Reasons for pursuing self-managed abortion vary as do experiences

Published May 4, 2021

Researchers conducted qualitative interviews and found that women who had reported attempting to end a pregnancy on their own had a variety of experiences doing so. For some, seeking self-managed abortion (SMA) was a preference or a last resort, while others valued having an interim step to try after suspecting pregnancy and before accessing facility-based care.

Key Findings

Reasons for self-managing an abortion varied based on whether pregnancy had been confirmed.
Motivations for SMA included privacy concerns and barriers to facility-based abortion (for those who had confirmed their pregnancies), as well as empowerment and the comfort that came from remaining unsure as to whether they were pregnant in the first place (for those who had not taken a pregnancy test).
Participants prioritized methods that were safe and available, but not always effective. About half used herbs, while others took over-the-counter medications. No one reported using mifepristone or misoprostol. Only one participant attempted to terminate the pregnancy via intrauterine trauma.
Six of the nine participants who had a positive pregnancy test prior to attempting SMA said their SMA attempt was not successful; the remaining five participants had not taken a pregnancy test and said their periods returned after attempting SMA.
Of those who ended up seeking facility-based abortion services, most wished they could have avoided the clinic.

Study Design

Researchers conducted qualitative interviews with 14 women between the ages of 18 and 49 who reported in an online survey that they had attempted self-managed abortion while living in the United States. Participants were asked about their reproductive histories, experiences seeking reproductive health care, and SMA experiences.

Implications

Self-managed abortion is not always a preference (pursued by those who favor home remedies) or a last resort (pursued by those who lack access to clinic care). The results of this study suggest that there is a third group: People who suspect but have not confirmed a pregnancy and who seek potential solutions to try before actively pursuing facility-based care.

“For many interested in SMA as an alternative to facility-based abortion, the window of time during which they believe SMA is worth trying is relatively short and occurs earlier on in pregnancy. People interested in SMA would likely benefit from a medication abortion product that was available over the counter, online, and or in the form of a missed-period pill.”

The article, “I’ll just deal with this on my own”: a qualitative exploration of experiences with self-managed abortion in the United States, is available in Reproductive Health.

Areas of Research