L ast November, when I was seven weeks pregnant, I experienced a headache that flooded my face whenever I moved. It seemed somehow related to, or bad for, the pregnancy.
My partner and I waited at the hospital for hours, doing crossword puzzles on his phone, before the triage nurses began warning patients we would be there overnight. We went home. I woke up the next morning with a fever, worried this was bad for the pregnancy too. On a whim, I took a COVID-19 test, and it came back positive. My neck and upper back ached even when I kept still. I came to resent my “pregnancy pillow”—a strange curving white snake nearly the length of my body—and instead lay on the bedroom floor and googled possible birth defects caused by sustained fevers in the first trimester.
After two days of a highly scheduled maximum dose of Tylenol, my fever broke. This is when I started to bleed. I knew relatively little about pregnancy at this time, but I knew, or felt I knew, that it was over. This was the mark of a miscarriage, the bright red sign. An eerie sense of calm washed over me. I knew this was coming. Of course, I didn’t really know this, but I’d been fearing it, every day. I knew even less about what my health care options might look like in the event of a reproductive emergency.
I was crossing the New Brunswick border in 2020 when I first read about Clinic 554, which at the time was up for sale due to lack of funds. It was Fredericton’s only abortion clinic, where the owners were frequently paying out of pocket to cover the costs of the procedure. Having spent my life between Toronto and Montreal, this came as a shock to me. My childhood home was only a block from what was then the Morgentaler Clinic in Toronto, which my mother pointed out to me as casually as any other building. My move to the East Coast had been on a whim, and I felt I would navigate reproductive health care the same way I would navigate every other aspect of arriving somewhere I’d never been: somehow, and later.
Four years later, I was pregnant and bleeding, waiting in an examination room at the hospital for the results of an emergency ultrasound. I’d been on the wait list for a family doctor since moving to the city and had received a phone call last fall confirming I was still on the list, still nowhere near being assigned to someone.
“Congratulations!” a clinician said when he entered the room, referring to the pregnancy. My partner and I exchanged a look. My understanding was that we were there to deal with a pregnancy complication. In fact, I considered bleeding to be the early pregnancy complication. Had the clinician not been told? He said to me that, according to my scan, I was measuring smaller than seven weeks. For this reason, he suspected my dates were off, that I was not as far along as I thought.
“How early can I be?” I asked him. “My first positive test was almost a month ago.”
“Those tests are . . . really sensitive now,” he said.
Though many clinical guidelines recommend waiting two weeks for a follow-up scan, the clinician suggested I come back after only seven days, as he would “never make a pregnant woman wait so long.”
When I returned the following week for another ultrasound, little had changed. The same clinician from the week before brought me my results with a strange air of cheerfulness. I’d been in the examination room waiting for him, distracting myself so as not to cry when he broke the news to me. Instead, he said, “I think we’re on the precipice of seeing something really positive.”
But what?
In the week between these hospital visits, I’d frantically googled terms like “measuring behind,” “miscarriage symptoms,” or “earliest possible pregnancy test.” I was starting to feel alone with the problem of my pregnancy. Even my therapist, when I recounted my strange consultation with the clinician, suggested I might be “taking things too far” with my research. Every search result, for pages, appeared in the light-grey shade of having already been clicked. Shorthand like “DPO” (days past ovulation), “LMP” (last menstrual period), “GS” (gestational sac) worked their way into my vocabulary.
I read account after account of pregnant women faced with the unfavourable scan—empty gestational sacs, embryos without a heartbeat, sometimes nothing at all. I read studies about early development, fetal growth statistics, ultrasound technology. I knew the early warning signs for miscarriage, and I knew I was showing them. I knew when an ultrasound should show a yolk sac, a fetal pole, a heartbeat. In my uterus was a growing gestational sac with nothing at all in it. Big, round, empty. It was no longer possible, according to my research, for me to be as early as the clinician suggested. And what about the bleeding? No one ever mentioned that early bleeding again. I knew things were not looking good for me, but no one else seemed to think so.
The thought of carrying a non-viable pregnancy made me feel frantic, contaminated. I asked the clinician about access to mifepristone and misoprostol—the abortion pills—and he said, “I’m shy to discuss that when things are looking so optimistic.” He signed a requisition form for another follow-up scan one week later, insisting I dial back my worry. “At this point,” he said, “we’re fairly certain you’re wrong about your dates.”
Even if I had been wrong about my dates, this would not have been good news. The gestational sac, at this point, was measuring too large to still be empty. I didn’t say this. Instead, I went home and phoned a clinician at my university’s health centre. She insisted I’d returned for a follow-up scan too soon, that of course nothing had changed. She told me to disregard the results.
T he following Monday, I returned to the emergency room for a third and final scan. I’d become practised in communicating to the pre-triage nurses exactly why I was there. This one in particular was much happier with me than the nurse I’d first encountered three weeks earlier, the one to whom I’d relayed various shreds of information in no particular order, beginning with “I’m bleeding.”
I took my place in the waiting room and tried to read—perhaps heavy-handedly, I’d brought Joan Didion’s Blue Nights, about losing her daughter—but ended up only sort of looking at the pages. Every few minutes, someone would enter the room and explain what hurt, what had happened, how hard it was to breathe. A young blue-haired person vomited frequently into a bag. A nurse explained to her colleague the difference between Botox and filler. A patient managed to walk coolly out of his ward and to the curb in front of the ER. He lit a smoke before he was noticed, when a group of shouting nurses ran toward him and yanked him back inside. When the commotion subsided, nurses went back to joking loudly with one another.
Time passed. I did nothing. Then I was taken to another, smaller waiting room. On the walls were posters of infants latched onto breasts, photos of women enhanced with a subtle golden glow. It was in the ultrasound waiting room that I encountered a member of my partner’s family. My reason for being there, I worried, seemed obvious. Anonymity in a small city, I was beginning to learn, was hard to come by. At a loss for what to say, I told him, “I’m not pregnant!” We laughed at this as if it were a joke. It was, in a way, a joke. I was pregnant. The joke was that I appeared to be lying. The joke was that I really was lying.
The ultrasound tech asked if I minded if a student observed, and although I did, it seemed uncouth to say yes. The tech handed me the transvaginal wand so I could insert it myself—which made me glad the student was watching. “Please,” I wanted to say, “always do it this way!” When the two women left for me to put my clothes back on, I went to the ultrasound screen and quickly took a photo with my phone. There it was: a big round empty space in the centre of the grey TV static of my uterus.
It took three more hours for a doctor to confirm to me that the scan showed what I’d known for weeks: the pregnancy was not viable. She began by telling me that she knew my in-laws, that she worked with someone in my partner’s family for over twenty years. This she must have ascertained from my partner’s name, as I’d listed him as my next of kin. She told me that if I needed anything over the holidays, my partner’s family could call her on her private line. I waited for her to tell me whether or not this was all over. I knew it was, but no one, so far, would tell me this. “Why are we talking about my in-laws?” I wanted to ask her. I didn’t realize at this time that personal connections would be my only way through the local health care system.
Finally, she wrote me a prescription for the abortion pill. I was diagnosed with a “missed miscarriage,” meaning my body still hadn’t realized the pregnancy had stopped developing. The ER doctor told me I could wait to miscarry naturally if I wanted to, but I would risk infection.
I sat in the hospital parking lot and cried and felt like an idiot. I’d been crying for weeks. I knew this pregnancy was not viable. I knew I was driving to the hospital to have that confirmed and to figure out how to get rid of all of this dead or dying tissue in my uterus. But I kept crying, thinking about how many hours I’d spent in the hospital, how long it had been since I’d gone for a run, how my pelvis seemed to protrude now, to accommodate nothing. I thought about the ER doctor who prescribed me a TED Talk on an Rx slip during a mental health crisis last year. The clinician who told me things were looking so optimistic on my early ultrasounds. The first ultrasound tech wrenching the transvaginal wand right and left inside me.
I was struck by how something like this can just happen, and all of a sudden, I was faced with a decision, in a time when I wanted just to collapse. Of course, I knew miscarriage was an option but failed to realize that the road branched in three directions—wait, take a pill, have a surgery—and that all three would come with their own pains and barriers and risks. I knew of the television miscarriage: the gasp at the sudden appearance of blood.
I took my prescription to a pharmacy, where I was told the pill could be ordered but I should go somewhere else.
T he average wait for a family doctor in New Brunswick can be between two and five years, with some people reporting waiting as long as ten. There are so few midwives available that when I called to ask about services, they told me they most likely couldn’t see me at all during the nine months of my pregnancy, that they were already planning to deny pregnancies that haven’t happened yet. Some doulas charge over $2,000 for pregnancy and birth support, but I could find only one who had any sort of science-based training. The rest seemed to deal in the realm of the zodiac.
At times, I felt overwhelmingly empty; other times, I felt claustrophobic, that there was something inside me that I couldn’t get out. I had visions of dying from infections, of doctors performing emergency surgeries while I was awake. I imagined being told that this had damaged my body, that I would never be pregnant again. I imagined being pregnant forever, carrying this empty gestational sac for the rest of my life.
Twice, I lay on my bedroom floor for hours, waiting for misoprostol to dissolve inside me, braced myself for the severe pain detailed by countless users on online forums (in a Reddit thread about medical abortion, a woman wrote: if you’d have handed me a gun i’d have shot myself in the head ), only to discover that nothing at all would happen.
I wondered if this was because I was prescribed misoprostol alone rather than in combination with mifepristone. I received contradictory responses to this question as well. I talked to more doctors and nurses. “Truthfully, I have no idea,” said one nurse during an online medical appointment. She suggested I get an ultrasound and sent the addresses of two clinics in the city. I called both, and both told me they didn’t offer imaging.
M y pregnancy failed, my miscarriage failed, my two abortions failed. The year was coming to a close, and I feared I would enter the new one exhausted, hopeless, trapped. Pregnant.
Doctors, nurse practitioners, OB/GYNs, and nurses gave me what at times felt like randomly generated information. I was told, due to my blood type, I would lose every possible future pregnancy if I didn’t receive a blood product injection (Rhogam) within seventy-two hours of my miscarriage beginning. I was told there was no need for the injection. I was told I could have the injection at any time. I was told things were looking optimistic at my eight-week scan when I was measuring less than six weeks along. I called clinics that told me they didn’t do blood work, couldn’t refer me elsewhere, weren’t taking appointments until the end of February. Every time I asked anyone anything, the information contradicted something I’d heard from someone else.
“Which is it?” I asked my partner in a panic. “Do they not know, or will they not tell me?”
What I meant was: How much of this was protocol, and how much was it a group of people taking shots in the dark? Was the reticence around abortion management informed by conservative political views? Fear of legal consequences? Avoidance of hysterical displays of emotion in the sterile environment of the examination room?
I didn’t want to sue anyone, or get into heaven. I just wanted to move on. I’d already lost weeks to nausea and fatigue, spent full days in the ER, was unable to exercise or do my job at full capacity. I was hormonal and depressed. Even thinking about trying to get pregnant again exhausted me. What if I miscarried again? How many first trimesters could I survive while life charged forward all around me?
I phoned the clinician at my university to ask about the failed abortions, and she told me to go back to the ER and get blood work and an ultrasound immediately, as I needed a Rhogam shot and was increasingly at risk of infection. The triage nurse at the hospital sent me home, as miscarriage and abortion are not emergencies. I asked about Rhogam, and she said, “You can get that anytime.” My partner had already left work and was en route to the hospital.
I stopped asking, “How can I end this pregnancy?” and started asking, “What’s going to happen if I don’t?” One doctor told me I could wait a maximum of three weeks for my body to miscarry on its own, at which point I would need a procedural abortion. My own research told me it can take eight weeks for the body to miscarry naturally, but that would also mean losing more weeks of my life to the pregnancy symptoms. I could drive to the hospital in Moncton, two hours away, for a procedural abortion, but I couldn’t get through to them when I called. It could also happen at my local hospital, but I would be, in the ER doctor’s words, “the bottom of the barrel,” waiting twenty-four or more hours with no food or water in preparation for surgery under general anaesthesia.
The holidays were quickly approaching, and it was becoming increasingly difficult to get through to anyone. I’d been spending most days in bed, continuing to experience all of my pregnancy symptoms despite the pregnancy itself no longer developing. At ten weeks pregnant, I was starting to lose my mind. I looked pregnant—which was probably more to do with bloating than my uterus having grown—but my clothes weren’t fitting, and I could barely stand to see myself in the mirror.
I researched combinations of herbs that can be brewed into a tea that supposedly induces abortion. I punched myself in the abdomen. Friends in other cities offered to arrange surgical abortions and have me stay with them. Perhaps this was the obvious thing to do, but with the obvious thing being so far from everyone else’s minds, I found myself going limp, losing the energy to take action. All I wanted was to be empty. Plans for Christmas dinners and brunches and New Year’s Eve piled up in my calendar.
Online, I read stories of women forced to wait too long for their miscarriages to happen, getting sepsis, and dying. I read about patients whose miscarriages led to infection, uterine scarring, and, in turn, infertility. I read about abortions performed without pain medication, about patients taking misoprostol and bleeding out in their bathrooms.
Finally, on Christmas Day, at eleven weeks, I started to miscarry. My hormones started to drop, meaning I could resume some of my normal routines. I wasn’t nauseous. I could go for short walks. I was no longer spending full days researching possible complications. Once or twice a day, I experienced cramping so painful I couldn’t think.
Through a series of personal connections, I was eventually seen by a doctor in another city, who made a plan with me: we would follow my weekly blood work until my pregnancy hormone reached zero, watching for signs of infection, and if my miscarriage failed to complete on its own, I would either try a third round of misoprostol or have a surgical abortion. As with all things, I would figure that out somehow, and later.
After he reviewed my file, I told this new doctor about my previous experiences at my local hospital. Confused, he said, “At no point were things looking optimistic.” A weight I hadn’t realized I’d been carrying around with me suddenly lifted. I knew this. All along, I’d insisted this. I had no idea about the relief I’d feel at simply having a professional validate what was so obviously true.
Though I was relieved to have a plan, I continued to be on the familiar precipice. Things were about to be over. If not, there was always another option, another plan. Later, something would happen. And the rest of my life? It swarmed after me: Emails from before my first visit to the hospital. Whole rooms I hadn’t cleaned, books splayed open on tabletops. I lived in pause.
I had dinner with Tracy Glynn, a founder of Reproductive Justice New Brunswick, and Valerya Edelman, a founder of Clinic 554. Edelman walked me through the types of care she and her husband, Dr. Adrian Edgar, had provided over 1,000 patients in the time the clinic was open. What stood out to me most was the focus on communication—not only informing the patient but listening to them.
Edelman had put together a booklet of information to give patients. It included a journal where they could record their experiences. Follow-up care, she told me, was always a priority. She’d also operated a twenty-four-hour phone line, providing guidance and resources to anyone in need of support. A few weeks earlier, I’d called Edelman. When she picked up, she told me she was Christmas shopping at the mall. We talked through what had happened to me so far, what I’d tried, what didn’t work, and she offered some other options. I continued to think about this for weeks—that someone had actually listened to me.
On one of my first walks after my morning sickness had started to dissipate, I passed the building where Clinic 554 used to be. Next door is a pro-life organization operating out of an unassuming house. When the clinic was open, they had a sign that read “Women’s Care Center,” which reportedly led some women to enter thinking they’d receive legitimate reproductive medical care. I remember when I first saw the sign and felt reassured. Now I couldn’t help but think of patients who may have been coerced into carrying unwanted pregnancies—who didn’t have access to vehicles or were unable to spend full days in the ER. Those who couldn’t get to hospitals in other cities or whose pregnancies went undetected for too many weeks and no longer qualified for the procedure.
As a patient with a wanted pregnancy, I felt I was some sort of abortion royalty, being let through the door of the hospital, but even for me, it became increasingly clear that despite treatment being offered to me, it was not going to be easy to get.
T he illusion of normalcy took shape even with my persistent bleeding, my pregnancy tests continuing to show two strong lines. I started to catch up on emails, see friends. Then I developed an infection and spent two days in two hospitals, at one point lying in an examination room for five hours with an unhooked IV in each arm, waiting to be taken in for surgery. An ER doctor came in and told me to forget the surgery, that I could instead try a round of antibiotics. Relieved, I took a cab to a pharmacy downtown, where I passed out on the floor while trying to pay for my prescription. The pharmacist offered to call an ambulance, but my walk home seemed infinitely easier than trying to get another answer from the hospital.
The next day, I felt better. The bleeding had nearly stopped. My temperature had come down, and my face seemed to have more colour. Could this finally be the end? There I was on another precipice.
S usan Holt, the new premier of New Brunswick, recently lifted the restriction that prevented Medicare-funded abortions from happening in private clinics. Although this is good news, it does not mean abortion care is more accessible right now. To open another clinic in the city will take time, money, persistence. More patients will try and fail to access timely and compassionate reproductive health care.
“Healthcare should not be based on luck or privilege,” Glynn wrote to me in an email. “We need to remove all barriers to care.”
The most helpful medical attention I received was accessible to me because I knew someone who knew someone else. Though I am grateful to those who helped me, this does not offer hope to others. It is also a path through the system I could access only by disclosing my most private information to an ever-widening pool of relatives and personal connections.
It wasn’t until I first wrote publicly about my experience that I was put in touch with the professionals who did offer solutions. Before that, my time spent as an anonymous patient in the system felt never ending. So what about everyone else, without a name to use as a passcode?
