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Self-Managed Abortion Attitudes Study

As policies continue to limit abortion access, the demand for and attitudes about self-managed abortion (SMA), the act of ending one’s pregnancy without the help of a medical provider, are likely changing. While several states criminalize or punish people suspected of having SMA, the public’s attitudes towards SMA criminalization is largely missing from the research literature. This study is a three-phase, mixed-methods study that will examine national changes in SMA prevalence, attitudes towards SMA criminalization and people’s interest in four alternative models of medication abortion provision (in advance from a clinician, over-the-counter from a pharmacy, online, and in the form of a missed period pill).

Research Questions

Has the national prevalence of attempts to self-manage an abortion without medical assistance changed over time?
What is the national level of support for criminalizing self-managed abortion?
What is the national level of support for alternative models of medication abortion provision, including in-advance from a provider, over-the-counter (OTC) without a prescription, online, when framed as a “missed period pill,” and has support changed?
Why do some groups that disproportionately lack access to medication abortion vary in their support for alternative models of medication abortion provision?

Study Design

The Self-Managed Abortion Attitudes Study (SMAASH) is a three-phase, mixed-methods study that seeks to evaluate SMA prevalence and attitudes towards SMA criminalization and alternative models of medication abortion provision. In the first phase of the study, in-depth qualitative interviews will be conducted via phone with men and women living in states that are restrictive to abortion with the goal of elucidating ways in which men and women may differ in their views about SMA criminalization.

In the second phase of the study, we will conduct a probability-based, nationally-representative panel survey of 250 men and 7,000 women about their attempts to self-manage an abortion, their attitudes towards SMA criminalization, and their attitudes towards alternative models of medication abortion provision.

In the final study phase, we will conduct in-depth interviews with specific subgroups with high or unexpectedly low interest in alternative models of medication abortion provision. These qualitative interviews will provide depth on the reasons why, how, and when alternative models of medication abortion provision are acceptable.

Implications

These data will provide evidence in support of policies to protect and expand access to medication abortion, to decriminalize self-managed abortion, support efforts to normalize the de-medicalization of medication abortion and support long-term goals to move medication abortion over-the-counter.