Reasons for pursuing self-managed abortion vary, as do experiences

Interest in self-managed abortion in the US has grown as states pass more restrictive laws. Research in recent years has shown that some people seek to terminate a pregnancy without medical assistance but has mainly focused on talking to people who eventually got an abortion at a clinic. New research from ANSIRH sought to describe self-managed abortion experiences of people outside of clinics.

ANSIRH researchers conducted interviews with self-identified women who reported attempting to self-manage an abortion since 2000. Motivations for self-managing abortion included privacy concerns and barriers to facility-based abortion for those who had confirmed their pregnancies. For those who had not taken a pregnancy test, empowerment and the comfort that came from remaining unsure as to whether they were pregnant in the first place were key motivators.

Participants prioritized methods that were safe and available, but not always effective. About half used herbs, while others took over-the-counter medications. No one reported using mifepristone or misoprostol, the most effective combination of drugs for a medication abortion. Only one participant attempted to terminate the pregnancy via intrauterine trauma, by inserting a long plastic spoon in the vagina.

Six of the nine participants who had a positive pregnancy test prior to attempting to self-manage their abortions said their attempt was not successful. The remaining five participants had not taken a pregnancy test and said their periods returned. Of those who ended up seeking facility-based abortion services, most wished they could have avoided the clinic.

Self-managed abortion is not always a preference or a last resort. The results of this study suggest that there is a third group: People who suspect but have not confirmed a pregnancy and who seek potential solutions to try before actively pursuing facility-based care. Such individuals would benefit from a medication abortion product available outside of clinics, through pharmacies, online, or in the form of a missed-period pill (taken after a missed period but without confirming pregnancy).

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