Imagine you are at your first prenatal appointment of a very wanted pregnancy. It seems like you waited forever for this appointment at 11 weeks gestation. Things have gone along quite swimmingly, experiencing minimal morning sickness and very little fatigue. During your exam, your midwife tells you that your uterus feels a little small for 11 weeks along. Perhaps your dates were off, she suggests, and decides to do an ultrasound. The office is a large practice and so they have an ultrasound machine in house.
Almost as soon as the probe visualizes inside your uterus, a small sac with a fetal pole emerges on the screen. Without a heartbeat.
You are crushed. All your dreams of being a mother are ripped away. The midwife is empathetic and after some talk about your loss, she asks you to get dressed and leaves the room.
When she comes back she gives you several options:
1. Let nature takes its course and wait for your body to expel the sac and embryo.
2. Take an oral medication to medically induce the products of the miscarriage.
3. Have a D&C, a surgical procedure to take out the sac and embryo.
After some discussion, you decide that option 2 is the best. You don’t think you can “sit around and wait” for nature because it would be emotionally taxing. You would like to avoid surgery if possible, especially since it would have to be with a provider (gynecologist) that you don’t know.
The midwife writes you the prescription for misoprostil and for a pain medication. The midwife says she will call you tomorrow and you make a follow up before leaving. Despite feeling emotionally drained and beat up, you head over to your pharmacy.
As usual, the pharmacy is busy. You wait in line to drop the prescriptions off. Once it’s your turn, the pharmacy tech enters the prescriptions into their computer and asks you if you are waiting for them. You answer that you are, and the tech points you to their waiting area. The waiting area is essentially two chairs at the end of an aisle.
You sit and watch customers pick up their prescriptions. The stream of people seems endless. All of them seem content and oblivious while you sit trying to hold back tears. A life you had hoped for has ended, and these people are just picking up their medications like it was any other day.
You’re startled to hear your name called so quickly. As you head over to the counter, you notice that the pharmacist has empty hands. You wonder where your prescriptions are.
“I’m not filling your prescription, Ms. S,” he says curtly.
Before you can reply, he continues, “The medication that was prescribed is used for abortion and it would be unethical and against my principles to fill it.”
“But that’s not the case,” you answer. You look around and realize the others at the counter are watching this exchange. You can feel tears building, almost spilling down your cheeks.
The pharmacist slams your prescriptions on the counter. “It is against my beliefs to partake in abortion. You can take these elsewhere.”
You gather the prescriptions and shove them into your purse quickly. With your head down and tears dripping off your face you leave the store ashamed. You feel too traumatized to head to the other pharmacy across town. Instead you go home and decide you’ll wait until the midwife’s phone call tomorrow.
When you tell your midwife what occurred, she is outraged. She tells you that she is going to call the pharmacist and straighten this out. She also has plans to contact the pharmacist’s supervisor.
Think this story is unbelievable? Well, it’s not. This happens to women across the country. Misoprostil is a drug that is prescribed for medical abortion in the first trimester, and many are unaware that it is also used for expelling the products of miscarriages. Pharmacists have the right to refuse fulfilling prescriptions against their religious beliefs but some fail to recognize this situation
There have been cases on of this on the news so I would imagine that it has opened some eyes. But what do these pharmacists do then, when a woman presents a prescription for misoprostil? Do they ask if it is for miscarriage or abortion? And do women feel obligated to answer this question?
Women filling the misoprostil prescription regardless of the reason do so under emotional distress. Neither woman wants to be scrutinized at this time in her life. Perhaps women’s health care providers could have a list of pharmacies in the community that will fill such prescriptions. This could avoid the terrible blow these women feel when they are turned away and scorned.