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The Guardian - US
The Guardian - US
World
Clea Skopeliti

Women who used abortion pills on US supreme court mifepristone case: ‘It’s maddening’

A white hand pops a white pill into another white hand.
A doctor gives a patient the first of two pills for a medical abortion in Kansas City, Kansas, on 12 October 2022. Photograph: Charlie Riedel/AP

Mercy’s periods had always been very regular, so when she missed one in 2016, she immediately took a pregnancy test. It was positive, and she managed to get an appointment at an abortion clinic the next day.

Despite being able to act quickly, she was in her seventh week of pregnancy by the time she could take abortion pills in Ohio – a state that was, at the time, debating banning abortion from the moment embryonic cardiac activity is detected (usually around six weeks). Ohio has since enshrined abortion rights in its state constitution following a referendum.

After the supreme court heard oral arguments this week in its first abortion case since it overturned Roe v Wade almost two years ago, Mercy reflected on her experience of accessing a medical abortion. There have been fears that the case – the US Food and Drug Administration v Alliance for Hippocratic Medicine – could curtail access to medication abortions, though legal experts say it does not appear to be going well for anti-abortion doctors.

When she arrived at the clinic, Mercy, 22 at the time, faced harassment. “There were protesters outside the building. They had signs and a billboard with a chopped-up baby on it. They screamed at me as I entered the building. It felt very threatening and judgmental – I would bundle myself up in hoodies to obscure my identity.”

During a follow-up appointment, she arrived just before the clinic had opened, and hid behind nearby bushes to dodge the protesters. “I was terrified,” she said. “I felt like a sitting duck.”

Despite facing intimidation from protesters, Mercy, now 29, knew she was not ready to be a parent.

“I wanted it, but it wasn’t planned,” she said. “I wasn’t able to have a kid at the time – I was a student and had trouble affording things. There’s no way I could have supported a baby.”

Amid debates about “heartbeat” bills, Mercy had been aware there were unavoidable delays. At her first appointment, the providers at the abortion clinic were unable to find the embryo with ultrasound and the appointment was rescheduled for a week later. Mercy was then required to wait 24 hours between seeing the ultrasound and obtaining the abortion, but due to her class schedule and clinic opening times, she had to wait another week.

The staff at the clinic were compassionate and non-judgmental, she remembers, saying: “They were fantastic to me. It was one of the most empowering experiences I’ve ever had. They reassured me it wasn’t my fault, I’d taken precautions and things happened.”

Her experience taking abortion pills in her seventh week went smoothly. She took the mifepristone in the clinic, and misoprostol later, along with a single dose of an antibiotic, which the doctor told her might make her drowsy. She said: “I just curled up on my bed and went straight to sleep. I don’t know how bad the cramping might have been, but by the time I woke up the next morning it was like I was having a heavy period.”

She described her experience as being “really straightforward and non-traumatic”.

“I was glad to be in a place that I considered safe, without others’ judgment and to be able to process it,” she said.

Caitlin, 35, underwent a medical abortion at a hospital in California the day after the news leaked that the supreme court would be overturning Roe v Wade in 2022.

“It was a very somber experience, and the doctor prescribing me the medication was clearly incredibly upset,” she remembers.

“My nervousness about the abortion was overshadowed by the leak. In some ways it helped with nervousness – like we were all in this experience together – but it was emotionally painful. I realised that in California, it was going to affect me much less than people in other parts of the country – but depending on who’s in power in the US, it could turn into a country-wide thing. I wondered: is this the last time I have this operation? I may never want or need it again, but I want to have the option,” she said.

Following an ultrasound, which she declined to see, Caitlin took the mifepristone pill in the hospital, and the misoprostol at home. She was nine weeks pregnant. “It was pretty painful,” she said. “It’s a lot for your body to go through. I thought, no one’s doing this because they want to.” But she was glad to be at home with support from her partner and roommate.

She said she had been “manically refreshing” the news for updates on the supreme court mifepristone case.

“I’m really nervous about the outcome. I really appreciate the ingenuity of the providers who send medication to the states where abortion is illegal. We’ve been forced to get creative. I’m not surprised conservatives are trying to reverse the work’s that been done,” she said. “I see the anti-abortion movement here to be another way to subjugate people in poverty.”

Kelly, 46, has had three medication abortions over the years. Her first was in early 2001, shortly after mifepristone had been authorized for use by the FDA in 2000. After unsuccessfully trying to access the morning-after pill in Salem, Oregon, she went to a Planned Parenthood clinic in Portland, where staff confirmed she was pregnant. “It was an accidental pregnancy at 23, I didn’t have a permanent job – and I knew from a young age I didn’t want children,” she said.

Her experience in 2001 – and 2016 and 2017 – of accessing mifepristone at Planned Parenthood in Portland was straightforward, with “very clear instructions” from the clinic. She was prescribed a painkiller to help with the heavy cramping that accompanies the second pill, misoprostol.

Kelly felt that being able to take abortion pills at home made the process easier. “Medical settings give me a lot of anxiety – to do it at home felt more comfortable. My partner made me food, I got to sit on the couch and be in my own bathroom,” she said.

“In my later two abortions, I was very settled in my career, but again didn’t want kids. I’ve never had any regrets, never any mental health issues as a result. I’ve been set on not having children.”

Reflecting on the supreme court case, Kelly said: “As a lifelong feminist, I am shocked that were in this level in the US. We’re just at a point where access to abortion has been turned on its head in the US. Mifepristone is completely safe. Thankfully, it looks like they’re not going to rule in favour [of restricting access] – but the fact it could be [restricted] is maddening.”

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