10 Things You Thought You Knew But Didn’t – About Sex, Contraceptives, Pregnancy and Abortions

Posted on May 8, 2012 in Sexual Health, Society

Submitted anonymously:

I had an abortion today. It sounds like a big deal and it was. It’s odd though, how much difference there seems to be between taking an iPill and taking an abortion pill. It’s just a question of 4 odd weeks, and one pill versus three, but somehow somewhere everything changes.

The sexual revolution of the 60’s and 70’s in the US ended up leading to wider-spread incidence of many STDs, and the flower child generation had their ideals tossed out and rubbed in the mud. But as developments in science and gender relations continued (somewhat) hand-in-hand, the issue of reproductive rights came to the forefront, and it’s a battle still being hotly fought. A woman’s right over her own body, versus the “personhood” argument that Oklahoma state thankfully just threw out — when does a fetus really become a person? Whatever your answer to that question, one thing that remains crystal clear in my head is that you can’t value the rights of an unborn unformed embryo over the rights of the person in whose body it is. The woman’s rights must come first. There are cases where obviously abortion should be an option, like rape, extreme complications or disability, grave danger to the mother’s health if the pregnancy is continued, etc. But who is to say that in India the severe social stigma, difficulty in advancing a career, nearly complete decimation of marriage chances, etc, do not constitute grave mental or emotional danger? Isn’t the most important thing about a birth the parents’ ability and willingness to provide the best possible quality of life and opportunities for a child?

All these arguments can be fought out point-by-point at the theoretical level, when it’s removed from personal experience. But what of when it IS personal experience, too close for objectivity, too close for comfort, too close for anything. Then the choice, for an upper middle class, educated, privileged and aware woman like myself, is clear. A lot of people I know have taken an Ipill, relied on it as effective birth control, like a condom. I know someone who planned a night of unprotected intercourse, because it would feel better for her long-term boyfriend, with her safety net being the emergency contraceptive she’d take the next day. Here’s what my experience taught me — nothing is 100% certain, and a condom’s 99% surety is WAY better than doses of hormones and their 98-55% effectiveness. If there’s anything worse being just a statistic, it’s being the minority statistic on a health issue like this.

So here is everything you need to know:

  1. It’s ridiculous that I even have to say this, considering how much it’s drilled into us from every side, but ALWAYS USE A CONDOM. With people like us, we usually know our partner’s sexual history, at least a little, even if it’s a random hook-up. Everyone knows everyone, and everyone’s heard things. And STDs are relatively hard to find, thank god. (Or maybe the stigma around them is still even greater, and no-one mentions having them even to their closest friends and partners. Or maybe I just don’t know enough people). Point is, from my personal experience, we tend not to worry about STDs, because we wouldn’t be in that position with our partner if we were. We still should be worried. And we should still ALWAYS ALWAYS use a condom. Why ignore that one tiny insignificant layer of protection when it can save you a TON of mental grief, at best, and pregnancy and disease at worst?
  2. If you’ve done it unprotected, take an Ipill. It costs a hundred bucks, is available over the counter, and get over the embarrassment of asking the chemist, people do it all the time. The ipill will work in one of three ways — prevent the ovaries from releasing eggs, prevent the sperm from fertilizing the egg or prevent the egg from attaching to the endometrial lining.
  3. Now listen carefully. When you buy an Ipill, buy two pregnancy tests as well. They’re called Ican, same company, similar packaging, cost fifty bucks each. Why buy these? Because…
  4. The Ipill is not always effective. I took it within 4 hours of doing the nasty and it should have worked, but it didn’t. You think you’re never gonna be that 1%, but yes, it can happen to you.
  5. Okay, now ladies, start tracking your periods now. It’s a pain, I know, you think it’s useless, but it’s not. Trust me, lying there having a hand thrust up your vagina for a pelvic exam, you’re really gonna wish you were sure about your dates. (You will still have to have a pelvic exam, so there’s no getting away from that hand, really) The dates will help you track your fertility cycle, determine your risk of pregnancy, and god forbid that test comes positive, you’ll be able to count exactly how many weeks and days you’re at. Weeks of pregnancy are NOT counted from the date of conception, but from the date of your last period ending.
  6. Before your period is due, try and look for other signs your body might be giving you. I felt pre-menstrual symptoms like light cramping and fatigue for a long time before my period was due. By week 5, I had started daily morning sickness, mostly just nausea, and I wasn’t eating too much, so the two times I did throw up, it was just water. And then there were cravings — most food seemed very unappetizing, even stuff I love otherwise, and to control the nausea I was sucking on nimbu. I went wild over a tub of chocolate ice-cream, and khatta aam papad never tasted this good. Super major unable-to-keep-anything-down nausea came later.
  7. There are apparently early detection tests that give you an accurate result at ten days, but Ican suggests it’s most effective around the date of the missed period. Take the test. First thing in the morning pee is the best, because it allows the hormones to build up, but holding your pee for maybe 6 hours should be enough. The test is easy, but follow instructions to the T. Most false results are apparently due to testing incorrectly. Take one early, and then another one a week later when your period is due. If negative, congratulations, don’t worry too much about your period not coming, stress can also delay it. Test till you’re sure, false negatives do happen.
  8. If positive, stay calm. Test again. Calculate dates. Talk to your partner, someone you trust, figure out your next step.
  9. You need to visit a doctor. Depending on how far along you are, they’ll suggest either medical abortion or surgical abortion. Apparently abortion pills are available over the counter, but it’s NOT SAFE to take them by yourself. In Delhi, they give you pills up to 2 and half months for unmarried girls, which they push to 3 months for married women with very small kids, extenuating circumstances etc. The pills themselves come packaged as RU486, I think, and cost under Rs. 500. You have three main options on how to go about it.
    1. Find a private gynaecologist, and go to them. Pros: small, relatively less expensive (under 7k). Cons: Very likely to judge you, guilt trip you, fleece you, and possibly could be a distant relative of your mother’s. Less privacy and anonymity. And you never know whether you’ll get a pro-choice or pro-life one, because you can’t ask people for personal recommendations.
    2. Go to a large hospital like Max. Pros: I’ve heard you can use a false name, large so anonymous, professional, safe, clean, and an “upper-class” air-conditioned environment. Cons: Likely to be prohibitively expensive (10-15k), because you’ll probably get an ultrasound, consultation charges are high, they might keep you under observation in which case you pay for a room etc. Also, I would be more likely to go there with my parents if anything else ever went wrong, and I wouldn’t want my medical record available there.
    3. This is what I did. I called Family Planning Association of India’s office just sort of hoping for a list of approved practitioners, who might help me. They said they provide the services, and take walk-in patients till 12 pm, and then after 2 pm. I walked in. They helped me. Pros: Government facility dedicated to providing safe access to reproductive healthcare and rights, so they don’t judge. The counseling was not coercive, it was almost friendly and very helpful in identifying details and answering my questions. The doctors were professional and non-intrusive, and it cost me under 2.5k. Cons: Largely caters to lower income groups, so people unused to or unable to adjust to the environment might have a problem.

10. If you didn’t find out quick enough, follow step 9 and hope for the best. A surgical abortion may still be possible, depending on the time. If not, keeping it discreet is probably no longer an option, tell your parents, let them help you figure out options like giving it up for adoption etc. Best of luck.

My experience with FPAI was a good one. Telling the lady at reception “MTP” (Medical Termination of Pregnancy) made her concerned, discreet, reassuring and even more helpful. From there I was sent for counseling, then to the doctor for medical history, then for a urine and blood test. My blood type is negative, so I needed to buy an Anti-D injection, which was the bulk of my cost. I would never have known about it if I’d taken the pills at home and it could have caused huge complications later. Next was the pelvic exam, then the first pill, and then the injection. The next two pills I took together, exactly 48 hours after the first. The bleeding was supposed to start an hour after that and continue for 15 days. It started early, but intensified after the second set of pills. The pain in that first hour was staggering — I may have passed out from it. The pills work by triggering a miscarriage. My partner said “Ouch, that’s nasty” — there is nothing nice about this. After 15 days, I go back for a check-up to make sure the process is complete.

It’s supposed to be a tremendously traumatic experience, and I read about people who couldn’t handle the guilt even years later. For me, it was scary, yes, but I don’t feel guilty at all. I feel stupid for not using a condom, mildly nauseous, and somehow very grown-up all of a sudden. But it’s my body and my choice. So I do not feel guilty. Maybe the trauma will come with 15 days of heavy bleeding, but I think I’m strong enough to handle it. People I know and know of cried for days. Talking to your partner and to trusted friends helps, and this is just me, but I walked in there alone.

I wanted to write this to share my experience, and help anyone who needs it to find the right information. Condoms rock, morning sickness is debilitating and abortion pills hurt. Like my partner said when I described gory but essential details to him, “Ohh. I’ll keep that in mind for never again.”