by Dr. Laura Lewis
Every day in Canada hundreds of women are challenged by an unintended pregnancy. It would appear that our solution is to provide abortion on demand – easy, accessible, and free. The latest solution comes in the form of the abortion pill or Mifegymiso®.
After working for many years as a family physician, I feel the need to let you know that there is nothing straightforward nor easy about this life-impacting decision. If this is you today, please take some time to consider your options and know that help and support is available.
It is important to be clear about the possible side effects and risks of the abortion pill. You have likely read articles about the abortion pill and it sounds easy – just take the pills and deal with the situation in the privacy of your own home; the government is even covering the cost. If this is where you are at right now, I’d like to highlight a few considerations to be aware of.
Abortion is permanent. And any permanent decision should not be made quickly. This is a life-impacting decision, so make sure you are 100% certain of this choice before making it. If you are not 100% certain, your physician cannot prescribe the abortion pill.
The abortion pill treatment for some women is more than just a heavy period. You may bleed a lot. You may bleed to the extent that you need emergency care to control the hemorrhaging. Make sure you have access to 24-hour emergency medical support. Heavy bleeding is considered a common side effect that occurs in up to 10% of women.
You may see the result of the abortion procedure. Some women see the aborted fetus or baby. At 9 weeks, it will be small – the size of a grape – but at this stage, you can see the head, and developing arms and legs. Many women at this stage believe their pregnancy simply reflects a clump of cells. Unfortunately, you may be confronted with the reality that it is not. Please be prepared for this.
The requirements for an ultrasound before taking the abortion pill have been relaxed. Your medical professional may now prescribe this drug to you without confirming the location of your pregnancy. Statistically, this may be considered an acceptable risk. However, if you are in the small < 1% of women with a tubal or ectopic pregnancy, this could be a life-threatening situation. Mifegymiso® will not treat a tubal pregnancy. Once the tubal pregnancy reaches a certain size your fallopian tube may rupture. This is a medical emergency and the presentation of a tubal pregnancy may be masked by the symptoms expected after taking the abortion pill – specifically bleeding and abdominal pain.
The abortion pill may not work…at least it may not result in the complete evacuation of your pregnancy from your womb and you will still require a surgical procedure. Up to 1 out of every 20 women require ongoing surgical management after taking Mifegymiso® to complete the abortion.
There is an emotional response to abortion – and it can range from relief to grief. Your response will likely depend on many factors including your age, stage of pregnancy, religious or cultural beliefs, previous mental health, or whether you are being pressured by others into having an abortion. Every woman is different and every woman’s response to abortion will be different.
If you are undecided about how to navigate this challenging situation in your life, my advice to you, as a doctor and as a woman who cares, is to please take some time to think through all your options. Many times the biggest obstacles aren’t as big and impossible as they seemed once fear is removed. Please reach out and speak to someone you trust, connect with your local pregnancy care centre, call a helpline. You do not have to go through this alone.
Help is available: pregnancycarecanada.ca/help
 Mifegymiso® product monograph p. 11