The OB/GYN walked us through my options for women who miscarry. There are three ways to expel the fetus – medication, waiting for it to happen naturally (expectant treatment), or surgery (dilatation and curettage). I chose the medicine.
A few days later, when I filled my prescription and returned to my father-in-law’s house, I found 4 pills—800 micrograms of misoprostol. Concerned that something was wrong, I called my obstetrics team, who confirmed that in Massachusetts, following the guidelines of the American College of Obstetricians and Gynecologists, I would first be given a dose of mifepristone and then, 24 hours later, misoprostol. Here in Texas I was missing a key component.
Texas politicians restricted mifepristone in an attempt to limit medical abortions and as a result I was not given access to this medically recommended pharmaceutical combination. The combination of mifepristone plus misoprostol offers women a greater than 95 percent chance of expelling the fetus within about one day of finishing treatment. With misoprostol alone, however, the probability drops to 80 percent. Mifepristone’s status is now in jeopardy with two controversial rulings issued Friday by federal judges.
I took the medicine and waited for the expected cramps. My bleeding picked up, but not as I was told. I didn’t see what I thought would be most of the fruit. After 24 hours I called the hospital in Houston and the staff told me to keep waiting. I called my own obstetrics team, who told me that they would have prescribed extra misoprostol if I was in Massachusetts, as per medical guidelines, but that they couldn’t do it while I was in Texas.
I flew back to Massachusetts later that week, still not sure if I delivered the fetus. As I tried to get ready to go back to work, my hormones continued to fluctuate. Another week later, as I entered my third week of bleeding, I experienced excruciating cramps. I assumed I wasn’t among the 80 percent for whom misoprostol alone helped the fetus pass.
Under the guidance of my obstetric team, I went to the emergency room with blood seeping through my clothes. After a 6 hour wait I was told I still had “artifacts of conception” in me. Because the miscarriage took so long, I was scheduled for a D&C the next day. I was now on the third of three miscarriage treatments. I went under general anesthesia to empty the rest of my uterus. Recovery took time and four and a half weeks after the spotting started it finally stopped.
While the bleeding and pain had stopped, the effects of my prolonged miscarriage remained. For over a month I had a constant physical reminder of my lost baby. Every time I went to the bathroom, I watched the life drain out of me. What was so easy – just a plane ride away – meant that I went from having access to the full spectrum of reproductive care to having limited options.
If I had been given mifepristone in Texas, would the miscarriage have resolved sooner? Would I not experience so many highly emotional, deeply uncomfortable days where I was unable to be fully present for my family or work and had to worry about my own health? Can I avoid $3361.83 in costs from the ER visit and surgery?
I am deeply saddened to have lost this baby – a baby that my husband and I wanted so badly. In emotionally charged times, you shouldn’t question whether politicians are limiting your doctor’s ability to provide science-based care. I am angry that my health was compromised.
On Friday, Judge Matthew Kaczmarik of Texas ruled that the FDA must withdraw mifepristone, a drug that has been safely prescribed for decades. The Ministry of Justice appealed the decision.
Having lived in Massachusetts most of my life, I never questioned whether my doctor was giving me medical advice or options filtered through a political screen. When the Dobbs ruling was handed down last June, I cried, worrying about what it meant for other women — especially young women — but I assumed it wouldn’t affect me here in Massachusetts as an almost 40-year-old woman with a great education and a job. in healthcare.
For so many women, their health concerns aren’t limited by an inappropriate trip to visit the in-laws, but by the actions of politicians in their home state. Until I was caught in the crosshairs of assaults on women’s health and abortion, I didn’t realize how my rights could evaporate when I crossed state lines. Many women are unable to avoid these unfair restrictions on women’s health care. A threat to one woman’s rights is a threat to the rights of all women, and we all deserve better.
Alexis Bernstein works in value-based care and digital health. She is a resident of Needham.