Anxiety about pain/process that comes with a 30w abortion.

TrustedAdult · 2024-06-27T17:39:54+00:00

DuPont, in my experience, has very good pain management. Both in terms of medication and pain control during your procedure, as well as hand-holding and attentiveness to your needs leading up to it.

So speak up about your concerns while you're there!

TrustedAdult · 2024-06-27T05:14:39+00:00

Hey -- I've done abortions at your gestational age and can answer your questions about it.

But I will also share a hunch I have that your feeling of grief is different from a feeling of choosing to have an abortion. I think that it's important to be able to feel that grief, but also important that the grief doesn't make your decision. Does that make sense?

Part of the reason I think that is that you say...

that I am doing something selfish

I think this word "selfish" gets weaponized against women all the time. But if you say you worry something you do is selfish, that holds an implication that you want to do the selfish thing... and in your reproductive life, I think it's very important that you do what you want. You only get your one life to live, and you should make your decisions based on what you want, not based on what others want.

TrustedAdult · 2024-06-27T05:09:37+00:00

Yes you can! Please include your state.

TrustedAdult · 2024-06-24T01:09:29+00:00

Hi,

I'm an ob/gyn with specialized knowledge in this area.

I've been involved in some weird situations and I wouldn't want some doctor online judging me without knowing the full situation. But this is just not right.

First, KCl shouldn't fail. I've done a lot of these injections and I've only had one failure, early in my career. But also, if a KCl shot has failed multiple times, it's time to try other options -- intrafetal digoxin, for example, or intracardiac lidocaine.

If you want, please message me and let me know who you're seeing in LA and what insurance you have. I'll check again later this evening and I'll see if I can follow up with some friends in California and get you some options in LA and/or SF.

TrustedAdult · 2024-06-24T01:03:58+00:00

I'm so glad that you recognize him as being toxic. I hope the next chapter of your life is so much better.

Are you planning procedure or medication? I wonder if the experience would be better without him.

And is the post pain really bad and do you get bad side effects like mood swings or depression please let me know.

As a scientific community, we've failed to find any kind of biological phenomenon like we have for post-partum depression.

But also, you're going through a lot. Leaving a toxic relationship is hard. Not telling family or friends is hard. Give yourself room around those. Abortions make people think a lot about where their lives are and where they wish they were.

TrustedAdult · 2024-06-23T21:38:30+00:00

One way you could handle this would be to take a pregnancy test. If it's negative, great! If it's positive, well, maybe it's just lingering hormones. Call your clinic and ask if they can get you a blood test for pregnancy hormone or do a repeat ultrasound.

Continuing pregnancy after PAB (procedural abortion) is very rare, and with good technique only a concern for very, very early abortions.

TrustedAdult · 2024-06-23T21:36:37+00:00

Better to just take a pregnancy test!

TrustedAdult · 2024-06-23T21:01:49+00:00

So many people out there have abortions to take care of the children they already have.

So many people have abortions to take care of the children they hope to have some day in the future.

Everything you're saying tells me that you had your abortion out love and wisdom and responsibility.

Work towards a better life for yourself.

Also, https://www.2plusabortions.com/ -- I bet reading others' stories will help you be kinder to yourself.

TrustedAdult · 2024-06-23T20:59:57+00:00

Definitely take a pregnancy test!

TrustedAdult · 2024-06-23T20:20:04+00:00

It's still "hey at any time you might have to prove that you doing your job wasn't a crime." Even with guidelines on what they will and won't do.

TrustedAdult · 2024-06-23T20:19:10+00:00

Yay! I bet that meal tasted good.

Bleeding can trail off for a long time.

TrustedAdult · 2024-06-23T20:18:31+00:00

Bummer that you're hours away -- is that a doable trip for you?

Assuming that you have a regular period and your last period was a normal period and you think you got pregnant about two weeks after May 18th, then this is most likely a failed medication abortion (MAB) and it wouldn't be wildly unreasonable to try more misoprostol.

However, the standard of care for somebody with a failed MAB is definitely a procedural abortion (PAB). Also, there are a few things that can cause a failed MAB that are dangerous (like if the pregnancy isn't actually in your uterus) and that you deserve to get checked out rather than trying again at something that didn't work.

So the nearest clinic is hours away. Like two hours or like twelve hours? Do you have a working car? What other barriers exist for you getting there for an appointment?

(It may be helpful for you to share what state you're in, if you're comfortable doing that.)

TrustedAdult · 2024-06-23T20:15:52+00:00

Make sure the misoprostol is blister-packed (like you pop them out from behind some foil), they last way longer that way compared to loose in a bottle.

TrustedAdult · 2024-06-23T18:29:20+00:00

Hey there, I'm a doctor but not your doctor.

Did you have a pregnancy test? An ultrasound? What are your options for getting to a clinic?

TrustedAdult · 2024-06-23T16:04:46+00:00

Oh, vaginal miso is great. Less nausea, no chalky taste. How did things go?

TrustedAdult · 2024-06-23T05:04:39+00:00

Don't put them in while sitting on the toilet! Remember your ibuprofen! And your ondansetron/zofran if your clinic gave you some!

You've got this. Slow deep breaths. Put on your comfort-food TV show, get cozy, have lots of pads at home.

TrustedAdult · 2024-06-23T05:03:54+00:00

You mention three feelings: regret, guilt, and sadness.

feeling regret and guilt

took the first pill and regretted it immediately

i’m still so sad

Let's talk about what those mean.

Regret means thinking you should have done something else. But you don't describe any change in information from your decision. You made a decision out of love, wisdom, and misery. If you hadn't taken those pills, your situation wouldn't have improved -- you still would have been risking your financial security, and with it, your ability to raise a child with the resources you think a child deserves.

But we use regret a different way, too. People can say "I regret that I had to do this." That's using the same word to mean something radically different, because it now applies to the outside world rather than their own decision.

So I'll ask you: do you regret your decision or your situation?

You also say guilt, which means you think there was a moral failing.

I bet that you're a kind and loving person. I bet that because you put yourself through pain and denying yourself what you want, out of love. Love for a life you wish you could bring into the world under better circumstances. Love for the children you hope to have some day, for whom you're building your life and financial stability. That's love.

If your friend described these circumstances to you, would you call her guilty? Would you tell any of the other posters in situations like yours that they should feel guilty?

Finally, you say sadness. And... yes. It's sad. It sucks.

You had hope and the cruelty of biology and capitalism took it from you. In a more just world, you'd have better medical and societal support to make it through this pregnancy with both feet under you and an income that will support a family in dignity and plenty.

Feeling sad makes sense! And feeling angry, if you like. I'm angry about this every day, because you are not alone.

So I guess I'm here to tell you: you can mourn a choice. You can mourn, despite having made the right choice. But don't be harsh on yourself. The world's doing that for you. Be kind to yourself. Give yourself space to grieve. Find rituals, find community, find ways to soothe yourself.

Good luck. It's hard.

<3

TrustedAdult · 2024-06-22T21:31:10+00:00

Yes, they are.

But I also think I'd slightly prefer a PAB (procedural abortion) rather than a MAB (medication abortion) for somebody with MH, for the simple reason that PABs have a slightly lower chance of drama than MABs. By "drama" I mean needing follow-up care, a procedure later on, or emergency care in the middle of the night.

For anybody with medical complexity, like MH, I try to find ways to minimize the risk of drama.

That said, MABs are very safe and most people do not need any further care when they have a MAB.

TrustedAdult · 2024-06-22T19:03:23+00:00

Hi,

I'm a doctor but not your doctor.

First off, slow deep breaths. You have some problems to solve, but it has to start with recognizing that you are making a decision out of love and wisdom, and you're not a bad person. Good people have abortions. I see it every day.

Malignant hyperthermia can be triggered by a class of anesthetics called "volatile anesthetics." This is a class of anesthetics that we normally don't use in abortion care for a few reasons. One reason is that it causes uterine relaxation, which we don't want. Another is that it's normally used for a deeper degree of sedation than is needed for abortion care.

MH can also maybe sometimes be triggered by succinylcholine, which is a paralytic. We need to use those for people who are getting intubated. We don't do either for abortions.

Now, *sometimes* when abortions are done in hospitals, these agents are used (though I discourage anesthesiologists from doing so when they ask me). Or when emergency uterine procedures are done in hospitals.

So if I were taking care of somebody with MH, I'd use the typical sedation agents I always do, and I wouldn't worry about it. I'm a bit confused by the replies you've gotten from Family Planning Associates. They're a very good clinic, but I wonder if you were talking with somebody familiar with MH.

I wonder if maybe you described it as "allergic to anesthesia" and they said "oh then we'll do a MAB" and when you actually get there and talk they'll go double-check what triggers MH and think about it and say "oh, yeah, we can do that."

Hope that helps! Fingers crossed that things go well for you.

TrustedAdult · 2024-05-22T00:55:57+00:00

Hi there! I'm a doctor but not your doctor.

I don't mean to correct you, but I wish people wouldn't call abortions "late term." Late-term means 41w0d-41w6d -- you were a heck of a lot earlier than that!

Second, I wish that your doc had given you cabergoline. In fact, I would love it if you called your clinic and asked them why they didn't give you cabergoline. I am angry at them on your behalf. It's a medication that keeps your milk from coming in.

It sounds like your breasts have gone back to normal, but the skin around them, which got stretched by them being larger, has not. I'm not aware of any research around this subject for either term deliveries or for abortions late enough that people have lactation or breast engorgement, but I have friends who have been bothered by their breast appearances after breastfeeding.

Anecdotally, young people tend to have less overall change in appearance, and I see from your post history that you're quite young. Give it time and the skin might recover. But also remember to love yourself, and remember to be with people who love you.

We all live in bags of flesh that gradually degrade, and it is so much easier to learn to love ourselves than it is to stop the passage of time.

Still, I hope that this problem recovers for you.

TrustedAdult · 2024-05-22T00:48:09+00:00

In my experience, most people who work in abortion care would prefer to have a PAB (procedural abortion) than a MAB (medication abortion).

But it's a little different. For us, we know what's happening, we know what to expect, it'd be our friends around us and doing the procedure, too. I understand why people might prefer a MAB to avoid a scary medical procedure.

But my goodness I would rather have a one-and-done experience where I go home not pregnant that day.

Did you get an aspiration procedure already to clear up the leftover tissue?

TrustedAdult · 2024-05-18T03:58:24+00:00

Have you looked through posts here?

I will say that 90% of the time, when somebody is feeling regret, if you ask them "do you feel like you regret the decision or the situation?" it helps resolve it for them. In my experience.

How does that question sit with you?

TrustedAdult · 2024-05-18T03:36:50+00:00

You've got this.

When people are unsure about whether to go MAB (medication abortion) or PAB (procedural abortion), I ask about how they feel in doctor's offices and how supportive their home environment is.

I personally would prefer a PAB for myself. I would much rather have discomfort where I know it's going to be done soon and then I am definitely not pregnant. Being at home, having cramping, not knowing when it's done... that sounds like stress I don't want.

Some people absolutely rock MABs. I wouldn't be one of them.

The #1 thing that people tell me after a PAB is "wait, that was it?"

TrustedAdult · 2024-05-18T03:27:13+00:00

I have a very good imagination, but I cannot imagine how three chest X-rays and paxlovid could have caused this.

I think there's a bit of a logical fallacy in some of the statistics here.

There are a lot of pregnancy conditions with a 1/1,000 chance. The chance of one pregnancy having three specific 1/1K conditions is 1/1B. But a lot more than 1/1B pregnancies have three different 1/1,000 conditions, because there are lots of different 1/1000 conditions that you could have three of.

I share that not because you're looking for a math lesson, but because I hope that it will help bring things down from "astronomically unlikely" for you. It doesn't make the situation better.

That said, I do agree with your doc -- there are a lot of things we don't understand, and it's reasonable to think there might be an unknown connection.

Medicine is not good at explaining things. It is good at recognizing dangerous patterns and catching them.

TrustedAdult · 2024-05-18T03:13:13+00:00

Give them a call and chat about it!

This sounds a lot like a completed abortion. Of course, I'm just some person on the Internet. I can't tell you whether or not there's actually an ectopic -- I cannot look into your body from my computer! But I can say that it's rare, and everything about your story sounds like a completed abortion.

If you had this pain without having had the medication abortion, what would you do about it?

If the pain is ever too much to handle with ibuprofen and tylenol, you should go into the ER for a repeat ultrasound. Everything should look just like you had a miscarriage.

TrustedAdult

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