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Article

Doctors and health care facilities need to prepare as self-managed abortion increases under restrictive laws

Many states across the U.S. have passed laws restricting access to abortion and several states are considering new legislation to further limit access. As these restrictions mount, we anticipate that more people will attempt to self-manage their abortion. Some will use safe and effective methods, like mifepristone and misoprostol pills purchased online. Others may use ineffective methods, such as herbs, and some may use unsafe methods, such as getting hit in the abdomen or inserting objects into the uterus.

In our review, “Complications of Unsafe and Self-Managed Abortion,” we outline ways clinicians and facilities can prepare for a future where even more people turn to self-managed abortion. We assert that appropriate care should be patient-centered and also address the patient’s legal safety, which may be a bigger threat than any medical risks in states where patients may be prosecuted for managing their own abortion.

Because medication abortion is extremely safe, patients presenting for care may only need confirmation that the abortion is complete. However, in cases where patients attempt to self-induce abortion using unsafe methods, life-saving care may be necessary.    

Read our full review in the New England Journal of Medicine.

Request a pdf.

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ANSIRH is a program within the UCSF Bixby Center for Global Reproductive Health and is a part of UCSF's Department of Obstetrics, Gynecology & Reproductive Sciences.

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