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Access to abortion facilities has become more restricted in the United States since the Supreme Court overturned federal abortion rights, and new research suggests that self-inflicted abortions — often by unsafe and ineffective methods — have increased because of these restrictions.
The proportion of women who self-administered abortions jumped to nearly 40% after the Dobbs decision. Research Published Tuesday in the medical journal JAMA Network Open – from 2.4% at the end of 2021, a few months before the court decision, to 3.4% in the summer of 2023, a year after the decision.
The findings come from a survey of more than 14,000 women under the age of 50 who shared their experiences, including hundreds of teenagers.
Survey data probably underestimated how common self-administered abortions are; The study's authors say underreporting is to be expected when asked about “sensitivity, stigmatization, and now, in some cases, criminalization.” But women may be less likely to share their experiences because of the rise in pregnancy and abortion, or because of increased public attention on the issue, they wrote.
Overall, despite underreporting, the researchers estimate that more than 1 in 10 women will try to self-administer an abortion at some point in their lives.
Self-administered abortions occur outside of the regular health care system and without the regular supervision of a doctor or nurse. For this study, women asked whether they had “taken or done something on their own to end a pregnancy without medical help.” They were asked a question.
Earlier Research After the Dobbs decision, he found that demand for abortion pills through sources outside the mainstream health care system has increased. Most sources of self-administered medication abortion pills offer information and support through online help desks or peer-to-peer networks. of Safety and efficacy Medical abortion is well established, and recent studies have shown it to be safe Telehealth As in physical clinics and at the same time Self-managed.
The new study found that self-administration of abortion pills is becoming more common, rising from about 18% of attempts before Dobbs to 24% post-Dobbs.
However, many other ineffective and sometimes unsafe methods were also common. More than a quarter of women who tried to self-manage an abortion said they took herbs, more than 1 in 5 said they punched themselves in the stomach, and nearly 1 in 5 said they used alcohol or other substances.
other Research In the post-Dobbs United States, it confirmed the rise of abortion in the routine health care system.
But privacy is one of the most common reasons women choose to self-manage their abortions, according to new survey data. A third of women cited this as a reason in 2023, a slight increase from the stock in 2021. About 1 in 5 women reported that the clinic would be too expensive, and 13% said they were worried about being met by protesters. Clinic.
Despite these concerns, about 15% of women who self-administer abortions experience complications such as bleeding or pain and require medical attention. About 5% went to the hospital, emergency room, or urgent care.
Black women and those who grew up poor were more likely than others to say they had self-administered abortions.
“As barriers to facility-based abortion grow,[self-administered abortion]may become an individual's only or preferred option for terminating a pregnancy,” the researchers wrote. “These findings point to the need to expand access to alternative models of safe and effective abortion care and ensure that post-(self-administered abortion) health care providers do not face legal risks.”