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Self-Managed Abortion in the U.S.

Self-managed abortion (SMA), or attempting to end a pregnancy on one’s own without supervision from a health care provider, may become more common following the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization to overturn the federally protected right to abortion care. For years, we have documented various aspects of self-managed abortion through our research.

The issue brief is a summary of our findings from studies conducted in collaboration with community leaders and colleagues. We have found that people consider and attempt to end their pregnancies outside of a clinic setting for many reasons, including barriers to facility-based care and a preference for privacy and autonomy. People attempt to self-manage their abortions using a range of methods, including herbs, supplements, over-the-counter medications, and the abortion pills mifepristone and misoprostol. Self-managed abortion with mifepristone and misoprostol or misoprostol used alone is safe and effective, but safety and effectiveness data on other SMA methods are lacking. Our research also shows that the majority of reproductive-age women believe self-managed abortion should not be illegal in the US, which means that policies criminalizing self-managed abortion in 20 states (as of 2022) are not supported by the majority of the people living there. Leading medical institutions, including the American College of Obstetricians and Gynecologists (ACOG) and the American Medical Association, call for the decriminalization of self-managed abortion.