A medication abortion begins after you take 200 milligrams of Mifeprex by mouth, usually at a doctor’s office or a clinic. The medication blocks progesterone, the hormone responsible for keeping the embryo attached to the uterine wall.
A medication abortion is not just one abortion pill, but rather a combination of two medications prescribed by a physician that work together to terminate a pregnancy and shed the uterine lining. The two medicines used are mifepristone and misoprostol. Mifepristone, which is taken first, works by blocking progesterone, a hormone necessary to sustain pregnancy, causing the embryo to detach from the uterine wall. Misoprostol is taken within a day or two of taking the first pill, usually at home, and works by causing cramping that empties the uterus, kind of like a really heavy uncomfortable period. Medication abortion is a safe and common procedure for terminating first-trimester pregnancies.
To shed light on what its like taking the abortion pill, 21 Magazine spoke with three women (whose names have been changed) about their experiences taking the pill.
Side Note: Abortion is still very much a controversial topic in Nigeria and is legally restricted in the country. If you ever find yourself in a situation were you’ve decided on having an abortion, please find a physician or a health clinic with improved health facilities.
How old are you, and when did you have a medication abortion?
Victoria: I was and still am 24 years old. It was very recent.
Temi: I’ve had two medical abortions; The first time I was 21 years old and the second time I was 23. I’m 24 years old currently.
Michelle: 26 years old.
Did you know right away that you wanted to end the pregnancy?
Victoria: YES. Although, I also felt guilty but I did what was right for me at the time.
Temi: Yes, I did. However I contemplated not going through with it because I was in a serious relationship both times, but getting the abortion was the right thing for me to have done, and I’ve never regretted it.
Michelle: I was rather indecisive because I had just gotten engaged, and I found out 3 days after.
What did you know about medication abortions before you had one?
Victoria: Not much. A friend of mine randomly spoke about it once, and I had read about it online. I knew the whole process involved me taking a few pills, but it never really made sense to me until I was in the situation.
Temi: What’s funny is, my boyfriend at the time had more knowledge on medical abortions than I did, so he was incredibly helpful through out the whole thing.
Michelle: Well, I had read a few things online. Just the basics; you bleed and it hurts a lot.
Why did you choose medication abortion?
Victoria: Because I didn’t want the other option and it was still early days. Also partly because of movies I’ve seen in the past. Surgical abortions are too invasive for me, and its scary because what if something goes wrong? I’m very glad that I found out early I was pregnant, so I was suitable for a medication abortion.
Temi: Well, because I was only four weeks long, so having a medical abortion was the best and most advisable option.
Michelle: It’s much safer and I was only a few weeks long. Plus, I just can’t imagine anyone inserting any sort of tools into my vagina.
What kind of clinic did you go to, and how much did the whole procedure cost?
Victoria: I went to a regular clinic in Lagos that was recommended to me by a friend that had gone through a similar situation. It was super easy and straight forward. I thought it was going to awkward going there but I can’t stress how easy it was. It cost a total of about N46,000 including the pills, consultation and scanning.
Temi: I went to a fertility clinic in Ikeja, Lagos. Everything cost about N60,000 because I also had an ultrasound scan, plus consultation fees. I believe the pills alone cost about N40,000.
Michelle: I went to an accredited clinic that’s known for their specialization in family planning and performing abortions, both surgical and medical. It cost me N60,000 in total; N20,000 for consultation and N40,000 or the pills.
Did you tell anyone about your decision to get a medication abortion?
Victoria: Yes I did. The guy I was involved with at the time and a friend. He knew not to influence my decision and was super supportive about it.
Temi: Yeah I did. My boyfriend then of course, and my best friend. Just those two people.
Michelle: Yes, my fiancé and my best friend.
Did anyone go with you to the clinic?
Victoria: Nah, although the person I was seeing (and the person who got me pregnant) offered to, but I preferred to go there alone and get it over with. I honestly didn’t want to create a big deal out of the whole thing to avoid getting emotional.
Temi: Yes, my boyfriend then went with me to the clinic.
Michelle: Yes, my fiancé.
What were the steps of your medication abortion?
Victoria: The pills came in a total of five. I was to take 1 at the clinic and the remaining 4 at once, exactly 24 hours after taking the first one, which I did. I placed the four pills right under my tongue for about 30 minutes until they dissolved. Once they did, I drank some lukewarm water to flush down the remaining pieces.
The bleeding started almost immediately, so of course I took a shower and then had my pads ready. The bleeding lasted for about 1 week. I wasn’t given any dietery restrictions at the clinic.
Temi: I got to the clinic and I had a vagina ultrasound first, just to make sure that I was still pregnant. Then not too long afterwards the physician came in and we went over everything one last time, before it was time to take the first pill. I was given a mifepristone pill which stops the production of progesterone, which is needed for a pregnancy to continue. After taking it, I waited there for a bit just to make sure I didn’t throw up because if that happened, then obviously the pill wouldn’t work.
Exactly 24 hours after taking the first pill, I took four pills of misoprostol by dissolving two pills in each cheek by my lower gum. The pills tasted so horrible, I was so scared of throwing up because that would obviously mean that the pills wouldn’t work. Thankfully, I didn’t (throw up). I was a mess though, because I started bleeding like 30 minutes after. The pain was a lot but nothing I really hadn’t experienced before.
Another side effect I experienced was diarrhea. I experienced a lot of that and I also passed a lot of big clots, but nothing that was alarming. I also knew when I passed the fetus, which happened about 5 hours after I took the misoprostol pills. I was an emotional wreck after that because it was just a lot to take in.
I bled for a total of about 2 weeks and a half. I went back once I stopped bleeding to get another ultrasound to make sure the pregnancy was expelled, and it was.
Michelle: So the pills, misoprostol comes in 4 tablets. I took one pill of mifepristone given to me by the doctor in the clinic. She told me to take the 4 pills of misoprostol after 12 hours from the time I took the first pill. The 4 pills are to be placed underneath the tongue whilst you wait for it to dissolve for about 30 minutes – during that period you’re just supposed to be in bed and of course wear a pad. Do not use tampons because you’ll experience bleeding and heavy clots so its better to use menstrual pads instead. Using tampons could lead to you getting an infection. I started bleeding about 45 minutes to 1 hour after I took the pills. I went in 3 weeks after bleeding for a checkup to ensure the pregnancy was successfully terminated. It was.
How did you feel about the procedure? Were you in pain or were you uncomfortable?
Victoria: I was in a lot of pain oh. I was in PAIN. And I hate having cramps, so this was just so uncomfortable for me. I took pain killers a few times but I was so paranoid because I didn’t want the pain relievers to counter the abortion pills, I know that sounds so silly but but like I said, I was just so paranoid.
The pain plus the nausea were annoying. I also felt bloated a lot during the abortion process, my tummy was so big for no reason at all. It was uncomfortable wearing pads for a week straight and the flow was very heavy of some days.
It was generally a bit bearable because it was like having your period, but just for a longer period of time.
Temi: Yes, I was in a lot of pain! It felt like regular uncomfortable period cramps, but worse.
I was nauseous, tired and just overall uncomfortable.
Michelle: Damn, the pain! Omo, I was literally shivering and sweating. My lower abdomen was on fire and I got a lot of sharp pains as I bled. I had my hot water bottle with me always and I took strong pain killers but still, I couldn’t sleep and I was crying all night. The blood clots don’t even drop until when you have to pee and sit in the toilet seat, then you feel the heavy clots (which hurt like hell). I would advise you go through this process on a weekend, so you can sleep in all day. After a day or two, the cramps reduce and you’re just clotting and bleeding after that.
Was there anything about the experience you wish you had known beforehand?
Victoria: Not really. My friend was very detailed about the whole process. I think her situation was even worse, from what she told me because she bled for 2 weeks. I’m guessing it was because her pregnancy was farther than mine, but she was kind enough to give me all the important and necessary details so I was prepared.
Temi: Not really, because I did my research once I found out I was pregnant and once I decided to go through with a medical abortion.
Michelle: Yes, so I actually bled for over 5 weeks. I had blood clots for 3 weeks straight which I thought wasn’t normal, and I actually thought i was dying, like my womb was destroyed (Lol), but after I went to the clinic for a check up, the doctor explained to me that some women bleed more than other women in some cases. After my check up, I was fine health wise and everything else was good.
What do you wish more people knew about medication abortions?
Victoria: Just that its safe and normal. Your body reverts back to normal once the bleeding stops and once the pregnancy has been terminated. Your normal cycle continues the following month also. All in all, just be safe and try not to get pregnant until you’re ready because the anxiety from the experience is unreal.
Temi: Medical abortions are very safe, as long as you’re up to 10 weeks and not longer unless that’s when its not suitable or safe.
Michelle: They are the safest method in my opinion. Go to a professional, do not self medicate. Sometimes your pregnancy could be “ectopic” and to know this, a scan must be performed during your consultation. If you use pills unsupervised and you happen to be carrying an ectopic pregnancy, you could die because the baby should be in the womb in order for your abortion to be carried out successfully.
*Names have been changed