Self-managed abortion, ending a pregnancy without formal supervision from a medical professional, has a long history within the United States, but the practice has gained recent attention as abortion restrictions increase. A new study by ANSIRH researchers presents the first national, population-based estimate of experience with self-managed abortion in the US. 

Researchers found that 1.4% of those surveyed reported a history of attempting a self-managed abortion while in the United States. Based on peoples’ ages when they attempted self-managed abortion, and adjusting for underreporting of abortion, researchers estimate that 7% of U.S. women will self-manage abortion at some point in their lives.

Researchers also found that Black and Hispanic women were more likely than white women to have attempted self-managed abortion. This suggests that the same systems that prevent Black and Latinx people from accessing other forms of reproductive health care might block them from accessing a facility-based abortion or foster a preference for self-managing an abortion. Women with lower incomes and those who faced barriers to abortion were also more likely to report self-managing an abortion.

Only 28% of attempts were successful in ending the pregnancy. One-third of those who had self-managed an abortion indicated that their attempts were unsuccessful and that they sought an abortion at a health facility. Herbs were the most common method used, followed by drugs or medications other than misoprostol (one of the drugs used in a medication abortion); misoprostol; a physical method; and emergency contraception after confirming a pregnancy; often in combination. Complications were not common.

One in five women said that the reason they attempted to self-manage abortion was because they could not locate a provider or would have to travel too far to get to a clinic. Unprecedented levels of new state-level abortion restrictions, the potential for a Supreme Court decision that could reshape federal constitutional protections on abortion, and the COVID-19 global pandemic could endanger abortion access even further, suggesting an urgent need to pay close attention to trends in self-managed abortion.