I have officially scheduled my abortion procedure. I’m fortunate to live in an area where there are several locations near my home. In many places in Michigan, uninsured women have to travel over an hour to the nearest clinic. If I had insurance, and a primary care physician, I would like schedule the procedure at their office, but without I must find a clinic that offers affordable treatment options. With little experience on this matter, I selected the clinic with the highest Google review stars. A simple search: “Metro Detroit Abortion Services,” a brief scan of customer reviews and a phone call.
Like most medical procedures, getting an abortion is not a simple process. I think that I’ve always somewhat assumed that early-term abortion was nothing to bat an eyelash at. I’ve taken Plan B, I know many women who have terminated their pregnancy and the focus of the conversation always seems to revolve around the decision and much less about the actual medical process. Perhaps we downplay how much of an ordeal it is to get the abortion because we fear stoking the flames of the irrational? So much attention is focused on the “horrors” of late term or surgical abortion it seems that very little is said about the medical procedure, which is the most common. Regardless of your opinion on the matter, there is no doubt that getting an abortion is at least logistically a pain in the ass.
I spent about twelve minutes on the phone today setting up my appointment. I called and told the woman who answered the phone that I wanted to schedule an abortion. She then asked me if I wanted a medical or surgical procedure. I wasn’t really sure what either entailed, but I asked which one was more affordable. They are the same price. But, because surgical sounds more intensive – and from what I’ve read it is – I opted for medical. I asked her to explain it to me. A medical abortion induces a miscarriage. It’s actually the same process many women undergo if they must terminate their pregnancy due to health concerns, so I suppose the stigma really does revolve around the decision rather than the reality of actually being able to carry a baby to term. There is a series of two pills (mifepristone and misoprostol) that works by blocking the hormone progesterone, which causes the uterus to break down and stop the pregnancy. The second medicine causes the uterus to empty. The woman on the phone did not offer to explain what’s involved in a surgical abortion. I also didn’t ask.
She informed me that the medical abortion has an $800 price tag not including the additional cost of antibiotics and pain medication. Turns out that I qualify for financial assistance, bringing my out of pocket expenses down to $360. Then, she started reading this long-winded script, which began something like, “I’m required to tell you the following information by law. The only thing you have to remember from it is today’s date and time because we will ask you for it later.” The next minute was a descriptive jumble of confusing requirements imposed by the state quickly rounded up by – “got that?” – sure, I guess.
I was told that I must print, receive by fax or physically pick up state-mandated informed consent materials at least twenty-four hours in advance of my procedure. Informed consent materials are written by the Michigan Department of Community Health rather than medical professionals and are intended to “provide a woman with accurate and unbiased information,” under the assumption that the medical professional selected by the patient cannot be trusted to do so, and that the state is more qualified to inform a woman about medical procedures than her doctor. The State of Michigan website requires women to click through and read material which includes a description of the abortion procedure, illustrations of fetal development stages (as if this was necessary), pre-natal care and a brief overview of the responsibilities of parenthood (also unnecessary). Additionally, the State of Michigan website offers a list of “clinics offering free pre-natal ultrasounds.” These clinics are state funded non-medical, crisis pregnancy centers whose mission is to dissuade women from choosing abortion. In 2014, the state of Michigan allocated $800,000 to these anti-abortion centers. If you pay taxes, you help to fund these groups.
Fortunately, I am someone who has educated herself about politicized pre-abortion “information” mandates. Many women do not know. I was told that if I were to forget to pick-up, or print off and sign the informed consent materials twenty-four hours in advance I would be sent home when I arrived for my appointment. Under the law, the clinic is unable to perform an abortion without proof that each woman has received and reviewed the state-mandated reading materials. I will need to find a place where I can print materials privately because I do not have time to drive to the clinic before my appointment and the last thing I need is for some librarian to harass me when I pay eighty cents for my copies.
With that, I set my date and the woman on the other end was ready to hang up and move on. I was not ready. I wanted to know what was involved during the appointment and I’m glad that I asked because it’s quite elaborate. She told me that I can expect to be at the clinic for about four hours and will need to complete fifteen minutes worth of paperwork when I arrive. First, I will receive an ultrasound, then blood work, then urine test, I will have to watch a video, potentially receive a pelvic exam from a doctor who will also speak with me about my options. Someone is allowed to come with me to the appointment but they must remain in the waiting room. Before I leave the appointment I will take the first of the medications. I can expect cramping and bleeding most on the second day of medication and should plan to take the day off during the process. I will also need a day to recover. They also recommended having someone with me during the second day in case there are any complications.
Four women have recently discussed their medical abortion experiences with me. None of the stories were easy or simple, or painless. I must admit – I’m freaked out. I’m not sure if I should keep researching or ignore these stories altogether with the understanding that everyone’s experience is unique. I would seek professional advice prior to my appointment to get the perspective of an experienced medical practitioner – but who is there to trust? A pregnancy help line? A resource with typically zero transparency regarding the organization’s motivations or funding sources? Plus, I don’t really need “help,” I would just like some impartial explanations. The politicization on both sides of the abortion debate make this process so much more difficult to navigate, discuss and understand.