My Abortion Was the Most Positive Experience I Had with Canadian Healthcare
I had expected the procedure to be fraught with difficulty, given the experiences of many women. I proved to be the exception.
Photo by Bayne Stanley / The Canadian Press
This article originally appeared on VICE Canada.
My abortion was the most positive medical experience of my life. I don’t say that to be shocking, though I recognize it’s a shocking statement. It was a shocking realization. We’re not taught to expect that abortions can be anything less than traumatic. We’re taught to expect shame, and pain, and something similar to what Globe and Mail journalist Jessica Leeder wrote about in 2018 after her own abortion. We're taught to expect an expensive, extended struggle. To smash into barriers, timelines, judgement, panic, and powerlessness.
When I read Leeder’s story this fall, it resonated because it was everything I'd been afraid of when I found out that I was pregnant. Our experiences couldn’t have been more different though, hers mostly in Nova Scotia, mine in the Yukon, and I wondered why mine isn't the standard for roughly 100,000 documented Canadian women go through each year.
For as long as I've been aware of the consequences of sex, I’ve known that if I got pregnant, I’d have an abortion by any means necessary. I grew up in a small town and went through a Catholic school system. Neither was pro-choice, but somehow I was. I don’t remember, in any great detail, what shaped this. I know I was resistant to authority, specifically when religion was involved, so religious arguments held no sway with me. Beyond that, it just seemed to make sense that I should be able to make the decisions around something that would, hypothetically, affect only me. As I got older and learned more about the issue, I only felt more strongly about it. I’ve never been conflicted on it and there's never been, with any partner, an “if” that made me entertain the hypothetical alternative—if we were married, if we lived together, if we were rich, if our jobs were secure, if the relationship was stable. Having children isn’t for me. There is no if.
When I found out I was pregnant in my mid-30s, my main form of birth control, since I was only sleeping with one person, was temperature charting. I made that choice for a few reasons.
As a writer, I’ve enjoyed benefits for 18 scattered months out of the last 15 years. IUDs, the tiny wishbone-shaped pieces of plastic that cost $500 each, were never an option for me. Additionally, even IUDs with low doses of hormones still contain hormones—the same reason I swore off the pill years ago after my pharmacy switched me to a “same-but-cheaper” brand I eventually identified as the cause of mood swings that had me dancing in the kitchen at breakfast, crying in the shower at lunch, and sleeping through dinner because I was too sad to be awake. So I charted temperature. It, like every other form of birth control, worked until it didn't. Even vasectomies have failure rates.
It was the cramps rather than the late period that tipped me off. I’ve always had painless periods. I was sitting in a bar having a beer with a friend when I felt these cramps that came like small, tiny starbursts low in my pelvis. It’s hard to believe two things at once, but I did then. The feeling was so foreign that, on top of the lateness, I knew I was pregnant. At the same time, I felt so much like myself in every other way (normal energy, normal appetite, normal everything), that I thought I knew I wasn’t. I’d been so terrified of pregnancy my entire life, I scared myself into believing I was every other month, even back when I was with someone who’d had a vasectomy. I figured that was all it was, so I gave it a couple more days before I went to the drug store to buy a test. I used in the nearest public washroom. I stared at the wall for three minutes and then I stared at the tiny digital readout on the Clearblue-brand stick. I threw it in the garbage when the word pregnant blinked up at me. Then I got in my car and drove to the emergency room, believing, again, two realities at the same time. I was panicked, but it was underpinned by calm. By this sense that it was all a mistake.
Being pregnant when you don’t want to be can throw you into a dissociative state. I felt betrayed by my body. Like we’d had a discussion about all this and agreed it wasn’t for us, but then it went behind my back and got knocked up.
In Canada, surgical abortion is covered. It’s readily available in major cities. In the Yukon, it’s available in Whitehorse every two weeks. I knew Mifegymiso, the abortion pill, was here, but that its $300 price tag wasn’t yet covered in the north. (This changed as of November 2018.)
I kept my credit card balance at zero for emergencies, so I was less concerned about cost than I was about the process for getting a prescription, which I assumed would be slow and fraught. Why wouldn’t it? I’d spent my 20s in Toronto and Hamilton, Ontario, visiting a doctor every three months to have him green-light my decision to continue with birth control pills.
As I peed in a cup and moved from chair to chair through the ER, I rehearsed arguments for basically everyone—the ER doctor, the slew of doctors I was certain I'd have to see over the course of the following weeks, nurses, the ultrasound tech, the pharmacy. In between, I googled recipes for homebrewed abortions (pennyroyal, cinnamon in high doses, blue and black cohosh) and looked up flights to Vancouver in case it would be faster and easier there.
Eventually, I was called into a curtained room and joined by a doctor who looked like he belonged on a TV show about hospitals and romance. He wore scrubs and a smile that was friendly without being congratulatory. I took deep breaths and prepared to be calm, yet insistent, that if this didn't happen immediately, my mental health was going to swan-dive into oblivion.
“Why do you think you’re pregnant?”
“I took a test that said I was.”
He said his test had said the same thing.
“Have you thought about what you’d like to do?”
“I’d like to take the abortion pill. I don't know how you say it.”
He nodded and told me that was an option, but that I’d need an ultrasound to date the pregnancy (nine weeks is the latest you can take Mifegymiso, which is more effective the earlier you take it) before I could visit a local clinic for the drug.
“How long will it take to get into the clinic?” I asked.
“We should be able to take care of everything by Tuesday,” he said. It was Friday. That was only three days away.
“Any questions?” He crossed his legs, relaxed, unhurried, present.
The ER is my de facto doctor. Even now, after almost three years in the Yukon, I’ve been unable to find a family practice that's accepting new patients. I’ve visited the ER often enough to know that no one relaxes there. This doctor was intentionally calm and thorough and it rubbed off. By the time I left the hospital, I was dazed, but heartened. I'd stopped wondering whether the herb shop in town sold black cohosh by the pound.
The ultrasound took place two days later. The technician didn’t congratulate me, or condescend. Instead, she made a joke about trying to work quickly because she could see how full my bladder was. I laughed. The next day I called to make sure my results had been sent to the clinic and I went in as soon as it opened.
“You’re sure this is what you want to do?” The nurse practitioner asked me that only once. It didn't feel like an attempt to change my mind. It felt like she was making sure I wasn’t being forced into the decision by anyone.
She said I was at six weeks and asked if I had insurance. I said I'd expected to have to pay, and she surprised me by saying she had a sample she could give me because the Yukon government was working to offer it universally anyway.
She was warm and detailed and reminded me of my older sister. She spent 20 minutes explaining how to take the pill, which is actually five pills—you take one (mifepristone) 24 to 48 hours before placing the other four (misoprostol) under your tongue to dissolve. She gave me a hand-drawn comic that illustrated the steps.
“I’ll be on-call for you through this,” she said. “Text or call when you take the pills. Text or call with any questions or concerns.”
I walked away wondering why, when it was only a box of pills, I felt like I’d been trusted to perform my own appendectomy, and was confident I could. I don’t know what the medical landscape is like for men, but for myself, and for most women I know, particularly when it comes to women’s issues, it’s less a landscape than a wall.
Multiple times over the years, I’ve taken the following issues to doctors, only to be dismissed without discovering a cause: six weeks of debilitating stomach pain; two years of bleeding during sex; persistent anxiety; birth control problems; a cancer-y-looking scab that re-forms on my much-sunburned nose every time I pick it off; an irregular heartbeat that skips regularly; a mystery issue identified by a walk-in clinic that then couldn't read the doctor’s handwriting well enough to tell me what the issue was.
Abortion is the only time I’ve visited a medical professional and felt like they were listening to me and involving me in the process. It was empowering. That’s the only word for how it felt to be given the tools and the trust to do what I wanted to do about a very personal issue. The speed with which it happened and the consistent respect I was shown were the only reasons I didn't spiral into depression.
I took the mifepristone at 5 PM. Thirty-nine hours later, I took the misoprostol and got into bed with (nurse’s orders) Netflix and an arsenal of painkillers. After three hours, the only thing I felt was guilt about lying in bed instead of being productive, so I went grocery shopping. I started bleeding while I was wheeling past the canned goods and I thought about how I’d heard that Mifegymiso is helpful to women in abusive relationships because it mimics a miscarriage.
The bleeding continued, like a heavy period, for four days. I felt bloated, but was otherwise surprised to find I felt good. I worked. I talked to friends. I went to the gym. I felt strong. I felt like I was in control of my life. Whole afternoons passed where I didn’t think about abortion. When I did, it didn’t break me into a million pieces the way it would have if I’d still been waiting to find out what was going to happen to me.
On the fifth day, more intense cramps passed a clump of tissue half the size of a dried apricot. Up to that point, it had mostly been bleeding. I texted the nurse.
“That should hopefully be it now,” she said and told me a blood test would confirm it. Three days later, it did.
“Procedure is complete,” she texted when she got the results. I was walking my dog at the time. I high-fived him. She reminded me that the clinic offered ongoing support if I was struggling emotionally, but I never did. The reason for that, for me, is that the process was so speedy, supportive, and respectful, that I wasn't traumatized by it. For me, it was positive. That doesn't mean it was a good time. I didn’t enjoy it. I don't want to repeat it on Friday nights going forward. But it made an awful situation easier. The only feelings I have around it now are of gratitude and appreciation.
I recognize my circumstances were unique. Not every woman seeking an abortion is in the position I was—30-something, financially stable(ish), housed, confident enough to stand up for my needs, cis, white, able to follow through on appointments, able in general, physically healthy, emotionally unconflicted, close to a major city, and with no one in my life trying to force me into or out of the decision.
I also recognize it's still far from perfect in Canada. There are many communities, both urban and rural, where it's difficult to get the ultrasound required for a prescription. This slows a procedure best done early in a pregnancy. The drug also isn't covered everywhere, and prescriptions are still limited to certain clinics and providers.
Some of these pieces, like offering easy access to, and universal coverage of, Mifegymiso, are higher-level policy changes. Others, like showing basic respect, take place on a personal level. All are necessary if we want to mitigate the negatives for the thousands of women who get abortions in Canada each year, and for the many more who don't because of existing barriers.
My experience should be the expectation, not the exception.
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