Pregnancy scare
April 20, 2011 8:47 PM   Subscribe

What have been your experiences with the medical abortion pill (RU-486 or mifepristone and misopristol)? If you have to have an abortion, would you do it in the US or the UK?

I took emergency contraception, but I *feel* pregnant and I am trying to plan ahead just in case.

I have family in both the US and UK, so I could go home to either place and get the abortion pill. Or, I could go the surgical route. I have health insurance in America.

What have your experiences been with the medical abortion pill?
With medical abortion vs. surgical abortion?
And would you do it in the US or the UK?

Memail privately for anonymity if you like.
posted by carolinaherrera to Health & Fitness (16 answers total) 1 user marked this as a favorite
I have always opted for the surgical option. This is obviously a personal judgement call and there is no best answer on that, but the people I know who have had a rough ride with RU-486 have an unpleasant tale to tell so I never went for that option. My experience with surgical abortion has been fine. I went sedated once and full anaesthesia once and there are pluses and minuses to both. I'm happy to share my experiences so if you want details, ask. It's not a cake walk either way, but it's not a horror show by any means, and I never had any trauma or regrets. The before has always been far, far worse than the after for me.

As it happens, I have had an abortion in both the US and the UK. I am assuming you are currently in the US; please correct me if I am wrong because my advice would be slightly, specifically different.

On balance, I would have it done wherever you are. It is a commonplace enough procedure that there is no significant medical benefit to seeking services in the UK over the US. Convenience and expediency are important emotional components, and closest is often best. (Just ask the 3,000 women who fly from Ireland to England every year how much more that journey adds to their burden.)

In the UK, you will most likely book in at Marie Stopes, which is like Planned Parenthood, and you will pay out of pocket. Having done both the Planned Parenthood/Marie Stopes version and the swank Park Avenue OBGYN routes, I would go for the referral from your American GYN to a private hospital or practitioner. Insurance coverage is a bonus.

Please note these preference are tiny on the grand scale of things. Mostly I was enormously grateful to have any access to any services at all.
posted by DarlingBri at 9:09 PM on April 20, 2011 [3 favorites]

I think that an abortion in the US really depends on what city/state you life in. I've had two surgical abortions--one was in a mid sized city with only one (overbooked) clinic, and the other was in a bigger west coast city. The experiences were day and night.

I didn't have the pill, but a friend of mine used it, and had a less than ideal experience. Comparing hers to mine, mine was over quicker, and I had an easier physical recovery.
posted by Ideal Impulse at 9:40 PM on April 20, 2011

I have never done it chemically, but after many girl's night war stories I can share with you this. Most women who elect to have it done surgically are either anesthetized or heavily sedated. Most of the experience will consist of you making the decision and processing it before the procedure. I was completely anesthetized. I pretty much went to sleep in one room and woke up in another. No pain, and no real experience to speak of. And it was just...over.

Chemically induced is another story. You have to experience and process this at home. Most of the women I've talked to experienced heavy cramping and bleeding. And most saw the expelled fetus.

One (out of all I've spoken with) felt that this provided closure. But many more felt traumatized. I certainly can't speak to your position or desires, but it is certainly something to consider.
posted by troublewithwolves at 10:05 PM on April 20, 2011 [2 favorites]

Would the poster have to pay in the UK? When I was living there a couple of years ago, all family planning and gyne services were free - I think they didn't even ask for evidence I qualified for the NHS (it was a sexual health & family planning clinic, but not Marie Stopes).

If I were you, I would first take a reliable pregnancy test, and then, if necessary, go to the place that's easiest to go to. Whether in the US or the UK, I would go to a Planned Parenthood or similar specialist (but not privatized) clinic - they are experts and know more about techniques than most GPs or non-specialist clinics. I don't know where your home in the US is, but when I lived in Connecticut I never saw protests near the local planned parenthood clinic -- never saw any by the clinic I went to in England either.
posted by jb at 11:14 PM on April 20, 2011

[this comment assumes you're staying in the US, since I have absolutely no info on UK procedures]

I'd recommend starting with the Planned Parenthood in your area -- if they are unable to fit you in on the schedule you need, they will be able to give you a referral to someone who can. How far away and how accessible will depend on your local area.

The ability to use the medical abortion technique depends greatly on how far along you are, as does the cost. So does how long the procedure will make you take off work.

All of my knowledge is theoretical [I miscarried before I had to abort] but I know there are a lot of different factors. How old you are, general health, any risk factors, etc.

Taking a pregnancy test at home will be impacted by how long it's been since the unprotected sex, how close to any missed period you are, if the embryo attached and is developing properly, etc etc. A blood test would be more reliable, but can again be hard to get depending on location.

I know of several boards where there's a lot of information collected, but I don't want to spam you with them until/unless you want it.

Good luck with things.
posted by gloraelin at 11:31 PM on April 20, 2011

I am registered for the NHS in the UK. I'm a bit concerned about the quality of public health services. (Not sure if this is reasonable, though.)

Cost is not a huge issue. I'd rather have have a safe, comfortable experience and pay a few hundred dollars/pounds than have complications.

Right now, I'm in neither country, so flying to either is my best option.
posted by carolinaherrera at 11:39 PM on April 20, 2011

You should not worry about the quality of the NHS. I have had personal experience with the NHS, good private American
healthcare, and Canadian healthcare. In terms of my experience (comparing expertise, wait-times, practitioner-manner), I would rate the NHS as top, then the Canadian system and lastly the American system. In particular, the gynecological and family planning care I received in Britain was excellent, though it was just a run-of-the-mill clinic; I'm currently going to a clinic run by a specialist women's health hospital, and it's only slightly better.

Is there any chance for care in your current country? If you are in Canada, for example, you could just get care there. Even without access to the public healthcare, there are hassle-free clinics in major
centers that provide care.
posted by jb at 11:48 PM on April 20, 2011

An abortion at a Marie Stopes will cost you about £500-£700. (I had to look it up recently when I had a scare). I would have been perfectly happy going via the NHS, my experience of NHS gyno care (couple of smears and an IUD) has always been very good.

Anti-abortion picketers are pretty damn rare in the UK, if that helps you at all. My local Marie Stopes occasionally has a bunch of Christians singing songs and handing out leaflets outside it, but nothing like what I've seen in the US.

(I talked to a friend about potential options when I was thinking I might be in the same place. She joked that abortions are available on the NHS but there's a 9-month waiting list.)
posted by corvine at 1:50 AM on April 21, 2011

It's far easier to get an abortion in the UK than it is in the US. This may be dated knowledge on my part (anyone who has an update on this, please correct me,) but you may be able to get the abortion pill in France. Is that a viable option for you? And what I've learned from friends who've had abortions is that they'd much rather get the surgical option than the pill.
posted by Anima Mundi at 4:25 AM on April 21, 2011

You should not have to pay in the UK. It is common for the NHS to contract their surgical terminations out to Marie Stopes, PP, BPAS and other private suppliers if there's any sort of queue. There really isn't any good reason to pay out of pocket unless you're very unlucky and happen to be registered in an area where there is extremely high demand, in which case going private may expedite the process.

I can't offer a personal judgement between the UK and the USA as options, but abortion is a routine procedure and the outcome statistics are very similar (obv. varies by state, county, etc) so there's no 'quality' reason to pick one over the other. In the UK you *should* get it free, and even if you don't the cost looks comparable. In the UK it is extraordinarily unlikely that you will come across picketers or other unhelpful people; in the could happen.

I'd opt for the UK.
posted by AFII at 4:28 AM on April 21, 2011

I can't answer US vs UK, but I have worked at Planned Parenthood, and my preference after having talked to a few hundred women would be the surgical abortion. The procedure itself takes less than five minutes, and requires no follow up. The medication abortion can cause severe cramping for up to twelve hours, and (in the US- I don't know about the UK) requires a follow-up ultrasound a week later to confirm the pregnancy passed. It's also only available for the first nine weeks of pregnancy (remember to count two weeks BEFORE the unprotected sex) so your window might be smaller than you expect.
posted by aint broke at 6:00 AM on April 21, 2011

This is why I asked where you are. The devil is in the details and if you've never actually gone through this process, the realities of the two systems may not be apparent to you.

I really need to point out that in the UK, where everyone is covered by the NHS, the overwhelming majority of women still pay for private terminations to reduce the wait. (This is not an NHS backlash against abortion provision, it's just an overburdened health service.) In the UK you will have to engage in a two-referral process. If you do it on the NHS, this is your GP and then the service provider. If you book in directly with Marie Stopes, it's two doctors at Marie Stopes back to back on the same day.

In the US, you can call and book an appointment with no referral and no wait.

It is actually not easier to get an abortion in the UK than it is in the US unless you are far from a clinic or in an area beset by protesters. And again, unless you are facing a specific geographic hurdle, it is not difficult in either place if you're paying out of pocket.

The procedure does require follow-up. No responsible service provider would provide a termination of any kind without scheduling a post-procedure exam, normally 10 days to 2 weeks later. The abortion I had in the US was in one city when I lived in another, and my follow-up care was provided by either my regular GP or my GYN, I can't remember.

On balance, were I situated exactly between the two countries, I would probably let the airfare and other local factors like who I might stay with decide. There are pluses and minuses to both systems but assuming you can smooth over the NHS issue in the UK and the regional issues in the US, it's six of one, half a dozen of the other.
posted by DarlingBri at 7:39 AM on April 21, 2011 [1 favorite]

Maybe you could pick up a pregnancy test in the next few days and this will all be moot...

That said, I've had both surgical and medical. I would choose the medical procedure over the surgical, if it ever became necessary again.

I had both through Planned Parenthood in New England. For the surgical I called my local PP and was told when to come in - it was within a day or two of calling. That procedure cost $500 and was partially covered by my insurance. I don't recall how much the medical procedure cost. Maybe $250, with the blood tests and whatnot.

Both require a follow-up visit to PP about 3-5 days afterwards. If you opt for the surgical, you will need someone to take you home afterwards.

I personally found the medical procedure much more relaxed and less stressful - I was at home, lying on the couch watching movies for the most part. Yes there was cramping and heavy bleeding but nothing horriffic - it seems unlikely to me that, if you were to have an abortion within the next month, you would see anything more than lots of blood and some tissue, if you bothered to look.

On the other hand, I was not nearly as sedated or pain-free as I would have liked to have been during the surgical procedure and not only was it stressful but it hurt and was slightly traumatic. It does *not* take 5 minutes - between waiting to be seen, being examined & having blood drawn, the surgery and the recovery, I was at PP for a good 4 hours. And I *did* have to return for a follow-up.

Feel free to memail me, if you like.
posted by noxetlux at 7:54 AM on April 21, 2011

I really need to point out that in the UK, where everyone is covered by the NHS, the overwhelming majority of women still pay for private terminations to reduce the wait.

I maybe mis-reading this, but it's absolutely not true that the majority of abortions are privately funded in the UK. In 2009 94% of all abortions were paid for by the NHS (although 60% of those were contracted out to the private sector). Link to DoH info

It might be true that the majority of women who choose to go private do so to reduce the wait, but they're a *tiny* minority of the overall patient group, of whom 75% have an abortion within the first 10 weeks of pregnancy.
posted by AFII at 8:44 AM on April 21, 2011

I would base your decision entirely on logistics. Things like who will you stay with and how easy is it to get there.

It sounds like you are more American than British, so I'd suggest the USA has a slight edge because you seem to be more comfortable with American health care culture. But really, there's nothing in it, and abortions are as straightforward in either location.
posted by plonkee at 10:54 AM on April 21, 2011

You wouldn't see a massive difference between the outcomes in either country. However, a termination is a surgical procedure, and you will need some sort of follow-up. I'd choose the location that gave you more practical support and better options for follow up in the months after the termination. I wouldn't recommend bouncing between the two countries, as it strikes me that you'd get short shrift on either side of the Atlantic if you were essentially flying in for a termination, then flying out shortly thereafter and hoping for no further issues when you got back to the States. You might also find that though you're registered with the NHS, you're still resident overseas, which might kick up some problems with your GP referral for services with a tight/restricted budget. A Marie Stopes termination would also be doubly expensive, as the dollar:pounds exchange rate would work against you. If you live stateside, why not stay stateside?
posted by Grrlscout at 3:08 PM on April 21, 2011

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