Standing in the bathroom of her boyfriend’s apartment, a 19-year-old MSU English sophomore glanced down at her over-the-counter pregnancy test. She prayed the results would be negative. Thoughts of “How did this happen? We were so careful,” ran through her head.
But she knew her body well. She knew something wasn’t normal.
As she turned the test over in her hand, a dreaded pink line appeared.
Positive.
“It was the scariest moment of my life and I was very let down by myself,” she said. “I had always said I would never let anything like that happen, but you don’t think about that stuff in the moment.”
After she found out about her pregnancy, she couldn’t eat, sleep or concentrate on schoolwork. She only could think about being pregnant.
“I actually had a list of symptoms of pregnancy,” she said. “I was even calculating when I would go to the bathroom. They say you have to pee more often. If it was the time I was technically supposed to go to the bathroom, I wouldn’t go - that would be like saying it was a symptom. I didn’t want to face the facts.
“But one thing I’ve always known is if I got pregnant and I wasn’t married, then I would have an abortion. From then on, I became this weird kind of focused (on aborting the pregnancy) and I knew I had to do something about it.”
Prescribing options
The 19-year-old never had surgery. She was deathly afraid of it.
After taking a second pregnancy test at Planned Parenthood, she found out a new medical abortion procedure was available.
Approved in September 2000 by the Food and Drug Administration, Mifepristone, formally known as RU-486, is a pill that provides women with a medical alternative to surgical abortion.
Mifeprex, the pill’s brand name, blocks progesterone, a naturally produced hormone necessary to sustain pregnancy.
That pill is followed by a second, Misoprostol, which contains a fatty acid that acts like a hormone, causing the uterus to contract and clear its contents.
Potential side effects of Mifeprex include heavy bleeding and cramping, nausea, vomiting, diarrhea, headache, dizziness, fatigue and back pain.
A woman only can use Mifeprex up to seven weeks after the beginning of her last menstrual period. This 19-year-old was five and a half weeks along.
“When I found out the pregnancy was within the time period, I told them immediately that is what I wanted to do,” she said. “Because I knew there was something going on, I had done a lot of research on the Internet and I knew I wanted a medical abortion.”
She is one of the 43 percent of women who will have at least one abortion. But since the approval of Mifeprex in 2000, women can choose between surgical and medical abortions.
Before FDA approval, Mifeprex was tested and reviewed during a five-year process. More than 2,000 women participated in clinical studies in the United States. France, England and Sweden approved use of the drug about 10 years ago.
Under federal law, Mifeprex must be provided by a physician who is able to assess the duration of the pregnancy, diagnose ectopic pregnancies and provide surgical intervention in cases of incomplete abortion or severe bleeding. Mifeprex is 92-95 percent effective and 1.4 percent of patients need a surgical procedure to end the pregnancy or to stop heavy bleeding.
The 19-year-old said she was concerned the pregnancy didn’t end and she might need surgery after taking the second pill. Nothing the clinic told her prepared her for the physical pain, she said.
“After I took the first pill, I didn’t feel anything,” she said. “Right after I took the second pill, two days later, I walked to the store about five blocks away from the clinic. Within five minutes, I couldn’t even walk. I had to miss class because I couldn’t even stand up. The pain was very internal.
“It felt like someone was trying to eat out my insides.”
She felt massive pain in her lower right abdomen for about four days. It hurt to touch, like a sore bruise after being kicked, she said.
“I felt like it was important to feel the pain,” she said. “Getting pregnant was a mistake and I felt like the pain was something I needed to go through.”
The college debate
On the morning of her abortion, the 19-year-old drove to three different ATMs and withdrew money from three different accounts before heading to the clinic in Lansing.
Although her boyfriend gave her $250, it still was difficult for her to obtain the money. Her sister also would give her $100.
The 19-year-old paid $500 in cash for her abortion in addition to $30 for pain medication. At no time during the procedure did the Lansing clinic ask if she had insurance. It also didn’t expect her to pay with a check or credit card.
“It was really hard because I didn’t want to carry around that much cash with me. So I wanted to get it all out of the bank on the day I had to pay them,” she said. “The day happened to be a Saturday, so that made it even harder.
“My boyfriend couldn’t get the money because his employers wouldn’t give him a cash advance without knowing what it was for and he wasn’t going to tell them what it was for. Saying it was for a new truck wouldn’t have sounded very convincing.”
Planned Parenthood Mid-Michigan Alliance in Ann Arbor is one of three Planned Parenthood affiliates in Michigan that offer Mifeprex. Both medical and surgical abortions cost $300 at the clinic. Prices at other clinics vary, depending on length of the pregnancy.
Lori Lamerand, vice president of the Mid-Michigan alliance, said she expects the clinic will prescribe the abortion medication to roughly 500 women in 2002. The clinic prescribed the drug to 250 patients in 2001.
Mifeprex manufacturer, Danco Laboratories, reported nonprofit clinics, such as Planned Parenthood, represent 70 percent of Mifeprex sales, while private practices and independent clinics represent the rest, Danco Laboratories spokeswoman Pamela Long said.
Physicians in 45 states and Washington, D.C., offer Mifeprex. As of June, about 20 percent of women seeking early-term abortions chose Mifeprex over surgery.
The age range with the highest rate of unwanted pregnancies is 15 to 24, which stirs controversy about whether the drug should be offered on college campuses. MSU’s Olin Health Center does not offer the drug. It also does not perform surgical abortions.
In a survey of 30 universities done by the anti-abortion American Life League, only Yale University officials reported supplying RU-486 on campus.
Officials from the Michigan Department of Community Health said in 2000 close to 27,000 women had induced abortions in Michigan, a decrease from past years.
“One reason for the decrease is the result of Medicaid voting in 1988 to stop funding abortions, unless it was a case of rape, incest or the mother was experiencing a health risk,” said Geralyn Lasher, spokeswoman for the Michigan Department of Community Health.
Abortion at home
Although the 19-year-old found a local clinic to offer a medical abortion, Olin Health Center could not provide the service.
Olin physician Dr. Glynda Moorer said Olin can’t offer the drug because it isn’t able to provide surgical intervention 24 hours a day, seven days a week if the abortion isn’t completed.
“If a woman starts bleeding very heavily, there may be a problem in which not everything is expelled from the uterus,” Moorer said. “In that case, we’d have to perform a surgical abortion. If it were a Friday or Saturday night and Olin is closed and a woman didn’t have resources, she could possibly bleed to death.”
State Sen. Dale Shugars, R-Portage, chairman of the Senate Health Policy Committee, said Mifeprex shouldn’t be offered on campuses because it could be detrimental to women’s health.
“About 90 percent of abortions today are done for birth control or sex selections, which are parents aborting the child because it’s not the gender they hoped for,” Shugars said. “I think a better policy on campuses is to encourage abstinence, or help these young women with classes or rent when they find themselves in crisis situations. I’d want to try and help a woman, rather than kill a life.”
Kathy Savard, president of MSU Students For Life, said one in every five abortions are performed on women who are in college. The international relations sophomore said she doesn’t want her tuition money paying for facilities that provide abortions.
“Women are taught that if they want to get through college and have careers, they can’t have a child,” Savard said. “A lot of women think they have no other choice but abortion. They think they don’t have the money or resources to have a child.”
Savard said clinics who prescribe Mifeprex try to shield women.
“They tell you when you take the pill to make sure the uterine contents has been expelled,” she said. “What women really see is the actual fetus, or child, and it’s emotionally scarring to them.”
Savard said during a surgical abortion, doctors purposely turn the ultrasound screen away from the patient so she won’t see anything that resembles a human form. She also is concerned with where women will abort the fetus.
“No one knows when the contents will be expelled,” she said. “If it was offered here, students would have to deal with that on campus. It could happen in a public restroom or the middle of class.”
Although the 19-year-old knows she eventually would have given birth to a baby, at no time during her experience did she think of her fetus as a child.
“I don’t like to think about how it would have been a baby, but I couldn’t have been a mom,” she said. “I’ve never regretted the decision to have an abortion or to use the pill.”
“Even now I have problems sleeping by myself, because when you’re by yourself, you think about it. But I don’t think it’s something you should put out of your head because it’s such a big decision. I still have to deal with the consequences and I know I made a mistake.”
A 31-year-old woman who had a surgical abortion 10 years ago said the experience was frightening because the clinic where she had the procedure failed to inform her of the pain and symptoms.
“I was nauseous and terrified when I first found out I was pregnant,” she said. “My boyfriend and I had a lot of crying emotional talks about what we should do and what the baby would look like.
“When I did go to the clinic, it was terrifying because I didn’t know what was going to happen and they didn’t explain things well to me. All of a sudden I was on a table and they gave me an ultrasound and this ‘man-doctor’ walked in and did the procedure.
“It was painful and there was really bad cramping involved, which no one had told me about. Afterward it was very emotionally draining.”
Mifeprex was not offered at the time she had the abortion, but even if it was, she said she still would have chosen the surgical method. Although the 31-year-old was sad for a few months after her abortion, she does not regret her decision. She also said her sadness never affected her life so that she couldn’t function or carry out everyday activities.
Recovering
The 19-year-old thinks medical abortions are less emotional than surgical. A surgical abortion would have been too invasive and she didn’t want to put her body through surgical side effects, she said.
The pain in her lower abdomen and heavy bleeding were tolerable, she said. She was glad she had the option of having the abortion on her own time and in her own home.
Martha Adrian, clinical manager for Planned Parenthood of Mid-Michigan, 300 N. Clippert St. in Lansing, said every woman’s reason for having an abortion is as different as every woman is.
“I’ve heard reasons here in counseling like their partners will kill them if they have a baby,” Adrian said. “Some people say those extremes don’t happen and women are just trying to justify having an abortion, but there are people who come in and it’s their cousin who’s gotten them pregnant, or they’ve been raped.”
Adrian said many woman use Mifeprex because it feels more natural and private than a surgical abortion. Women can do it at home and most of the time, there’s no surgery involved, which cuts down on risks, she said.
“Some women choose to have it in their own home where they don’t have to deal with the extra pressures,” said Preeti Prasad, a member of the Michigan Abortion and Reproductive Rights Action League and a political science junior. “Sometimes there are protesters who scream, ‘Baby murderers!’ and go after girls who are obviously distraught to begin with.
“If these women are scared and someone’s screaming that they’re going to go to hell, it frightens them even more.”
The action league is an organization devoted to ensuring patient safety by monitoring protester activity at women’s health care clinics.
Despite breaking up with her boyfriend a month ago, the 19-year-old said this is the first month since the abortion that her life is back to normal. During the months following, the abortion altered her moods, hormones, periods and eating habits. Her grade-point average also dropped.
“I’ve put on the weight that I lost and my grades are back up, but I still don’t deal with stress well and for a long time I wasn’t very happy,” she said. “Some people said I should go see a counselor, but I have friends who know about this stuff too, and I think that’s just as good as talking to a counselor.”
Although it keeps her awake at night, she doesn’t regret her decision to have a medical abortion.
“I’m 19-years-old, I’m not going to be able to raise a baby,” she said. “And I’m not educated enough to raise one. I give a lot of credit to the girls who do that and drop out of college. But there was no question that I was going to get a college degree and I wasn’t going to make my mom raise it.”
But she doesn’t want to defend her decision.
“No one knows what they’re going to do unless they’re in that situation and they have no right to tell anyone else what to do when these things happen. It’s by law a right of mine to have an abortion.”
Erica Berg can be reached at bergeri1@msu.edu.
