What Really Happens When You Get A Medical Abortion

Photo: Ashley Armitage
When Lauren* found out she was pregnant, she knew she wasn’t emotionally ready to have a baby.
“I was pretty scared and upset, I literally broke down in tears when I found out I was pregnant and then went straight to sleep until the morning, as I didn't want it to be a reality.”
The next day, she rang her nearest branch of Marie Stopes. “I called the clinic, who scheduled in a telephone consultation and then an appointment – which had to be a few weeks later as I was only 5-6 weeks pregnant, which was too early for a medical termination.”
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Contrary to popular belief, a medical abortion doesn't consist of just one “abortion pill” but a combination of two medicines. The first, mifepristone, blocks the hormone progesterone, which causes the lining of the uterus to break down and ends the pregnancy.
The second, misoprostol, causes the womb to contract, causing cramping, bleeding and the loss of the pregnancy in a similar way to a miscarriage. Abortion pills are commonly used for medical terminations up to nine weeks of pregnancy, but the method can be used up to 24 weeks.
Lauren, now 28, had to wait around six weeks for a termination. “Physically, it was really strange because while waiting I had to deal with feeling more and more pregnant each day,” she says.
Her body was starting to change, which was hard to endure, knowing she wanted the abortion. “I just wanted it all to stop,” she says.
She took the mifepristone during her first appointment, before returning to the clinic 48 hours later for the misoprostol.
“My cramps started in the taxi home which was pretty scary,” Lauren says. “The process itself took a long time, and I had pain from this point – early afternoon – until quite late at night.
“I felt sharp, very stabbing pains, and then lots of heavy bleeding. It had not been that long since I'd had gynae surgery for an accident I'd had with my partner so quite a lot of the physical and emotional feelings from this came rushing back.”
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You can take pain medication like ibuprofen but if you are sick within one hour of taking the pill, you need to inform the clinic as soon as possible in case you need to take the medication again.
After Lauren vomited, she called an emergency number on a leaflet the clinic gave her – but it didn’t ring. Anxious and in need of immediate advice, she rang NHS Direct but was told by the operator that a doctor would call back within four hours.
“I was told in the end it would be fine as I'd kept the abortion tablets down for longer than 1-2 hours before vomiting,” she says.
Marie Stopes offers six free counselling sessions, either face-to-face or over the phone, which Lauren sought several weeks after the termination.
“I started to feel really upset and angry, which is when I sought the face-to-face counselling through the clinic,” she says.
“When I was there for my first counselling session it was insanely busy, there was a man in the waiting room practically shouting down the phone when phones weren't allowed and everywhere else there were people crying and upset,” she says. “It was awful.”
Lauren then found out she had been allocated a male counsellor – without being told beforehand – who she found difficult to open up to.
“For such a specifically female procedure, there should perhaps be a little more thought as to whether male therapists should be offered for this line of therapy,” she says. “I found it far too awkward to discuss anything with him, and actually ended the session soon after getting there because he just didn't get it.”
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For the remaining sessions, Lauren decided to have counselling over the phone. “They were so good, really lovely, supportive women – I specifically asked for women each time – who just completely understood everything I was feeling and offered really good advice about how to process some of the emotions.”
Lauren was able to access an abortion legally, during which she was given advice and support, which is crucial for any medical procedure.
“It would have been terrifying not being able to contact anyone for advice, I would have felt even more panicky without it,” Lauren says.
Yet in the UK, hundreds of women are seeking abortion pills online because they can’t access legal termination services – including those experiencing domestic violence, or women who aren’t eligible for NHS-funded care.
Legally, charities here can’t provide abortion pills. But more than 500 women in the UK approached Netherlands-based charity Women on Web over a four-month period, beginning last November, seeking mail-order abortion pills. Women cited various reasons, including long waiting times and childcare issues.
Abortion remains a criminal offence in England and Wales unless a woman’s request is approved and authorised by two doctors, or performed in a registered medical facility. This means women who use abortion medication bought online not only miss out on the support issued by trained staff but they also face up to life in prison if caught.
“Informed consent is a key part of the process,” says Rachael Clarke of the British Pregnancy and Advisory Service (BPAS). “A woman must be informed beforehand of what to expect – partly to ensure her peace of mind and to let her know what she will need to have to hand (a good supply of sanitary towels, for instance – and ideally some time off work to pass the pregnancy), and partly so that if anything goes wrong she is well informed enough to know when she may need to contact a doctor.”
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“Medical – and indeed all abortion – is a safe procedure for which serious complications are uncommon,” Clarke adds. “The risks posed with getting pills online are not generally the pills themselves as long as women use reputable sites such as Women on Web, but there is a lack of immediate medical support if they are concerned about the process or believe something has gone wrong.”
The most serious side-effect, Clarke says, is the possibility of the abortion being unsuccessful – which is why women who have medical terminations are told to take a pregnancy test two weeks afterwards.
“Other serious side-effects such as haemorrhage occur in less than 0.2% of medical abortions,” she says.
Post-abortion care support is also an essential part of the procedure, which is provided by organisations such as Marie Stopes.
“It's dreadful that not all women have legal access to this choice, everyone should be able to make their own decisions about their bodies,” Lauren says. “Particularly something so important like pregnancy and healthcare.”
*Names have been changed to protect identities
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