San Francisco, California — Today, researchers at Advancing New Standards in Reproductive Health (ANSIRH) published a new study in JAMA Network Open detailing self-managed abortion rates before and after the Supreme Court decision overturning Roe v. Wade.
The findings show that the proportion of the U.S. female population that has ever tried to end a pregnancy on their own without medical assistance increased from approximately 5% pre-Dobbs to 7% post-Dobbs. People's reasons for deciding to self-manage their abortions were being early in pregnancy, concerns related to privacy, and the expense of in-clinic care. Self-managed abortion includes any action taken to end a pregnancy without medical supervision via medications, herbs, or other methods.
Of those who attempted to self-manage their abortion, the percentage of people using mifepristone nearly doubled post-Dobbs from 6.6% in 2021 and 11.0% in 2023. Experience with self-managed abortion was even more pronounced among people of color and LGBTQ+ people who face disproportionate barriers to accessing abortion care.
This in-depth analysis demonstrates that in an increasingly restricted abortion care landscape, more people are turning to self-sourced methods to end pregnancy.
“We know that restricting abortion doesn't mean that the need for care will go away,” said study author and ANSIRH Associate Professor, Lauren Ralph. “Even before the Dobbs decision, people trying to make ends meet, young people, and people of color struggled to access the in-clinic abortion care they wanted and needed. As barriers to in-clinic abortion grow, self-managing may be a pregnant person’s only or preferred option to end a pregnancy. Self-managed abortion fills a critical gap, giving people another option for care on their own terms.”
“More work needs to be done to inform people about mifepristone and misoprostol, which are the safest and most effective methods of self-managed abortion. Use of these more effective medications also would reduce the likelihood that people need to seek medical care after attempting self-managed abortion, where they may be at risk of arrest,” said Dr. Daniel Grossman, ANSIRH Director and OB-GYN.
As abortion is increasingly restricted, self-managed abortion attempts will likely continue to rise. Study authors concluded that efforts to connect pregnant people with safe and effective methods of self-managed abortion, as well as efforts to ensure that healthcare providers are aware of self-managed abortion, can help mitigate some of the legal and health risks people who attempt self-managed abortion will face.
The study relied on data from surveys administered in December 2021-January 2022 and May-July 2023—before and after the Supreme Court’s Dobbs decision overturning the legal right to abortion.
For more information or to get in touch with our experts, contact:
Virali Modi-Parekh
Strategic Communications Director
(415) 353-4784
[email protected]