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Welcome to Better Sex With Dr. Lexx, a monthly column where sex therapist, educator and consultant Dr. Lexx Brown-James shares expertise, advice and wisdom about sex, relationships and more. Approaching education about sex as a life-long endeavor — “from womb to tomb” — Dr. Lexx (AKA The #CouplesClinician) is your guide to the shame-free, medically accurate, inclusive and comprehensive conversations for you, your partner and your whole family.
“Happy Mother’s Day!” is not a phrase I get to share with my friend Melissa, who recently lost a pregnancy and almost died in the process.
When Melissa found out she was pregnant, there was rejoicing all around. She and her husband, too much ibuprofen 2 year old Stewart, were pleasantly surprised to be pregnant so early on in their family-planning journey. You see, Melissa and Stewart are amazing at being the favorite aunt and uncle and only recently decided they wanted to have children. Melissa is technically geriatric maternal age (any pregnant person 35 years of age and over) and throughout her life meticulously planned her reproductive health to ensure if and when they did want to conceive, they were in charge of the timing.
And, that time was this year. After the peak of a pandemic, during reproductive political uproar, and amidst calls to end racism, Melissa and Stewart created “Squish.” A glimmer of hope at a time that felt just right for them. Sadly, their time with Squish was short. The first appointment ultrasound showed that Squish didn’t have a heartbeat. And at 8 weeks pregnant Melissa would ultimately miscarry and need a medical abortion.
The issue: Melissa lives in Georgia, one of 42 states that has implemented anti-abortion legislation — which inherently affects miscarriages too. By making abortion is inaccessible, illegal, and extremely difficult to get, the new laws limit and penalize those who are miscarrying too.
Fortunately, Melissa and Stewart are college-educated, knowledgeable and have access to healthcare. Surely, they would be able to access the medical care they needed so they could grieve this loss and decide next steps? With some education from their physician, Melissa made the informed decision to have a medical abortion using pharmaceuticals that are typically readily available: Misoprostol and Mifepristone, two medications that work in tandem to cause what is typically described as a ‘natural’ miscarriage. The idea of using pills was appealing to Melissa because it would not require a surgical procedure and instead, she could plan around this loss.
She had time to go home, get cozy, wear her comfortable pajamas, with her husband by her side binge-watching TV in solitude as her body would expel the lifeless cells they lovingly called Squish.
And yet, as beautiful and comforting as this could be, it wasn’t Melissa and Stewart’s journey. With 12 states having a near-total ban on abortion and 15 states restricting access to medication abortion — specifically access to mifepristone after 8 weeks (like GA), Melissa was unable to have the full round of medication that is the medical best practice to facilitate a medical abortion. And, she paid for it.
Typically mifepristone and misoprostol are given in combination. Both tablets are placed at the opening of the cervix and allow the cervix to dilate to ensure the body flushes out tissues that are no longer serving their proper function. In Georgia however, because of the abortion bans, Melissa was only given one medication — misoprostol. After bleeding for 9 days, Melissa was still lightly bleeding, the medications just about did it’s job, but on the 10th day things went downhill.
The day started with a positive pregnancy test and small fever. And for a person who was supposed to be miscarrying, these are not great signs. Testing positive for pregnancy tw0 weeks post medical abortion is typical, fevers however, are a reason to check with the doctor.
As the day progressed Melissa noted feeling well and took the day to rest. Fortunately, Melissa has done the work to know she should not suffer through pain (a lesson so many women struggle with); so, when she spiked a fever of 102 that felt out of the ordinary, she went straight to the hospital. Melissa’s awareness and access to healthcare saved her life.
Melissa found out that she developed sepsis — a deadly infection that can lead to tissue damage, organ failure, and death. The culprit? An incomplete abortion. The scariest part is, most women, those who work, take care of family, mothers, ignore small fevers, aches, and pains. Women are especially known to prioritize others over their own health. Melissa needed the second medicine mifepristone to help her body release the decaying material housed in her uterus, the material that was slowly poisoning her. And if she would have waited any longer, she could have died.
For four days, Melissa lived at the hospital on antibiotics. Her husband stayed by her side and her mother flew in from the midwest to help her recover. Her friends rallied by sending food, encouragement, meditation, and medical advice. (It helps to have physician friends!)
The fear and anxiety was palpable and questions swirled. How could this happen? How will she heal? What’s the long-term trauma from this?Will she be able to get pregnant again if she wants?What does she do next?
And on top of those worries, Melissa and Stewart were slapped with a $44,000 dollar bill that was adjusted to $14,000 after insurance. That’s $14,000 dollars to lose Squish and almost lose Melissa.
Fortunately, Melissa survived. She was able to seek out and receive the care she needed. She had advocates. She is knowledgeable. So knowledgeable that before leaving the hospital she asked about her restrictions. Her doctor told her she had none. Which is odd because after a miscarriage people need to know quite a few things: Use pads, not tampons or cups, monitor blood flow and temperature to ensure the infection is cleared, and a few other pieces of pertinent information. It wasn’t until she brought up intercourse, that her doctor flippantly added that there is to be nothing in the vaginal canal for two weeks — a super important detail that got left out of this recovery process discussion.
Melissa’s situation makes me wonder. What about those who are not as knowledgeable? What about the people who can’t get back to a doctor? What about the people who are scared of the cost? What happens to them? Do they make it? Is the point of all of this – these restrictions and obstacles to care — that they don’t?
And now that Melissa is on the other side, healing, and grieving Squish an important question creeps in: Do I want to get pregnant again?
Anxiety, fear, avoidance is happenstance after any type of trauma. And who wouldn’t be nervous, fearful, or slow to try again after such an event? It is clear they want a child; and yet, the trauma of not being able to get all the reproductive care necessary to be successful gives Melissa pause. And I can’t help to wonder how many other mothers have decided they do not want to risk their lives for birth. All due to the failure of their government officials to protect reproductive justice.
Before you go, check out these celebs who shared their abortion stories to stand up for reproductive rights :
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