I am 39 and had a surgical abortion yesterday at seven weeks, and am writing to share the full process for anyone who might be feeling anxiety around this - and as a memory-keep for myself.
I discovered I was pregnant two weeks ago.
As soon as I found out, I made a phone appointment with BUPAS for a few days' time.
Learning about medical abortion
The call took place in an unfortunate set of circumstances: at the time, I was camping, and so while everyone else was outside having a few drinks, I was sat inside the van listening to the woman on the other end of the phone. I should clarify here: I don't have children, I've always been ambivalent about it, and perhaps like a lot of women (and certainly all men), I had a vision of abortion as "they whisk you in, they whisk you out, it's just a pill and a fairly heavy period".
But as I spoke to the BUPAS woman over this one-hour call, my stomach dropped with every passing minute.
The first piece of bad news came when I explained that I'd had an extremely delayed period a few months prior to this, despite being regular as clockwork my whole life. The advisor noted that this sounded like a chemical pregnancy and that because of this, they couldn't just send me the pills: they would need me to go to a clinic to get a scan.
The second piece of bad news came when I gave my postcode. The advisor said "Oh OP, my heart always sinks when a woman gives me a postcode in your region, because it's a medical abortion black hole."
I discovered that to proceed with a medical abortion (aka to be given the pills), I would need to go to a clinic in one of three cities, all over a 40-minute train ride away. She said at the appointment I needed to remember to tell them to turn the ultrasound screen away. I reluctantly booked an appointment for the 25th.
Next, the advisor moved on to the practicalities. Once I'd had the scan and been given the pills, I would need to go home and lay out the three packets. Don't quote me on this as my memory is hazy, but essentially: packet 1 would cut off the pregnancy growth hormones. Some time later, I would need to take packet 2, and this would trigger essentially a miscarriage (?). She then noted that because I have never given birth before, I would need to study the photos she had just emailed me very closely, as I would have no point of reference to ascertain how much bleeding and pain would be "normal". She also explained that because my body had no muscle memory of labour or miscarriage, I might need to use packet 3: an extra dose to ramp things up. The advisor went into extreme detail, which is only right. She said some hours later through the bleeding, I would feel an urge to push, and at that point I needed to get myself to the toilet and I would pass something the size of a lemon. This made my blood run cold. She said they advise you not to look and to simply flush. She said there would be more continuous bleeding after that.
At that point I broke down and said "maybe I'll just keep it then", to which she sounded very surprised. My logic was this sounded horrific and intrusive and I might as well just actually give birth. I came off the phone feeling shell-shocked and deeply depressed.
I got out of the van and went for a walk, and after that I called my mum who said she would support me in whatever I did. I sat there watching the night fall thinking about how fucking terrible this was going to be: a train trip there and back and then having to self-monitor bleeding out at home. I'm lucky in that I live with my very supportive aunt next to an A&E, but I was very uncomfortable at the idea of her having to take responsibility for my wellbeing like this - its a lot to ask of someone.
I began researching surgical abortion. The BPAS advisor had explained that most women choose medical because often they need the covertness of "simply" taking pills, or they have no childcare for the kids at home and so cant just go into hospital for the day. None of these applied to me, and so I decided that surgical, as a faster, less messy process, was the right choice.
The pre-surgical appointment
I called my GP who forwarded my call to the gynaecology unit. I was given an assessment appointment for three days later, where a nice, no-nonsense doctor took me through a quick consent form, took my bloods, and gave me a scan. She asked me whether I wanted to recover it afterwards for burial or cremation which made me well up.
Something to be aware of so you can brace yourself: two distressing things happened. Firstly, the screen was not turned away, and before I had time to avert my eyes, I saw the ultrasound. Secondly, I was in a waiting room full of new mothers and their partners. This was very distressing.
I was given an appointment to undergo the surgical abortion two days later, at a hospital a 30-minute drive away (yup, I really do live in a black hole...).
I felt torn about this. On one hand, I wish it'd been a longer wait. On the other hand, I had already had a two-week wait since I'd found out, and I knew there was no new information for me to work through, it would just have been prolonging the agony.
The agonising decision
"Unfortunately" for me, I had no struggles throughout my very brief pregnancy - no cramping, no sickness, no fatigue. I say "Unfortunately", because this made me feel more of a connection to it I think than if it had been unpleasant. It also left me with the depressing sense that this was something my body was handling well.
I had to work through a number of permutations.
Against:
- Moving: I'm buying a house at the other end of the country where I don't know anybody other than my partner yet. I have no support network, and my actual support network is scattered across different cities and countries. Although my wonderful mum had offered to fly over and give me any support I needed, I knew that if it "takes a village to raise a child", I don't have that one village.
- Money: I've lost 70% of my income in the past two years as a result of AI. I'm supposed to be shifting gears and am currently broke. Again, my mum told me not to let money cloud my decision which is so kind, but it was another factor weighing on my mind.
- Autism: there is substantial autism in my partners family, and not only the high functioning kind.
- Partner against it: I had the conversation with my partber and he was categorically against it. I know women become single mothers, but ethically I did not feel comfortable willfully, consciously choosing that path. My attitude is that of course life happens and you can find yourself a single mother, but I personally would never want to set off down that route forewarned. My vision of motherhood would have been to have a child in a family. It wouldnt be something I would want to do "whatever the cost".
- Mental health: I have a history, having had a nervous breakdown in 2022 coupled with panic disorder for a few years around that time.
I could just picture myself: alone, broke, with a child with potentially some very severe needs, and me slowly crumbling psychologically.
For:
- Of course, having only ever been ambivalent and not dead set against it, there were images continuously flashing through my mind: of holding a baby, watching a child grow, leaving your mark. But set against these was also the very real parallel version, in which I had a child I would be unequipped to raise due to needs I wouldn't be able to tend to.
- My age: this is something the surgeon empathised with. Doing this at 39 holds an extra layer of intense grief that isn't the same as when you're 26. At my age, you aren't just saying "not now". There's a very strong likelihood that you're saying "that's it now". There's something very sad about knowing you are actively pulling a door shut behind you, possibly forever.
In the last week before my abortion, I found myself uncontrollably sobbing, especially in the mornings, as competing visions flooded my mind. I was also acutely aware of how so many women struggle for years, decades, spending tens of thousands to get to where I am, and here I was, just throwing it away.
The surgery
Two days later, my aunt and uncle drove me to the hospital. It was a beautiful day and the hospital was in a beautiful setting. Before we left, I found myself wavering again, but once we hit the road, that dissipated.
I arrived at 11.30am having fasted beforehand. I was alone in the waiting room when the nurse came to see me. She told me I was last on the list for the day and my stomach dropped. She said this was in case I needed to change my mind, and I see why they do this: this could be valuable alone time for any woman, but especially women who have been coerced into this situation. This time could be vital to reversing a decision they don't actually want. In my case though, it felt like an unintentional cruelty in a way - an extra few hours to sit there and reflect after all the reflection I'd already done.
The nurse took my bloods pressure and went through the allergy sheet. Then I was taken into a bay where five other women were waiting for gynaecological procedures. I need to warn you that depending on your frame of mind, you could find this challenging: you're sitting by your bed with your things and all the curtains are open. You have to wait there for a few hours listening to women swap baby stories and labour experiences while you just shut your eyes and try to block everything out.
First, the anaesthetist came to see me. I've been lucky in my life to never be in a hospital before, and nor have I ever had anaesthetic of any kind.
Next, the surgeon came to see me. She pulled the curtains around the bed and something about seeing her face made me break down. I began to sob uncontrollably, and she took my hands in hers and asked me whether I was doing this voluntarily. I said yes. I said "its just a horrible thing to have to do, isn't it?". She empathised with me. She then asked me whether there was any particular reason I had requested to have the copper coil fitted instead of Mirena, I said no. She said she strongly recommended the latter, I consented.
After the surgeon left, I coerced the nurse into letting me sneak out for a cigarette (don't judge!). I started crying again in the lift down, and sat in the sunshine for a bit. I came back upstairs, and two hours later, it was time for me to get ready.
I put on my gown and inserted two pills as far as they would go. The nurse asked me whether I wanted to do it in the toilet or on the bed with the curtains shut and don't fucking ask me why, but I chose the former (???) which resulted in me having to lie on the cold toilet floor doing it, wondering: "is this what my life is?". 😂This is to soften your cervix, and you can have a nurse do it if you prefer.
An hour later, the porter came to collect me. I was feeling sullen but somehow not nervous or anything. By this stage I had given up any internal fight. The porter was being really chatty, I guess to try and put my mind at rest, and although I'm normally a very chatty person myself, I could only answer in single words.
I was taken into some kind of anaesthetic room and asked to undo the back of my gown and lie down on the bed. They started putting monitors on my and slipping that thing into the back of your hand, and at this point I started sobbing again. The anaesthetist then stopped and asked me again if I was doing this voluntarily, I said yes. She asked me to check the signed consent form and to confirm that was my signature, I said it was.
The next thing I know, I was awake and it was done.
Afterwards
The porter wheeled me back to the bay which I actually really enjoyed 😂 I felt like royalty and in really good spirits! He shuffled me onto the bed, and I lay there for a while. All the women had had their procedures so any tension in the room had dissolved. Everyone started peeling away as they were discharged, until I was the last one left. The lovely nurse gave me some of her own personal coffee as "NHS coffee is appalling". Then she gave me a sandwich, and as a lover of cheap, trashy triangle sandwiches, I was in heaven. After about 90 minutes, she asked if I could try getting myself to the bathroom and getting dressed which I did with no problems. There was blood but nothing more than a light period.
After the full two hours wait, I begged her to discharge me so I could have a cigarette 😂 and as a fellow smoker she couldn't really argue with me. She knew my aunt and uncle were just 5 minutes away, so I collected my things and she walked me down to the bench in the sunshine. As soon as I lit my cigarette I saw my uncle waving in the distance, so I walked over to the car and we drove home. I felt alert and in no pain.
I was given a three-day course of antibiotics, information about the Mirena coil and a card showing it had been fitted, plus two pregnancy tests. That night I had dinner and went up to bed afterwards. When I got upstairs, I had a terrible physical feeling - some kind of bloated, faint, unusual feeling, but it passed after half an hour. I took two paracetamol and went to bed.
I was expecting to be conked out, but I wasn't. I woke up at 4am this morning, however I do have issues with insomnia and generally having a lot of nervous energy so I'm not surprised that even a general anaesthetic didn't leave me wiped 😂
This morning, I did some more sobbing. I suppose the hormones are now flooding out of my body. I made the best decision I could with my set of individual factors. If I'd only had one or two of the "against" points, maybe I would have pushed on with this: if I'd been broke but had a partner who wanted it, or if I'd been moving to a new place but earning a very good living, or if there were this very high chance of having a child with different needs but I had a village around me...
Unfortunately I felt there were too many odds stacked against this. That doesnt mean I didnt agonise over this. I tried to make what I consider to be a selfless decision. It wasnt so much about what I really wanted: it was more about what I felt I could provide.
I am so grateful to the NHS. All the professionals I dealt with were kind, competent women who supported me every step of the way, as did my mother, aunt and friends. I feel lucky to have so many amazing female influences in my life. What I did find hard though, is that I didn't know any woman in my situation: a woman who had had an abortion out of active choice, not a medically prescribed one, and especially not a little further down the road, with that sense of a door swinging shut. I can't lie about this: I will always be vehemently pro-choice, but in my case at least, there was no escaping the notion that I was denying something from coming into being, and as I was crying in the anaesthetic room, I was repeating "I'm sorry" over and over.
There's a whole shadow sisterhood out there - one that doesn't get to be as open about their experiences. Women who don't get the chance to openly swap stories about their experience of being pregnant and making decisions, the way mothers can swap stories openly and freely.
Today, the morning after, I feel 100% physically fine with zero pain and nothing but spotting. I am still finding myself sobbing randomly, but I'm sure this will pass as the hormones settle down. I don't regret my decision, but it would be perfectly logical to assume that something like this changes you forever, and I suppose I will always think "what if", as any person, parent or non-parent, always does in a life.
To anyone wondering whether a surgical abortion us a good idea over medical: in my case, it was the cleanest, quickest and safest option and I'm very glad I chose that over medical.
Take care and good luck, whatever path you choose 💐