMS cocktail of terrible cramps and exhaustion. My breasts had become so swollen and tender that I’d grown to dread hugs from friends and family. I’d been feeling nauseated and sick for several days, to the point that even when I was starving I couldn’t stomach the idea of eating.
But, surely, there were other explanations. I’d recently taken Plan B and, when my period failed to show up, I’d researched the effect that Plan B can have on your body and your menstrual cycle, unable to believe that the hormone bomb hadn’t worked. Surely, the levonorgestrel-laden pill had just somehow disrupted my normal hormone equilibrium. Surely, this was a fluke, and I’d be back to normal in a couple of days. I reached for another pregnancy test.
For as long as I can remember, I’ve felt deep in my bones that I’m meant to be a mother one day. It feels not so much a choice for me as a biological imperative—something my body itself craves. Children evoke in me an almost physical yearning, a kind of “womb ache” that’s difficult to explain to those who don’t feel similarly. I guess my maternal instinct is just especially strong—and it’s only gotten stronger as I’ve gotten older.
That’s why, looking down at the proof of the tiny embryo growing inside me, my heart was breaking—because I knew I wasn’t going to keep it. As much as I wanted kids someday, I wasn’t ready yet; my partner and I were in love, but not married or living together. I didn’t have the finances or stability I knew I’d need. I had dreams of traveling, of going back to school, of becoming established in my career. A baby simply wasn’t yet part of the plan. And so, though it absolutely killed me, I knew what I had to do.
Abortion in the U.S.
While abortion statistics in the United States have frequently been conflated or misrepresented based on differing political agendas, the most recent studies from 2014 have found that the rate of abortion is 14.6 per 1,000 women—the lowest rate ever observed in the US. Despite this, 19 percent of pregnancies in 2014 ended with the decision to terminate, suggesting that abortion is very much still a part of women’s everyday experience. The same study reports that in 2014, over 900,000 abortions were performed.
But abortions are anything but easy to come by. Though the historic 1973 Roe v. Wade decision ruled that abortion was legal during the first trimester of pregnancy, it preserved the rights of states to regulate and restrict the procedure during the second and third trimesters. As a result, the right to terminate a pregnancy has been intensely debated, fought, and restricted on the state and national levels, resulting in a complicated patchwork of laws regulating if, when, where, and how women can abort.
In my state, for example, as of 2017, women can only obtain an abortion after a state-directed counseling session and a mandated 24-hour waiting period. Additionally, state health care plans can only extend to abortion if the mother’s life is at risk. Navigating such a fraught subject is confusing and stressful to say the least, especially since conversations surrounding abortion experiences are few and far between. I, for one, had no idea where to begin.
At my gynecologist’s recommendation, I called an independent clinic. It was all very straightforward: they asked my name, my age and date of birth, and when I had my last period.
“It looks like you’re just a few weeks along, so you have a couple options,” the clinician told me. “You can elect to have a medical or a surgical abortion. Which would you prefer?”
All those years of high school and college-level biology and reproductive health classes had not prepared me for this. I knew next to nothing about the actual mechanics of an abortion, and I’m not alone. Misperceptions and ignorance surrounding the procedure abound. In fact, in a 2016 Vox poll focusing on perceptions of abortion, four out of five respondents felt that abortion was more dangerous than giving birth, despite ample evidence to the contrary; furthermore, the poll revealed that about a third of respondents didn’t even know whether or not abortion providers have to maintain a medical license.
Despite their relative frequency, abortions are still largely kept hidden and shrouded in mystery. Information is revealed on a sort of need-to-know basis—and now, I needed to know. I asked the clinician to help me understand the differences between the two procedures.
Types of abortion
Medical abortion, she explained, involves taking two hormone-containing pills to end a pregnancy. The first pill is taken under the clinic’s supervision and contains a hormone called mifepristone that halts production of a key hormone important to pregnancy. The second pill is taken 24-48 hours later, usually in the comfort of your own home. This medicine, misoprostol, induces cramping and bleeding to cause the uterus to empty, similar to a miscarriage. Many women choose this option, the clinician said, because it is less invasive and they are free to end their pregnancy in private.
Surgical abortion, by contrast, is an in-clinic procedure that works by using suction to remove a pregnancy from the uterus. I’d be able to choose between having local or general anesthetic, and the procedure would last only a few minutes. This procedure, she said, was preferable to some women because it was so quick.
“I think I’d prefer the medical option,” I told her, knowing immediately that I’d prefer to experience the rollercoaster of emotions I’d undoubtedly have in my own home. She noted it down, took my insurance information, and we set a date for a couple weeks later.
Preparing for the procedure
The morning of the procedure, I woke up nervous and uneasy. After a fitful sleep filled with macabre abortion dreams, I had no idea what to expect. Would there be picketers? Police escorts? Would people try to show me pictures of ripped-apart fetuses? I’d heard all the horror stories and I wasn’t sure I was ready to deal with that, even with my partner by my side. But the morning progressed uneventfully: the clinic looked just like any other doctor’s office, apart from the bulletproof glass and the security officer standing by.
After signing in, we headed into the waiting room to wait for my name to be called. There were already several women of varying ages and walks of life there, and the room steadily filled up as the hours passed.
My name was called several times—first, to deal with payment, as my insurance did not cover abortions, and then to have my vitals taken. Waiting to get just these preliminary steps out of the way took the better part of the morning, and it was pushing 2:00 by the time I was shown in to see the counselor on staff.
I tensed up, thinking this would be the moment I’d be told I should reconsider, but the counselor was friendly and professional. She introduced herself and went over my options again, asking if I still wanted to proceed with the medical option.
“Will I have to wait much longer for that one?” I asked, wanting to get out of there as quickly as possible. She didn’t know; they had a lot of patients to see that day, she said, and it could still be awhile. But, she said, I could elect to do the surgical procedure—it only took a few minutes to do, so I might be out of there faster. “Okay,” I said. “I’ll do it.”
Having an abortion
Faster, it turns out, was relative: when it was finally my turn to have the procedure, it was almost 4:00, and I was emotionally and physically exhausted. As I was brought into the procedure room, I was again briefed on what was going to happen. I was going to be given local anesthetic (since my partner had had to leave hours before, I wasn’t able to be placed under general anesthetic since I had no one to drive me home) and then a vacuum aspirator would be inserted into my uterus to suction out the pregnancy. It would, I was told, be painful, but it would only last a few moments. Then I’d be taken into a recovery room and be free to go a short time after.
I’d been somewhat prepared for the physical pain, which was substantial but, as promised, short-lived. Nothing in the world could have prepared me for the mental pain. The moment the vacuum aspirator turned on, I fell apart. All I could think about was the tiny embryo—my potential child—being sucked out of me, its budding life snuffed out. I couldn’t control my sobbing, even after the procedure was over. Though I knew I’d made the right decision, the guilt and sadness was overwhelming. I couldn’t stop thinking that I’d terminated a child—my child. I’d decided to get rid of it, to toss it out. The blood I felt seeping out between my legs felt, for a small moment, like murder.
My decision, my choice
Do I regret my decision? Looking back, I’d say no—but it’s a little more complicated than that. I do firmly believe that it was the right thing to do: my partner and I weren’t in a place where we’d be able to properly support a child, and the huge amount of time and energy it would require would’ve completely derailed all my career and personal ambitions.
But there are moments when I find myself looking longingly at pregnant women, wondering how it would have felt when my belly started to swell or when I felt my child’s first movements inside me. I don’t know if I’d be able to have another abortion, and I don’t know if I’d ever want another woman to go through the same thing I did. But I’m grateful that I had the choice, and I know that, for me, I chose right.