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Self-managed abortions may rise as access to care decreases, providers say

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(NEW YORK) — As it gets harder to access abortion care because of state laws and restrictions, self-managed abortions may become more common, abortion providers told ABC News.

Self-managed abortions are done by a pregnant person without the formal supervision of a healthcare professional, according to Guttmacher.

In a pre-Roe era, self-managed abortions were often risky — but today, managing an abortion at home can be much safer thanks of the advent of medication abortion pills.

Unwanted pregnancies can be exceedingly distressing. Health providers are raising concerns that some people in situations without access to safe, legal abortion could try any means possible to end a pregnancy, that may or may not be safe or effective, Dr. Deborah Bartz, a gynecologist at Brigham and Women’s in Boston, told ABC News in an interview.

“Now, because of the post-Dobbs situation, we are recognizing that there’s going to be much greater desire for patients to undertake self-managed abortion because they can’t legally access the services that they desperately want and need through the standard health care system,” Bartz said.

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Medication abortion isn’t a new practice, first approved by the FDA in 2000, and now allows abortions to be done outside of a medical facility that is safe and effective, according to the Guttmacher Institute. Even prior to the overturn of Roe, the Guttmacher Institute estimated that roughly half of abortions in the U.S. were medication abortions.

While patients in the U.S. need a prescription to obtain misoprostol, one of the drugs used in the FDA-approved medication abortion regimen, the drug can be purchased without a prescription in other countries, including Mexico, according to the Guttmacher Institute.

While there is limited data on how common self-managed abortions are that do not involve a medical provider at all in the U.S., there are reports that it does happen and may be on the rise as states impose barriers to abortion access, according to Shah.

According to a 2014 national survey by the Guttmacher Institute, 1.3% of people obtaining clinical abortions reported having used misoprostol on their own to “bring back” their period or end a pregnancy.

In a 2017 survey of 7,022 women in U.S., 1.4% reported ever attempting to end a pregnancy on their own. The majority of these individuals reported using drugs or substances other than misoprostol, and only 28% successfully ended the pregnancy.

The spectrum of how people self-manage their abortions on their own ranges from effective to ineffective treatments, including herbal treatments, unsafe chemicals, incorrect medication or dangerous physical harm, according to Shah.

Research shows that medication abortions using the abortion pills, that are FDA-approved, mifepristone and misoprostol, are safe and effective. But there is little known about the safety or efficacy of these same medications when obtained and used by going around the regulatory steps in the United States.

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