What it feels like to have a medical abortion
Because someone should have told me
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A Personal Account of the Medical Abortive Process, Hour-by-Hour
DISCLAIMER:
The following article is an account of my personal experience taking the two prescribed medical abortion drugs, Mifepristone and Misoprostol. I identify as a Highly Sensitive Person (HSP), as well as being highly neurodivergent with combined (inattentive and hyperactive) ADHD (diagnosed in adulthood).
FOREWORD:
I identify as an extremely intuitive woman who is in touch with her body and her cycles. I have been tracking my cycle, without using a basal thermometer for over 14 months. I can pinpoint the exact day I am ovulating and can feel, without tracking, when that phase is over and my luteal phase begins, along with the plummet in hormones. I don’t take hormonal birth control (truthfully, I don’t take anything over-the-counter if I can help it). I don’t have an IUD.
Due to my own lack of education, I wasn’t awake to the fact that women could remain fertile for up to 24 hours after their ovulation day. This resulted in an unplanned, accidental pregnancy that occured in February of 2024.
PREGNANCY:
About a week before my expected period, I started getting signs that my body was in the process of creating life. I was out for coffee with a friend and found myself unable to tear my eyes away from the children and babies that toddled around the café. I’d heard the term ‘baby fever’ before, but the internal draw I had to the small children and the women tending to them was enough to draw a teasing comment from my friend. The awareness of my inexplicably strong baby fever was enough to pique an interest on my intuitive back burner. In conjunction, I had been harbouring a tiny, niggling feeling I had made a mistake during my ovulatory window about a week prior. I told my partner immediately that I may have made a mistake, and he assured me he would support any direction I chose to take should a pregnancy unfold.
A few days later, during a yoga class, I cried like I had never cried before. I couldn’t place the emotional release at the time, but it felt like some sort of surrender; some sort of succumbing to the universe. As I walked home from yoga in the cold air in early march, I prayed I wasn’t pregnant. I was about 10 days away from my expected cycle. I spoke to the stars as I walked home. “Please don’t let me be pregnant,” I said. “I’m not ready.”
Because I’m someone who generally knows their cycle, worry was upon me when I when my cycle was one day late. I cycle regularly, and am usually within 12 hours of my expected date of bleeding. My cycle was one day late, then two. Then three days late, then four. In the days leading up to my expected period, I had been more exhausted than I had ever been — chalking it up to a circulating flu I was fighting off. I was sleeping almost 15 hours a night, and had a high internal body temperature. I felt like and oven. This also sparked worry — my body felt strange. I was so exhausted. I didn’t want to do anything other than sleep and eat. I felt like a human sloth.
On day five of my late cycle, feeling like a portable furnace, I drummed up the courage to get two pregnancy tests, of different brands, from my local pharmacy. I live in a small town, and see many of the same people every day. This can be nerve wracking, as you don’t quite get the same anonymity from your cashier as you do in a city. I got my two tests, and went about my day as normal, planning to take them when I got home.
I took one test at around 5pm and the second one 30 minutes later. I have to pee frequently, so the whole “two different urine streams” were easy for me. When I went back to check, I can’t describe the mix of emotions I felt in seeing both tests turn up positive. I was shocked. Scared. Intrigued. But mostly, had a grim resolve that I could not, under any circumstances, keep the baby I was undoubtedly growing inside my body.
The days in between my knowing of my pregnancy and the process of abortion were the longest days of my life. Despite feeling like I had the flu, The rush of hormones coursing through my body actually improved many aspects of my internal and physiological world. I’m neurodivergent with ADHD, and for the first time in my life, I felt… clear. Calmer. Balanced. It turned out that I could also eat many foods that I hadn’t been able to before — dairy, wheat — while simultaneously experiencing deep food aversions. Nothing in my fridge looked appetizing. Most of the time, looking at food, I felt like I wanted to throw up.
SEEKING ABORTION:
I am extremely lucky and blessed to be living in canada. On top of that, I live on the West Coast of Canada, where the medical system is arguably the most ‘ahead’ (as it can be, for allopathic medicine) and is the most well-supported financially.
Because I was relatively early in my pregnancy (five weeks), and I knew my body well (I’m highly-sensitive and was already cycle-tracking), the specialist I spoke to over the telephone didn’t require me to get an ultrasound before prescribing the medication needed for a medical abortion. This was an absolute gift.
For some reason, I couldn’t bear the thought of going out of town for an ultrasound (I live in a small town, with a rural hospital, so an ultrasound would have required a trip). The thought of lying on my back with jelly on my tummy while a tech rubbed the freezing metal sensor over my womb seemed more invasive than I was ready to handle. The idea of embarking on the ultrasound process also made the pregnancy all the more real.
The entire process for me involved calling a general women’s clinic in the area, being referred to a doctor who specializes in abortions and then waiting for her to return my call so she could prescribe the medication that would be sent to my local pharmacy.
I’m very fortunate that while despite living in a small town, where people generally have a much closer window into each other’s lives, my primary local pharmacy is women-run, women-owned, and incredibly compassionate. They care about their patients, and were generally all-around lovely throughout this whole process.
ABORTION PREP:
I was given the instructions on the process of taking the medications, which consisted of two different drugs, and six pills in total. In Canada, the pills that are prescribed are Mifepristone and Misoprostol. Mifepristone blocks progesterone (a hormone needed for growth in pregnancy) and ultimately “terminates’’ the pregnancy. After that pill, you wait 24 hours, and then take all four of the misoprostol tablets, in both sides of your mouth where they dissolve against the flesh of your cheeks.
I picked up the prescription on a Friday — As soon as I got in the car at the pharmacy, not wanting to prolong the process any further, I held the first little blue pill in my hand and quickly swallowed it dry. I then went to work preparing for my private, personal lockdown. As fate would have it, I had been following two free birthing mothers on instagram for a while — one of whom had recently given birth and was talking about the importance of having food prepared for the first month following birth. I knew I would be entering ceremony, of sorts — and would be completely incapacitated for a few days. The information I’d heard from others and from sourcing the internet was all over the map. Some women were fine after a few hours, and some women literally felt like they were dying. Because I’m so highly sensitive, I wanted to prepare on the cautious end of the spectrum.
By this time, I was in a grim resolve — entering a warrior mode. I’d swallowed the pill that would ultimately kill what my body had been so effortfully growing in 24 hours. In my mind, I had 24 hours to grieve. I stopped by for groceries on the way home, enough for 2–3 days of meals, as well as stocking up on ibuprofen, acetaminophen, and the recommended depend-undies suggested by both the doctor and an experienced friend.
PILL #1 (Hours 1–24):
The first 24 hours were incredibly strange. Because it was so early on in the pregnancy, I knew cerebrally I was releasing was an organism; nothing more. That’s what I kept telling myself. “This is an organism. It’s kind of like you’re growing a plant. It doesn’t even have a head yet.”
I wish I could say this mantra helped me, but it didn’t. Not really. I spent the first 24 hours in a weird sort of grief, waiting for the feeling of the pulsing hormones and life-force running through my body to come to a stop. Sometime about 8 hours into the pill, I felt something change. It was as if my working body had been a train that had suddenly slowed upon arrival at the station. No more chugging of hormones coursing through my body, no more euphoric-feeling buoyed by the growth I was creating from within. What I had been growing felt like it had stopped. There was a lifelessness within me, a feeling of dropping a precious object I hadn’t realized I was carrying. What met me in its place was grief.
PILL #2 (hours 24–48):
I waited with a low-grade anxiety for the first 24 hours to pass. Once it had, I was antsy and impatient to begin the process of the second pill. I wanted to begin ceremony — to light my candles, set a sacred space of intention, and to begin the journey that I imagined would be the next 24–48 hours. I was waiting for my partner to arrive from where he lived in the neighbouring town, so I could get to the business of putting the four secondary pills in the flesh of my cheeks, as instructed, and get this show of release on the road.
Finally, after an agonizing four-hour wait and a few emotional hurtles to discuss between the two of us (mostly centering around my need for him to be absolutely present, instead of concerned about a banking issue he’d been experiencing), we were both able to land in the space with committed, conscious intent and begin the process. I lit my candles, and stepped away from my partner and onto my yoga mat to sit in ceremony with myself. I acknowledged the power of modern medicine, and my gratitude for that; as well as my inner power to help me navigate the process I would soon be undertaking. I felt like a warrior, walking into a battle obscured by fog. I did not know what awaited me.
DAY 1 6:30pm-8:00pm
After having sat with the pills in the sides of my cheeks for about 7 minutes, feeling a bit silly and a bit like a western-medical chipmunk, I felt the pills dissolve and got myself a cleansing glass of water. Then, I waited. I waited for something to happen, to feel something, to fall into the process of what so far had only been described to me on a well-highlighted, generically detailed instruction sheet read aloud to me by the caring pharmacist at my local pharmacy.
DAY 1 8:00pm — 3:00am
Around 8pm, (which felt like an eternity), I finally felt some movement. At first, a little pang of pain — like the onset of a regular menstrual cramp. (I usually have intense, but short periods — regular bleeding on day 1, debilitating bleeding and pain on day 2, back to regular bleeding on day 3, wrapping up my cycle in 4–5 days). “Okay,” I thought to myself. “Regular period cramps. Pretty bad period cramps, but regular ones. Ish.” At this point, I hadn’t taken any ibuprofen or other pain relievers. As a stubborn, holistically-centred healer who deals with most colds and flus with tinctures and teas, I at least wanted to see how I felt before diving into pain medication prematurely.
Luckily, my partner was wise enough to recognize a storm before it hit. Gently, he pushed and nudged me to at least take some Tylenol before the peak of the pain set in. I was already feeling some pain, he noted, and it had only been 90 minutes. This certainly wasn’t the peak. Thankfully, I conceded and took some acetaminophen.
Within another half an hour, the pain had shot through the roof. By 10pm, I was lying on the couch, completely immobilized by pain. I couldn’t drink water, I couldn’t change my position, I couldn’t look around. It felt like someone tiny had crawled inside my uterus and was stabbing at the thing I’d been growing inside with a sharp, inefficient knife. Knife-like pain waves shot through me intermittently. Luckily, after the acetaminophen had kicked in (which had just made me disassociate from the pain, instead providing any real relief), I’d gotten wise and decided to take some ibuprofen. I genuinely don’t know where I would be if I hadn’t had the support of ibuprofen at that time.
I sunk into the tunnel of blankets I had made for myself and concentrated on my breathing. It was also at this time that I began passing blood and tissue. This was equally fascinating to me as it was alarming — some of the pieces of pregnancy tissue were the size of silver dollars. I’d never in my life passed anything near the size of tissue that was leaving my body at that moment.
Between the hours of 10:00pm and midnight the pain increased steadily. Within the process, a clear pattern had emerged: the cramping would increase, followed by the knife-like intensity of sharp pain that would render me completely unable to move, function, or speak. This intense pain would last a period of time (my best guess is around 20 minutes or so, maybe less), at which time I would regain awareness of my surroundings and be able to make an adjustment to my cocoon — smoke some weed (cannabis was an incredibly supportive and important ally for pain relief during this process); drink some water; receive a hot water bottle. It would seem like things were calming down again; I would even begin to chat — and then the cycle would begin again, rendering me unable to speak. This continued for about 3–4 hours. Amongst this cycle were occasional races to the bathroom to pass more blood and tissue. Because my comfort during the process felt adamant, I had opted to use my period underwear designed to be worn overnight and for heaviest flows. After the first few hours, I had bled through two pairs — although I could time the passing of the tissue with a rush to the toilet if I was listening closely enough to my body (when not distracted by the pain).
The peak of the acute pain arrived about 6 hours after the initial dosage. At this point, I had become completely immobilized, unable to elicit any sounds that communicated the pain. I lay very still, with intense focus on my breathing, and asked my partner to talk to me. I used the sound of his voice to hold on to consciousness during what was easily the most painful experience of my life. As a former gymnast and competitive athlete, I have broken five different bones, experienced four dislocations, and torn through every ligament in my ankle during a crash landing that resulted in a shattered growth plate at the age of 16. Hour 6 of misoprostol, I can say with confidence, was easily the most pain I have ever experienced. If I had not already been on a combination of pain killers, cannabis, herbal tinctures and nervine teas, I feel I most likely would have called an ambulance.
Gratefully, for me, the peak of the pain only lasted around 2 cycles of the knife-searing jabs that shuddered throughout my body. By 1am, I was again able to speak.
I rode out the cycles of pain waves for the next few hours, distracting myself with cannabis, deep breathing, and well-curated comedy specials. I continued my cycling trips to the toilet, as well — blotting up blood and clots from period underwear in hopes of making them last through the night so I could avoid the discomfort of the diapers that had been recommended to me by my doctor and fellow women. Cannabis, herbal teas, and the company of my partner, proved to be extremely important elements in this phase of the process. Because cannabis is a plant I engage with as a medicine, it worked well for me during this time. Physical contact, touch, and words of reassurance were also important.
By the time 3am rolled around, I could tell my body was getting tired. In truth, I can’t actually remember when II fell asleep. I remember that at some point, I did sleep; waking up periodically to race to the bathroom and release more tissue and blood (my body also does this during a normal bleed — my bleed wakes me up in time to go to the bathroom, so most of it is released there instead of into the period panties I wear at night). I would occasionally get up and smoke more weed, or take another ibuprofen — something I normally wouldn’t do mid-sleep unless it was absolutely necessary. I slept exhaustedly.
DAY 2
At some point, I really did just fall asleep. Exhausted from the night, (my partner) and I crashed and awoke well after the sun had risen the next day. I woke up around 10am, feeling like I had gotten hit by a truck. As someone familiar with the festival and electronic music scene, I felt like I had partied non-stop, for four days straight, indulging in all the recreational drugs available and opting to skip all the sleep. I had expected the day to go slowly on day two — which in turn became an understatement. I continued most of the way I had during day one, sitting up for the first time to eat at 5pm. I couldn’t get up at all during day two — except to use the washroom. The days after the procedure blurred together — a mix of pain, rest, bleeding and smoking weed. I do remember taking ibuprofen and acetaminophen the whole second day — something I would never have done under regular circumstances. I also remember being surprised by the volume of blood I was still releasing on days two and three. After much researching and reddit-ing later, the blood I was steadily releasing appeared to be normal.
*** DISCLAIMER: I am neurodivergent as well as an extremely highly-sensitive person, with an extremely sensitive nervous system and have a strong reaction to pharmaceuticals. I don’t expect the following will be the case with everybody, but I wanted to include it in my report as it was the case with me. ***
COME DOWN
As day two progressed, I could feel my body begin to process the drugs that had been in my system. I identify as an HSP, and usually abstain from drugs and alcohol because of how strongly it impacts my physical and mental state. As the misoprostol began to clear from my system, however, I began to experience strong muscle spasms and involuntary convulsions. This side-effect was scary. I had always been someone who twitched when exhausted, and often before falling asleep — but the convulsions and spasms I experienced coming down off of Misoprostol felt like hell. I had no control over my body, and my partner couldn’t lay next to me as the spasms were so exaggerated. On top of that, coming down off the drug in the evening caused an extremely adverse psychological climate. As a survivor of very troubling childhood abuse, as well as an experienced raver (and therefore experienced with the feeling of “coming down” off of a party drug), I am well practiced in working with my mind and talking myself down from negative thought patterns and feelings. The amount of effort that it took to maintain a sense of relative psychological stability, however, was challenging. This, by far, was the most difficult part of the abortive process. My mental state began to deteriorate into the evening. By 11pm, my partner had finally collapsed into an exhausted sleep — having been up and supportive to me at every moment of the process thus far. From the hours of 11pm to 5am the next morning, I was on my own. The challenging mental environment and strong physical convulsions made for a terrifying, exhausting experience. This phase felt like near psychosis, and pulled out every practice, psychology hack and trick I had in my inventory of mental health skills to remain calm. Finally, as I could feel the hours of dawn approaching, my body became too tired to keep me awake any longer. I fell into an exhausted, but dreamless sleep.
DAY 3
Day three was a midler version of day two. Shaken by the cognitive and physical experience of my body processing the remainder of the drugs, I cared for myself very tenderly during the third day of the process. I was, however, able to get up and walk around, stand on my balcony in the sun, and cook a little. I didn’t have enough energy leave the house just yet, and was still bleeding heavily. The day was a rotation of rest, cannabis, nourishing food, lots of liquids and electrolytes, and occasional standing in the sun. I was shaken from the psychological and physical aspect of the drug come down. I was starting to feel restless indoors, however, which I took as a good sign. I was afraid to sleep that night, given the effects that arose in the evening, however the psychological warfare only seemed to be present on the one day while I cleared the drug from my system. I still convulsed heavily at night. I didn’t take any ibuprofen or acetaminophen on this day.
DAY 4
By the time day four had arrived, I had been up, making myself food and busying myself, slowly, around the house. My movement was tortoise-like, but movement felt good and possible. I was stiff and sore from the days of deep rest, and was in desperate need of a shower, clean sheets, and a change of clothes. I was still in a fair bit of pain — similar to regular (i.e. strong) period cramps, and was bleeding as heavily as I would be mid-period. At around 4pm, my partner and I left to get outside. I took a short walk, sat outside in the sun, and rested some more — in open air. The walk to and from the beach took the remainder of energy I had — and I was asleep that night by around 9pm.
Days 5–15
By day five, I was ready to resume ‘regular’ life — although emotionally, physically, and psychologically exhausted. Althought I had been made aware of this possibility, I was shocked at the amount of bleeding and cramping I experienced through the following days. For the next 10 days, I bled as if I was on my period — in the middle of my cycle (enough to fill one overnight pad or two diva cups) per day. I also had cramping strong enough that it didn’t feel safe to exercise. I began walking, and doing light movement, but as someone who is usually a highly active person, I didn’t feel well enough to resume my normal activities.The convulsions finally stopped around day seven, The bleeding and cramping continued, day in and day out, for ten days straight.
After the tenth day, the bleeding and cramping finally eased off. I felt like I could resume normal exercise, and it felt somatically like the process had completed itself.
RETURN TO ‘NORMAL’:
My moon cycle (period) returned five weeks (37 days) after the final day of cramping. The returned period was quite heavy, and still had some large pieces of tissue, but otherwise felt healthy. As someone who is neurodivergent and experiences quite difficult periods, my luteal phase, as well as my cramps, were the most difficult and painful I’ve had since my first period at 13. To me, this felt logical — I was restarting a process that had been interrupted.
REFLECTIONS — THE GOOD:
Overall, there are a few aspects of the process of medical abortion I felt quite grateful for. It was incomparable, primarily, to be able to have the experience at home. As someone who has a deep relationship with ceremony, plant medicine and her internal world, having the space to process the abortion itself in real time in the comfort and privacy of my own home played a large part in my general state of health and well-being. Additionally, as someone who experiences anxiety from hospital and clinical settings, it felt more nurturing to be able to release the grief and processing through a slower process — one which felt more intimate for me and my body. I was able to witness the release from my body, as well as move through the feelings that arose — instead of being sedated and never bearing witness to the organism I was releasing from within. For this part, I remain grateful to have completed the abortive process through the medical and pharmaceutical option.
REFLECTIONS — THE BAD:
There are a few stark aspects of medical abortion I deeply wish I had known and understood before I embarked on it. Primarily, the length of time the medical abortion takes over your life is significant — I was completely preoccupied by my physical and emotional state for over 15 days. I was in pain, and bleeding, for all 15 of those days. For four of those days, I couldn’t leave the house, and for two of those days, I was in such a state of debilitation I was truly vulnerable, helpless and exhausted. If I had fully understood how long the process would affect my body, I would have considered the clinical abortive process. Additionally, the intensity of the drugs were indescribable. Although I am aware that I am most likely a rare case — being a Highly Sensitive Person as well as neurodivergent, it was the formidable experience of the medical abortive process that drove me to compose this article. The medical abortive process is no small undertaking — and I believe there needs to be more research and studies done on women who are outside of typical physiological and neurological norms. The ‘come down’ of the drug was the most difficult psychological environment I have experienced — which includes five years of experience in a forestry job where the mental toughness required is compared to that of the U.S. marines. The physical experience was taxing, especially with the muscular convulsions that appeared nowhere on the internet, nor on the list of expected side effects of misoprostol.
If given the chance to make a different decision, I feel I would think long and hard about choosing the undertaking of a medical abortion. Being a person who deeply believes that every hardship contains a lesson, however, I would most likely choose the same result.
My motivation behind writing this article is to give women a more intimate, hour-by-hour description of what the process of a medical abortion was like; which herbs and medications helped, and what pitfalls and moments of difficulty struck me most. Emotionally, an abortion is never an easy decision — and is one that stays with you long after the process is complete — igniting a permanent change within. We are so lucky, as women of Canada, however, to be given the option to take the abortive process into our own hands and complete this deeply impacting event in an environment and setting that works best for us.
HERBS USED:
Cannabis (flower — indica, organic), for pain and relaxation
Hemp root (salve), for pain / cramping
Nettle (tincture, tea) for blood loss / iron
Oat tops (tea) for nervous system support
Passionflower (tincture), for ‘come down’ anxiety, nervine soother, mood regulation
Rose (tea) for emotional support, to balance mood
Skullcap (tincture), for nervousness, anxiety, relaxation and to promote sleep
PHARMACEUTICAL DRUGS USED:
Mifepristone (hours 1–24)
Misprostol (hours 24–48)
Ibuprofen (days 1 and 2)
Acetaminophen (days 1 and 2)
