Home Alone

*Warning: This post is a lengthy discussion of the issues concerning Early Medical Abortion. It contains information that some may find distressing.*

Today is the final day of the High Court hearing where the British Pregnancy Advisory Service (BPAS) are challenging the Department of Health, in order that women may be allowed to take the Abortion Pill, RU486 at home. Under the current system, the woman is prescribed and given two pills at the clinic, which block the pregnancy hormones and cause the developing embryo to detach from the womb lining where it cannot survive. The second set of pills is given in the clinic 48 hours later, which will cause her to miscarry. What the BPAS wish to do is challenge the 1967 Abortion Act which states that ‘any treatment for the termination of pregnancy’ must take place in a hospital or clinic and allow women to take the second set of pills at home, their main argument being that a woman will be able to better manage ‘a natural miscarriage’ in the comfort of her own home, where she will be better physically and emotionally prepared to cope.  Ann Furedi, the Chief Executive of BPAS claims that many women describe the cramping and bleeding as a “blessed relief”. The Abortion Pill, or EMA (Early Medical Abortion) “isn’t a period, but is probably the closest thing to it there is”.

A pill-popping exercise and Post-Abortion Syndrome

Stop right there. First of all, one of the many problems with the RU486, is that it turns abortion into nothing more than a pill-popping exercise. Many will not see a problem with that, but regardless of whether or not you believe the unborn child to actually be a child and have any rights, (for a photo of a 9 week fetus click here) abortion is the destruction of unborn life. Many many women, and I know, I have spoken with enough of them, suffer lasting emotional trauma after an abortion, when the reality of their choice has kicked in. The vast majority of women who undergo an abortion do experience a measure of guilt and pain, which society does not want to recognise, because such a recognition means an identification of what abortion is. Therefore a woman struggling with the after-effects of an abortion is unable to seek support of her close friends or family, who will condemn her for two reasons, either that she had the abortion itself, or more commonly, that she is experiencing grief and pain. Society embraces and endorses abortion as being a valid lifestyle choice and so a woman who suffers unforeseen emotional consequences as a result of that choice is seen as being self-indulgent and/or undermining the validity of that choice. Phrases like “well it was for the best, it was what you wanted to do”, “it wasn’t really a baby anyway” being all too common. A woman suffering from Post Abortion Syndrome or abortion related PTSD needs to be able to vocalise her experiences to a non-judgemental listener, one who will seek to ascribe neither blame, nor validation to her decision, but simply be there to listen and also to help her find ways of marking her loss. Many women who have been through an abortion  and need help beat themselves up in almost unimaginable ways, they don’t need any more guilt than they already have. Now when you make the woman physically responsible for the ending of her pregnancy, this only compounds the potential after-effects.

(Incidentally it is worth noting that neither BPAS or Marie Stopes offer any free emotional post-procedure counselling, their websites talking about the importance of having a good friend, counselling only being available on an appointment basis, in contrast to all the major pro-life charities, who are there at the other end of the phone 24/7, free of charge. )

So that’s the issue with pill-popping, it puts the burden and responsibility back onto the woman herself and reduces a devastating procedure into the routine everyday action taking a pill to alleviate an ache or pain. The comparisons that Ann Furedi makes with a patient who suffers from, for example, high blood pressure, only seeks to trivialise the issue further and is a straw-man argument. A patient with high blood pressure needs pills or medication to alleviate or control the symptoms of his condition and hopefully cure it. Pregnancy is not an illness or disease, an unborn child is not a symptom that needs to be eliminated.

A quick, safe decision?

Let’s look at the next issue surrounding the Early Medical Abortion, namely the time limit. The RU486 may only be taken before the woman has reached 9 weeks of pregnancy, therefore woman wishing to take this option need to do so quickly, the quicker the better. I can testify, having had 2 unplanned pregnancies, that in those first early weeks, one is in an absolute state of shock. Your hormones are all over the place, you are extremely tired, emotional, terrified of the future and often unable to think clearly. Even if, as with my second child, the baby is planned, you are still rather overwhelmed and incredulous that you are pregnant. It doesn’t seem real, apart from the two lines on the stick; there is no obvious physical manifestation that you are actually carrying a child. For me the weeks between 4 and 8 are the hardest, you know that you are pregnant, but you don’t actually have anything to show for it and it’s easy to go into a state of denial, particularly as you are bound to silence, for obvious reasons.

Though I need to be wary of disclosing too much private information, I feel it is appropriate to share some information regarding my pregnancy with my first daughter. As most know, my husband is not the biological father of our eldest child. Her biological father, with whom she now enjoys a close, loving and fulfilling relationship had always been explicit that he never ever wanted to have children. When I became unexpectedly pregnant, it is not melodramatic to state that for him, it was a total and utter disaster. It soon became very clear that at some point a choice would need to be made between the child and my relationship and that the relationship would not survive a child. Both sets of parents were extremely concerned, I took many phonecalls from his father urging an abortion and my mother also put pressure on me, stating that perhaps now was not the right time. His parents were terrified of the effect of an unwanted child on their son, my parents were terrified that our relationship would split up. At some point, someone well-meaning booked me in for an appointment at Marie Stopes. I rang them to discuss the situation when I was 7 weeks pregnant, about a week after I had taken the test. They informed me that I had an appointment to be prescribed the RU486 the next day. I stated that I was unsure as to my decision, (at that point I was pro-life though not practicing my faith) briefly outlined my circumstances, i.e. unplanned pregnancy, desperately unhappy partner, worried parents and had only begun a new job 5 months previously. Their response was that it sounded like an abortion would be the best option for me, the EMA was definitely the safest and most recommended method as it wouldn’t involve surgery, however they pressed home that I was really short of time, I desperately needed to act quickly. I asked for counselling, in order that I could discuss my options more fully and their response was to give me a counseling slot, half an hour before the time I would be given the clinical slot, but they did not want to cancel the clinical slot.

I decided there and then to cancel the entire thing, knowing how rubbish I am at saying no to people, and already under enough pressure, I felt that the sheer existence of this clinical appointment, looming immediately after the counseling might tip the balance or that I might be persuaded to make a quick decision. I was also concerned that the person on the phone, did not seem willing or able to discuss the alternatives. Marie Stopes were also guilty of using the oldest salesman’s trick in the book, namely of not only emphasising my limited time, but also of stating that if I didn’t take the given appointment that they couldn’t guarantee that there would be any available in the allocated time. It was a now or never scenario. I felt enormous pressure to abort with Marie Stopes keen to endorse and facilitate the decisions of others, not once did anyone ask “how do you feel about this, have you considered keeping your baby?”

I went home in floods of tears and announced somewhat melodramatically that I was keeping the baby and although I knew he would think I was mental, that I couldn’t abort because that would mean that I would burn in hell forever! I need to add that is not my stance now, but my daughter’s birth was an enormous turning point in my journey of faith.

What got me through those incredibly awful early weeks, was the determination that I couldn’t hurt my baby and the support of a very good friend, who helped me to see that what I saw as obstacles were not really obstacles at all, and that the very worst thing I could do would be to rush into a decision. 9 weeks may seem like plenty of time, but in reality, many women do not find out until they are at least 6-7 weeks pregnant, and 2 weeks is not sufficient to get one’s head around the enormity of the decision and make any kind of rational judgement, particularly when you are being pressured by an abortion provider. It worried me that counseling was not offered for a decision of this gravity. Let’s contrast the attitude of Marie Stopes/BPAS with that of a responsible Family Planning Clinic, which my friend visited aged 17. She had suspected that she was unexpectedly pregnant, went to the FPC who confirmed this, whereupon her first reaction was “I want to get rid of it”. Admittedly this was some time ago, attitudes are now different, but she was told “you’ve just found out that you’re pregnant five minutes ago. You cannot possibly make that decision. You need to go home, have a week to think about this, spend some time and come back next week, if you still feel the same then we will discuss options”. Her daughter is now 13 years old, she also has an 11 year old and despite having been kicked out of home as a result of her pregnancy, is a qualified staff nurse.

The reality of the procedure

Pressuring women is not the responsible option. Having subsequently been motivated to do some post abortion counselling work, almost every woman I have spoken to who was prescribed the RU486, has an absolute horror story to relate. To describe the cramping and nausea as being similar to period pain is a cruel deception. Women are not properly informed as to their potential ordeal until it is too late. Clinical sanitised language is employed and it is only once women are given the second set of pills, or in some cases, pessary, are they told “what you are are about to experience is a mini labour”. Not every woman suffers from period pain, so for many this is a meaningless comparison, many women think they will just experience a mild tummy ache. I have heard stories of women in agony for hours, one that I think will stick with me forever, was of one woman who had an intuitive compulsion to walk up and down the stairs of the clinic to alleviate her terrible pain, with some nurse Ratchett type urging her back into bed and to stay still. She had a dreadful fever, was throwing up and all the nurse could say was “oh good that proves its working well”. The RU486 is a taste of labour for many women, but instead of the relief described by Ann Furedi, it is accompanied by emptiness and grief, the labour bringing home to them exactly what they have lost. Those of us who have children and have experienced the pain of labour, can also testify to the joy and wonderment when our children are finally delivered, your body having been working up to this for several hours.

Not so for women affected by the RU486, they have absolutely nothing to show for their pains and are often so scarred that they are deterred for life from ever experiencing the empowering nature of childbirth. They associate it with an ugly outcome. Though I attempt to refrain from being graphic in these matters, the outcome is horrific. Women are given a carboard kidney dish in which to “pass the sack”, which then needs to be put into a paper bag allegedly resembling a lunchsack, whereupon it is checked to ensure that it is intact. Then they are sent home with paracetamol to deal with the fall-out and get on with life.

The argument goes that it is much kinder to let women manage their abortions in the comfort of their own home. From the stories I have heard, home is the very last place that women need to be, they need medical support and assistance, even if it is of a very brusque nature. Sometimes women need serious pain relief and intervention and a clinic or hospital is undoubtedly the best place. Complications such as incomplete or failed abortions which require surgery or problems associated with bleeding are not rare. What concerns me about this, is that it will be the vulnerable who will be most at risk. Teenage girls taking this pill without the knowledge or support of their parents, quietly taking the pill all alone in the privacy of their bedrooms, experiencing excruciating pain and potentially serious complications and too scared to ask for help or support. Apparently clinics will have a manned helpline for those concerned with symptoms, but the helpline will be of no practical support if someone needs urgent medical attention. All sorts of things could happen. The so-called ease and convenience of this pill could mean that many are pressured into taking it by boyfriends or abusive partners, relatives or even pimps without the proper care and support. Worse still, it is not beyond the bounds of imagination that women may be unknowingly duped or forced into taking it, particularly given the amount of women estimated to be working illegally in the sex industry. It seems so simple, go to the clinic take a few pills, go home, then take a few more 48 hours later and problem solved. Just a little bit of tummy ache to contend with. Nothing could be further from the truth.

Many women do experience natural miscarriages at home, with a significant proportion needing follow-up medical attention. Furthermore most women who do experience a natural miscarriage have the support of friends, families and partners who understand that this is an emotionally and physically gruelling time for them, with time off work often granted for compassionate reasons. I cannot see women taking the RU846 at home being accorded anything like the same amount of support, the myth is take the pill, solve the problem and get on with life. Besides, a miscarriage is a dreadfully traumatic experience for any woman, and yes probably they are more comfortable tucked up in bed, or curled up on the sofa. Not so for the woman going through a mini labour on the quiet, who has absolutely no idea of what to expect, whether or not her pain or blood loss is normal and no-one to talk to about it, unless she can sneakily use her mobile whilst locking herself in the bathroom or bedroom, unable to physically manifest any sign that she might be in pain in case someone suspects. The bedroom or bathroom will forever be associated with horrific memories and associations, a constant reminder of her ordeal.

There is also the issue of disposal of the fetus. Existing Department of Health guidelines state that dignity and respect should be afforded to fetal tissue and to leave women to deal with this aspect not only contravenes existing guidelines but is downright cruel.

Holistic healthcare – body and soul, or an expedited solution?

This is being sold under the premise of healthcare and concern for the woman, whereas if healthcare was the main issue, proper counseling would be mandatory before any abortion takes place, so that the woman is able to fully consent to the procedure and knows exactly what to expect. Since when did mental health cease to become a healthcare issue? The whole point of the 1967 Abortion Act was to ensure that abortion was as safe as possible for women. A successful challenge would totally undermine the spirit of the act, would compromise women’s safety and put abortion safely back behind closed doors.

And if you still think that this is done in the name of altruism, consider this. BPAS charges £530 for a medical abortion, although the NHS funds 93% of abortions carried out by them. Marie Stopes charges the same, although they will let you have your consultation over the telephone  rather than face-to-face and will charge an extra £35 if you need them at the weekend. Do you think that if all of a sudden women are allowed to take their pills at home, with no medical supervision, that the prices will fall? If the challenge is successful, the clinic’s overheads are reduced, meaning plenty more money in the pot to guess what sell and promote even more speedy abortions to even more women. It’s a nice little earner for them, make no mistake. And for those who are sceptical, check out Planned Parenthood in the US. A similar “altruistic” organisation, providing choice for women, abortions given, no questions asked, who have this week been uncovered not only covering up cases of child abuse and statutory rape, but also giving advice to pimps and sex traffickers who bring in their clients for a no questions asked service.

Regardless of one’s views on abortion, today’s challenge is motivated far more by profit than altruism. If you truly care about women facing crisis pregnancies, you’ll enable them to make a properly informed, wholly consensual choice, instead of rushing them into a course of action which will have serious long-term emotional and physical repercussions. To any woman who has ever suffered a miscarriage, to equate it to being the closest thing to a period, shows how out of touch BPAS and Ms Furedi really are.