‘My country is not taking care of me’: Woman who nearly died from an infection after an incomplete abortion on why access is so important

Melissa Novak missed abortion sepsis collage
After an incomplete abortion, Melissa Novak went into septic shock — a life-threatening complication. She believes not having access to both mifepristone and misoprostol played a role. (Illustration: Nathalie Cruz; Photos: Melissa Novak)

Melissa Novak was nearing 40 and knew that the chances of her getting pregnant were becoming less likely. But then this past February, she took a pregnancy test — and it was positive. “I knew it would be very unlikely that pregnancy would come so easily, so that fact that it did felt like this beautiful gift,” Novak tells Yahoo Life.

Her obstetrician said they could see her in eight weeks. So in March, right before leaving for a family trip during which she planned to share the exciting news, Novak went in. “We go in for the ultrasound and the technician says, ‘This doesn’t look right. There's no heartbeat and I'm sorry,’” she recalls. “I knew miscarriage was possible, but here I was given this gift so quickly and it felt so unlikely” that it would be taken away just as quickly.

But once she realized she’d miscarried, Novak wanted to move forward. “How do I move about my day knowing there’s something inside of me that no longer belongs or isn’t what it’s supposed to be?” she says. “A lot of pregnant folks talk about when you realize it’s not viable, you feel like you need to move on.”

The consequences of limited access to abortion care

Novak, who lives in Georgia, didn’t want to have a surgical abortion, so she opted for a medication abortion instead, which typically involves taking two prescription drugs, mifepristone and misoprostol, within a 48-hour period to complete a miscarriage or end a pregnancy. However, because of Georgia’s limited access to abortion care, her obstetrician told her she could only prescribe one of the pills. “My doctor said we have a medication we can give you” — referring to misoprostol alone — “and one we can’t use,” referring to mifepristone, even though the medication is FDA-approved for terminating a pregnancy up to 10 weeks gestation. “She said there’s going to be a lot of blood,” Novak recalls. “You can take this medication and it works.”

Despite the fact that mifepristone is still available across the country, except in states where abortion is banned, some providers, including in Georgia, are using misoprostol alone for medication abortions. While misoprostol is 80 to 100% effective at terminating a pregnancy on its own, according to the Kaiser Family Foundation, taking both medications is more effective and has fewer side effects.

“Mifepristone and misoprostol administered together have been studied extensively,” women’s health expert Dr. Jennifer Wider tells Yahoo Life. “This combination is very effective and well-tolerated. Misoprostol alone can work, but studies show it’s less effective and sometimes produces harsher side effects, which can include nausea, bloating, indigestion and vomiting.”

Four hours after inserting four misoprostol pills vaginally at home as instructed, Novak started bleeding as expected. She went on her family trip, came home and was surprised that she was still bleeding. “I called my OB and said, ‘I’m still bleeding — is that okay?’” Novak says. “She calls me and says it’s a little odd. ‘Are you still testing pregnant?’ I was. I was testing extraordinarily pregnant — the line was coming up, glaringly obvious.” But Novak wasn’t pregnant.

Screenshot of Melissa Novak, who was in septic shock from an incomplete abortion. (Photo courtesy of Melissa Novak)
Screenshot of Melissa Novak, who was in septic shock from an incomplete miscarriage. (Photo courtesy of Melissa Novak)

“I’m not going to make it home”

Her doctor suggested she wait four more days, but a few days later, while driving to a spa appointment, Novak felt like she was coming down with a cold, followed rapidly by a fever. She turned her car around, called her husband and said, “‘I’m not going to make it home. I’m going to the ER. I don't even know if I'm going to make it to the ER. I may pass out,’” Novak recalls. “My fever came on so hard. I was hunched over the steering wheel. My whole body was shaking, with intense pain in my lower back.”

Novak managed to make it to the hospital and told them that she’s “still miscarrying.” She recalls, “I was ashen,” adding, “I’m in septic shock at that point, but nobody knows.” Septic shock is a life-threatening condition caused by a bacterial infection.

Her fever spiked to 104 degrees in the ER and her blood pressure was dangerously low. She was given antibiotics and had blood cultures taken, along with an ultrasound, which revealed some pregnancy tissue that hadn’t been fully expelled, known as an incomplete abortion or incomplete miscarriage. “I was having trouble talking because I was in agony,” she says. “I was so tired and I'm suffering in this way and it’s beyond what I think I can handle.”

“I’ve never felt so powerless”

Doctors decided to perform emergency surgery, known as a D&C, to remove the remaining tissue. Novak admits she found herself starting to go into “some dark places,” thinking, “I don’t think the surgery is going to work. I think I'm going to die. My body just felt so broken.”

She shares that not only was her husband scared, but her best friend Morgan Unruh — a family medicine physician who later shared Novak’s story on her Instagram to raise awareness about the dangers of limitations to abortion access (Unruh has since taken that post down) — was “looking for flights to come out because she’s thinking: my friend could die,” says Novak.

After four days in the hospital, Novak recovered. But she continues to feel frustrated over the lack of access to mifepristone — an FDA-approved drug whose access across the U.S. is currently in jeopardy —and how that may have led to this “life-threatening” experience. “I don’t get to make my own health care decisions,” she says. “I’ve never felt so powerless.”

One silver lining, however, is the care Novak says she received from the hospital staff and the support from friends and family, as well as commenters on Unruh’s original Instagram post, which have helped her heal. “A huge piece of this process for me has been the importance of community — the people who responded to Morgan’s post and to me sharing their own stories, checking in on me, uplifting me,” she says.

Novak adds: “All these people took so much care of me. My country is not taking care of me, but my community is.”

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