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Self-Managed Abortion in the United States.
Nisha Verma1, Daniel Grossman2
1Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA USA.
Current Obstetrics and Gynecology Reports
|June 12, 2023
Summary
Self-managed abortion is safe and effective, with growing demand in the USA due to increased barriers to facility-based care. Clinicians can help patients navigate medical and legal risks associated with self-managed abortion.
Area of Science:
- Reproductive Health
- Public Health Policy
- Medical Ethics
Background:
- Obstacles to facility-based abortion care are increasing in the USA.
- The Supreme Court's decision to overturn Roe v. Wade has impacted abortion access.
- Self-managed abortion (SMA) is a growing area of reproductive healthcare.
Purpose of the Study:
- To provide up-to-date information on self-managed abortion in the USA.
- To review the safety, effectiveness, and prevalence of SMA.
- To discuss the factors influencing SMA and its associated risks.
Main Methods:
- Review of current literature and evidence on self-managed abortion.
- Analysis of data from a nationally representative survey on SMA prevalence.
- Examination of trends in medication abortion and associated legal risks.
Main Results:
- An estimated 7% of US adults had attempted self-managed abortion by 2017.
- Individuals facing barriers to care are more likely to attempt SMA.
- Medication abortion (mifepristone with misoprostol, or misoprostol alone) is increasingly used and is safe and effective.
- While medical risks are low, legal risks, including criminal investigations, are significant.
Conclusions:
- Self-managed abortion is a safe and effective option, particularly for those facing barriers to clinic-based care.
- The preference for SMA is also driven by convenience, accessibility, and privacy.
- Clinicians are crucial in providing accurate information, supportive care, and mitigating legal risks for patients undergoing SMA.
