I'm a midwife who works in abortion care. AMA(565 Posts)
MNHQ have commented on this thread.
Go ahead. I'll try and answer everything the best way I can. Sorry if this is boring (I love my job and can go on about it a bit.)!
I was terrified of the idea of the pills due to anxiety and having kids at home so despite initially consenting to them because I could do it sooner, I went for surgery. I am so glad I was, and in my case, with sedation, it wasn’t painful. The nurses who were with me couldn’t have been lovelier. I do have recurring dreams about the fact that it was a procedure the fact that they were all so nice makes it easier to deal with.
In my case I initially really thought I would carry on with the pregnancy despite accidental. But both my son and I got really ill while I was pregnant and I became hugely anxious and panicky. I realised I didn’t think I would cope well or that it was fair on the rest of my family. I also think I had ante-natal depression which made it everything seem so much worse in my head. One thing is I wish I could have accessed counselling more easily to be absolutely sure of my decision given my increased anxiety and being ill etc - every time I asked Bpas I was told “sure, you can book it after your next appointment” until they were telling me I could book it after the procedure. I don’t think it would have changed my decision but at the time I only had DH, who wasn’t keen at all and was also worrying about how we would cope, to talk it through with. I felt really desperate and my polite phone voice doesn’t always convey that well. I know that funding is a huge issue though. I have found a local charity so I can go and talk through my feelings about it and plan to donate to them when I do.
Thanks for all you do OP Oh and I am glad your baby is pro choice too.
So just to clarify, it would never hurt the baby no matter what gestation?
When do their nerve receptors develop?
And also to clarify, there is a chance feticide might not work first time?
What happens then?
Is there any effect to the baby in the interim before it works the second time?
Are aborted babies left whole? Does this depend on gestation?
Has a baby ever been born alive and if so would you look after/comfort them until they pass or just ignore them?
@slithytove as I've said above, there is a lot of debate about the nerve receptors. I was talking about the current legal cut offs. I've not experienced feticide not working first time. It would work because we do it under scan, so we can watch to make sure it has worked.
I feel like you are dancing around my question a bit
Abortion is allowed past 24 weeks for viability reasons I believe, and you personally believe there should be no limit on baby gestation. Past 24 weeks, would or could the abortion process hurt?
Is the baby left intact?
Slithy, I'm sorry, I feel like you're trying to trip me up and I'm not sure what you're trying to get me to say. We perform feticide after 23 weeks to make sure that there is no pain or chance the baby could be born alive.
Is the baby left intact, it really depends on the gestation and the type of treatment. I'm not exactly sure if everyone in this thread might want to read in great detail about this but am happy to talk about it if a few people say they're happy to. (or via pm.).
Sorry if this is a bit much but I'm interested to know how it all works.
So the pill doesn't terminate the baby it just induces labour and the baby dies during the labour, is that right. So it just causes a miscarriage?
What is the surgery? Can this effect chances of future pregnancy, or damage the womb?
At what point can you no longer have the pill?
I understand how the feticide works. Is that just for after 23 weeks and not necessary before? Could a baby be born alive with just the pill before 23 weeks?
My SIL had a very late abortion of a wanted pregnancy due to a serious genetic disorder. The baby was unlikely to survive and if he did would live for a year or two at best and with no quality of life. She felt unable to continue with the pregnancy knowing the foetus could die inside her at any time and became hysterical at the thought.
She had to give birth to the dead foetus vaginally. I imagine that's how it often happens with late abortions, slithytove.
She and DB took hand prints and held him. They had a funeral. I didn't attend because I was seven months pregnant and it would have been cruel.
DB and SIL are very religious. I was impressed when her priest told them that abortion in a case of foetal abnormality that extreme was ok by him.
slithy I doubt the OP actually nos the answers to all your questions, nobody nos for sure what what stage the fetus can feel pain, some parts of America insist pain relief is used after 20 weeks as they think it’s then, but the vast majority disagree with this. If specialist doctors can’t agree then how can the OP no everything? After 24 weeks though it’s for wanted babies that are unviable or too poorly, so they arnt going to be deliberately causing or allowing pain to the baby are they?
Foetuses aged 24 weeks or less do not have the brain connections to feel pain, according to a working party report published in 2010 by the Royal College of Obstetricians and Gynaecologists (RCOG).
I don't know if there's been any further research done.
I'm shocked people still think babies are born alive after abortion in 2018. Yes, in the olden days they were. Now the process is much more humane (or as humane as can be depending what your stance is), the baby/foetus is not delivered alive.
@Sagradafamiliar I'm not so shocked, there is a lot of mystery and myth surrounding abortion. That's kind of why I wanted to do this thread, to help people understand that we're not evil and we do want the best for people and do whatever we can to be kind.
I'm glad you've done the thread, if these are the kind of myths which endure then I'm not surprised people find the idea of them upsetting.
I’m not trying to trip you up but I do want a definite answer if you know.
If the answer is you don’t know, then fine, that’s as much as you can say.
if it’s no, they never feel any pain because before 24 weeks there are not enough nerve receptors and after 24 weeks feticide is used which is pain free, then that’s brilliant.
If it’s yes, feticide causes pain, but before 24 weeks doesn't, then at least we know.
My key question is around the feticide. I would like to know that after 24 weeks, the baby doesn’t feel pain from abortion.
I’ve asked questions as it’s an AMA...
And I have another. After 24 weeks is an aborted baby classed as a stillbirth and registered in the same way a stillborn baby is? Is the cause for still birth noted differently?
Alb1 i imagine no one wants to cause pain, but is that possible? Can a baby be aborted after 24 weeks without causing pain?
Because if it does, that doesn’t really matter does it? The decision / outcome is not altered regardless.
And one could argue that pain of abortion in those late cases which are currently legal, is less than the pain a non-viable baby will suffer once born. And therefore acceptable.
The answer is, I do not know.
At the moment I don't work in a facility which performs abortion after 24 weeks so I'm not exactly up to date with everything. But yes, I'd imagine they'd be registered as a still born baby.
They stop the heartbeat so i would think that there is no pain as the foetus is dead.
I would not want to continue in those circumstances either prawn. The pain of a stillbirth (which is agony, I do know that) compared to losing a child you have had in your life, slept with, cuddled, kissed, fed - it’s nowhere near the same. Far better to suffer the loss before hand if it’s an option.
Which is why I support the law as is... I’d just like to know that the feticide process doesn’t hurt the baby.
I hope your SIL and DB have recovered as much as is possible, though I know there will always be a hole in their and your family.
Yes I know it stops the heartbeat. I hope that in the process, the cells dying, the needle going in, the injection going in - I hope that doesn’t hurt.
Q After feticide is carried out, does labour have to be induced or does it come naturally?
In my stillbirth the doctors said that she died during the process of labour. But in others I know, labour started because the baby had died in utero.
slithy I was another poster who said I thought there should be no time limit. You seem to be linking that to the possibility of the baby feeling pain. My guess is that might make it unacceptable to you, but it’s hard to tell because you haven’t said.
I’ll answer the question in a different way. The OP has explained that the baby’s heart is stopped with an injection, to make sure that it is dead and therefore doesn’t experience pain during the abortion procedure. It seems quite possible to me that once you get to certain point of gestation the baby would, briefly, feel the injection as pain. Despite that, I still don’t believe there should be a time limit because I think that brief experience of pain is an acceptable part of terminating an unwanted pregnancy.
slithy yes the baby is still registered as stillborn (I no people through sands that have been through this procedure), the stillbirth certificate requires a cause of death like a death certificate does with a letter signed by the appropriate medical person, so I would imagine that would say termination for medical reasons, or similar.
Slithy it would be started in late medical abortion, or the following day, if the woman chose it, surgical abortion would be performed. (D&E If you want to look up what this involves).
Also crosspost as I didn’t realise you’d have seen the stillbirth certificate, but friends who have experienced this did also have a stillbirth certificate I believe
My opinion doesn’t matter thislido but yes, I am happy with the law as is regards limiting abortions.
If the baby feels pain to me that isn’t a reason to change the law, but change the process. Administer pain relief. Knowing the baby will never be in pain may also make the decision easier on women.
Thanks all for answering what I know for some are difficult questions.
Sorry glittery I didn’t quite understand your last answer - could a D&E be performed following feticide after 24 weeks?
Slithy, I'm just talking about where I work (where we do up to 24 weeks). I wouldn't want to comment about other facilities as I'm not enough of an expert and would be speculating.
The trouble is, pain relief would probably be local anesthesia which really really hurts. Feticide is very quick so it is kinder to just do that.
Sorry if you thought I was being obstructive. I'm not, I'm just a bit thick. X
For the PP who mentioned it - I've had a pregnancy dated by vaginal examination and feeling my abdomen too, by both doctors who saw me (mid '90s). No chaperones (but female doctors). I believe this was very normal back then, I was never scanned at any point. I suspect that ultrasound technology was only available in hospitals then so used far less?
I expected to be examined before being prescribed the pill too, as a nurse told me that would be done along with checking my BP etc when it was first prescribed - but that didn't happen. I asked and the GP said recent guidelines had said that this wasn;t usually necessary, so they'd stopped doing it - but some doctors may have carried on as that's what they'd always done.
The late term abortions I know of, the women were injected into the amniotic fluid, not directly into the foetus' heart so I'd imagine there was no pain involved.
Thank you for this thread and the work you and your colleagues do OP
@nevertol through my various gynae obs experiences I have been told expressly by various medical staff that nothing can be achieved through vaginal exam, either to 'prove' pregnancy, or whether pregnancy mc can be evidenced.
Your go needs reporting for assault. I was horrified to hear your experience.
If this was necessary then you would be/should be made fully aware of reasons and understand the need. The reason you're not is there isn't any!
I've often thought that. I was in a Marie stopes abortion clinic in Birmingham in case anyone else had the same experience. I remember at the time excusing it as I had been so careless so I deserved it if you see what I mean. I think it was for dating purposes (at lest that's what he said) and I can't remember if I had a scan or not.
@MimsyBorogroves I'm sorry you had the same experience. I've had nightmares about it for years. It was nothing like eg a smear exam. I felt violated.
Glittery ! Courageous act to do the AMA, conducted very professionally by you.
Much credit to you for the kind and considerate work you have done here and undoubtedly dobe during your career.
The world certainly needs more women supporting women, like you and your amazing colleagues. I can't speak highly enough of you upholding choice for women and their bodies.
I have known girls of 12,13,14,15,16....need your services. Sadly they have all been terrified, highly emotional and above all, secret.
I have know girls, labour alone in silence locked away from any support. I have helped to support others to feel emotionally supported through choice and decision made, and parents not aware.
One who laboured in secrecy at term had no idea what was happening, terrified, and delivered alone the baby of her father's rape of her, awfully deformed and unsustainable. The baby suffered desperately and died. SA in families often results in such scenarios, or forced abortion, explained as other than.
Having had to face these choices for myself was horrendous.
I have also known women kill themselves as a result of being denied abortion, they made the only choice they felt they had left.
I have got the impression from some comments that it's easy to intervene in DA situations. Actually it's quite widespread.
Even where abusers are hauled out, they don't get actions that prevent further abuse and killings, and are given the care of DC!!!
Courts too frequently advocate fathers rights over vulnerable DC. DC get killed.
These are women's 'choices'
Grateful that in this area that you work, at least, women do get choice.
@Smotheroffive I wouldn't say I'm courageous (unless I get outed and lose my job I guess!). Thank you for sharing your stories. The thing which really solidified my opinion about any gestation for any reason was sending a woman away who I was sure would commit suicide rather than have her baby.
I hope this thread has helped at least one person to not feel shit about themselves, or their choices. Maybe given an alternative perspective to someone. I'm sorry if I've upset anyone with my extreme views.
I'd imagine the amount of women who use abortion as a form of contraception are far and few between. I mean if
judgy people knew the reality of it, including what it can do to you emotionally then they wouldn't just come out with such nonsense.
When I was 20 I had a surgical abortion. I remember going to the first appointment with my mum where they asked why I wanted an abortion etc. Then on the day it happened I went alone, I didn't have a clue what was going to happen or what they were going to do (whereas now I would ask about the process and what was going to happen.)
I had to put on a gown, lay on a bed and the lady gave me a general anaesthetic injection. Next thing I woke up on a bed, slightly bleeding and not really knowing what was going on. Then I got dressed and had to go in a room, eat a plate of sandwiches then I went out and walked home.
I look back at how bizarre it was, especially as a young adult on my own. It took me a long time to get over that (because my boyfriend made me get rid of it.)
It's how it looks from wherenim standing OP, and having to defend your wish to stand alongside women at some of their worst times and give, not only non-judgemental, but actively supportive choice. This environment of considerate and respectful support only exists in very small pockets.
I wondered how you prevent those with the pile opposite views from getting employment in this field (I am thinking of all the activists and what lengths some will go to - you mentioned one before whibwas negatively affecting women) does this happen rarely, or do others try this?
And is the role sex protected in terms of women not having to choose medical care from women because its already provided?
Does this only happen in rape cases perhaps, or do women ever have to have male medics despite rape or PTSD situations?
@Smotheroffive interesting questions! I guess you develop a knack for knowing when people are truly pro choice, so you can hopefully weed most people out at interview. I've definitely worked with one person who I'm sure wasn't, she didn't last long in the job because she found it really hard to cope with.
Most poems who are nurses or midwives in this job are women, but not all. A lot of the drs are men. In cases of trauma we would do whatever we could to arrange appropriate care. I've never had a women decline our male Dr yet, even in cases of rape. But if they did, we'd rearrange the treatment for them.
I hope this thread has helped at least one person to not feel shit about themselves, or their choices
It has helped me OP. It has been really interesting. I also definitely now consider myself completely pro-choice whereas before I am not sure I was.
I've found your AMA very interesting and I'm so glad that women and girls in need have someone as compassionate and principled caring for them. Thank you.
Hi. I had a termination over 20 years ago. I've never had any regrets, I was not in the right position to bring a child into the world.
I now have 3 much wanted and loved DC.
I am grateful how things turned out.
For some reason, I have v little (next to no!) recollection about any of it. It was surgical, that's all I have ever been able to recall.
Reading this thread has made me realise that I have some unanswered questions, largely how many weeks I was. I have always wondered, but this thread has really made me think.
Do you think that is something that I could ever find out?
Thank you @GlitteryPoopooplop for your compassion and understanding. I hope I was treated by someone as kind as you.
Thank you again OP!
I think what I'm trying to say is whether vulnerable women are offered women medics (esp.in sensitive cases) purely because those women (and a lot of other women too) find it too confrontational to say no....so they don't actually have real choice.
Yeah, the drs are men . I have heard endlessly just on here alone [MN] the women complying with actually unwanted procedures and by the opposite sex, also unwanted.
Thank you for this thread Op, I've never had an abortion but I did have a very premature child (28wks 1lb 10oz) and I'm pro choice.
No child should enter this world unwanted, there are far too many children who live dysfunctional lives and end up harmed, neglected, abused etc, as awful as it sounds I do think that to end a pregnancy in a humane way is by far the better option and that's before I even consider the life of the poor women who has made such a hard decision.
I know not all abortions are due to abuse, tape etc and the woman had decided it's not the right time etc and that too is up to her. Her body, her life, her right to choose.
Keep up the good work Op, you are much needed.
Thank you for what you do OP.
You mentioned that you see the woman on her own and then admit whoever is accompanying her so that you can be sure she is not being forced into an abortion - if it turns out that she is, how can you safeguard her?
I personally wouldn’t ever have one unless medical. I’m pro choice but I have limits but their my personal limits and I’m not about judging people who’s circumstances I’ve no idea about.
I’m just glad their are lovely people out there like you supporting women who find themselves in this situation. X
You mentioned that you see the woman on her own and then admit whoever is accompanying her so that you can be sure she is not being forced into an abortion - if it turns out that she is, how can you safeguard her?
It varies depending on the situation. We have safeguarding forms which are designed to ask more details about what's going on with the client. We have have the police in before, in extreme circumstances. We have access to women's aid etc etc.
Is it too early to have a surgical abortion at 4 weeks? And do you think having a local anthestic is painful or ok... also can the coil be fitted at the same time? Thankyou
@tensun15 It depends, 4 weeks isn't possible to see on scan generally, unless you mean 4 weeks since conception (which would be 6 weeks pregnant). You can definitely elect to have surgical abortion early, as long as its been confirmed by scan. It's slightly more complicated before 7 weeks because the pregnancy is so small so the dr just has to do some extra checks.
We put coils in at the same time as surgical abortion, in fact it's a great time to have one put in.
Local anesthetic really depends on the person. It's very very quick (5 or 10 minutes) so lots of people are fine, but also, some people find it terrible, and struggle to cope. Usually clients feel fine within an hour or so after the procedure.
@GlitteryPoopooplop I am at a Nupas now. Waiting for my consultation. Due to having a lletz last year they say I might need to have it under GA.
Will know more after the consultation.. but might also have to come back if internal scan doesn't show clearly .
Thankyou for getting back to me x
Good luck. Let us know how you get on. X
@GlitteryPoopooplop I have to go back in 2 weeks as the scan didn't show . All the ladies I saw today were really lovely and helpful. Due to the lletz I will have to have a GA so will carry on as normal (well try) until then.
Also I will be having the coil
I had an abortion at 14 after being raped. Worst experience of my life I remember fainting and I was walked back to my room with my Robe open so everyone saw the back of me naked but they didn't care.
Was so painful didn't realise how painful it would be.
I'm glad there's people like you doing this job it must be so hard. I was 12 to 14 weeks so had like the tablets inserted with a tampon was really hard.
@Maybeitsjustmeor I'm so so sorry you had to go through that. I'm glad you felt supported.
Thanks. It was a long time ago so I'm hoping things have changed a lot since then.
Thanks for this thread OP, it's much appreciated to read how it is from a HCP point of view.
Thankfully when I had a surgical abortion aged 17 I experienced nothing but kindness from the nurses on the day of the procedure. Going under GA (I'd been referred on the NHS by sympathetic GP and after a scan showed I was 14 weeks was scolded by an aged Consultant for being so shameless as to have sex and to refrain if I didn't want a baby and that there were no options and I'd have to have the baby. Me and my mam went back to GP who was disgusted but not surprised and pointed me in the direction of BPAS (forgot to say this is early 1990's)
My dad drove me down to the private clinic, I think it was called ?Danham Lodge, in Doncaster 4 hours drive away and I had a consultation with a doctor with no nurse chaperone. I was told to completely strip naked and lie on the bed where he did a breast and vaginal examination. I remember feeling traumatised but just assumed this was the norm?
I was booked into a B&B directly opposite for the procedure to be done the next day and I remember the kindness of the landlady - obviously she'd had lots of girls/women staying previously. She gave me an alarm call next morning and on my way out the door gave my arm a squeeze and said 'you'll be fine'.
After booking in I was shown to a 4 bed bay where by we all stated why were there (voluntarily) - only lady who had an obvious bump in the bed next to me was there because she'd briefly split up from her husband and had slept with a black partner so was worried the baby would be mixed race (she was scanned and too far to have the procedure). Another was a 14 year old whose brother had made her pregnant.
My most prominent memory is the lovely nurse who held my hand going down to theatre and reassuring me, she was so kind and stroked my face and wiped the tears away and told me I WOULD be ok. I'll never forget her.
When I woke up from the GA I was crying though I don't remember it and the same nurse held my hand back to the ward. We were given a cooked meal at tea-time in a canteen style set-up and my dad picked me up the next morning. Before this my dad and I were never very close but it definitely brought us together - I'll never forget how supportive mam and dad were.
Sorry for the essay but this has brought the memories of it all back to me - and I can absolutely say, even aged 17, I absolutely did not take the decision lightly or think it was a form of birth control. I was a naive 17 year old just out of an abusive relationship where he was finally jailed for violence and stalking.
Thank God for people like you OP
Hello how many people back out of the abortion at the surgical table
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