Among women in the study, nearly half reported using the licensed abortion drug misoprostol or another drug in their most recent attempt to terminate a pregnancy, while 38 percent used herbs they heard could induce abortion, and nearly 20 percent used a physical method, such as to be hit in the stomach. Nearly 28 percent said they had managed to terminate the pregnancy. Among those who had failed, 33.6 percent had subsequent abortions at a clinic (often 100 miles or more from home), and 13.4 percent continued the pregnancy. Eleven percent said they had suffered a complication after their self-attempted abortion.
The most common reasons why they tried to terminate a pregnancy alone without involving the health system were that it seemed easier or faster that the procedure at a facility was too expensive and that the nearest clinic was too far away. Although this study did not include adolescents, pregnant teens are often reluctant with or unable to seek parental consent, which many states need for a medically supervised abortion, which encourages some teens to attempt a self-induced abortion.
According to Dr. Ralph and co-authors “report abortion clinics and practitioners that they are caring for an increasing number of individuals who have attempted self-administered abortions.” The researchers predicted that women’s efforts to induce abortions on their own are becoming more and more common as access to facility-based abortion care continues to decline.
For example, the last clinic in Missouri that delivers abortions operated by Planned Parenthood could be forced to stop practice in a dispute with state regulators. It won a postponement to continue operations through next May. Missouri and Mississippi are among a number of states where lawmakers have banned abortions in early pregnancy, and most recently, Texas banned all abortions after six weeks of pregnancy, a point where the vast majority of women do not yet know they are pregnant. Last month, the Supreme Court accepted a case that could result in toppling Roe against Wade.
“As more abortion clinics close and restrictions increase, the convenience of self-administered abortions is likely to make them more widespread,” said Dr. Ralph in an interview. “Just because states make abortion harder to access does not mean that the need for abortion disappears. We should make sure that women have the safest and most effective methods available. ”
She noted that pandemic-induced restrictions on personal medical visits may have made it easier for women in many states to access self-directed abortions in their homes. Several doctors are now willing to advise abortion by phone and may even “distribute abortion medication by mail or deliver it to women in the parking lot,” she said.
Used correctly within 70 days of the onset of a woman’s last menstrual period (10 weeks gestation), medical abortion is effective in terminating pregnancy more than 95 percent of the time, the Guttmacher Institute has reported. There are two prescription drugs that are best used in combination that can induce abortion early in pregnancy. One, an oral drug called mifepristone, is first taken to block the hormone progesterone needed for pregnancy to continue; the other, misoprostol, dissolves in the mouth or is inserted vaginally one or two days later to induce contractions and expel the contents of the uterus and terminate the pregnancy.