About 7% of women A new study finds that 20% of women of childbearing age in the US have attempted to self-induce an abortion outside of the formal health care system, up from 5% before the Roe v Wade case in 2022.
The study, published Tuesday in the journal, Jama medical journal, measured how many people reported ever having “managed” their own abortion in 2021 and again in 2023 — a timeline that allowed researchers to examine how Dobbs v Jackson Women’s Health Organization, the Supreme Court case that overturned Roe, has affected self-managed abortions. People of color and LGBTQ+ people were more likely to report having ever attempted to end their own pregnancies.
“We think that because it’s going to be harder to get access to abortion in a facility, we’re going to see an increase in self-directed abortions,” said Lauren Ralph, lead author of the study and an epidemiologist at Advancing New Standards in Reproductive Health, a research group at the University of California, San Francisco. “It’s a really important piece of the puzzle as we try to understand the full impact of the Dobbs decision on people’s reproductive lives.”
Since Dobbs, 14 states have passed nearly complete abortion bans. On Monday, Iowa became the fourth state to ban the procedure after about six weeks of pregnancy, before many women even know they are pregnant.
Of the women who reported attempting to induce an abortion in 2023, 11% reported wanting to have an abortion. said in 2023 they had used mifepristone, one of the abortion pills typically used in a two-pill protocol, and 13.7% said they had used misoprostol, the other pill, alone. Another study, published in March, estimated that there are about 26,000 more people in the U.S. pills used to induce an abortion at home than if Roe had not fallen.
Medical experts generally agree that these pills can be used to safely self-manage an abortion during the first trimester of pregnancy, and the World Health Organization even offers a protocol on how to do so. Misoprostol can be used safely on its own – but often has more side effects than the two-pill regimen – while mifepristone is used alone can lead to further complications and is generally not recommended for terminating a pregnancy .
Many more people tried to end their pregnancies in potentially unsafe ways. In 2023, about 25% of those who tried to self-manage their abortion used herbs, 22% hit themselves in the abdomen, and 19% used alcohol or other drugs. Another 15% said they experienced a complication — such as bleeding or pain — after their self-manage abortion attempt that prompted them to see a doctor or nurse.
When asked why they tried to arrange an abortion themselves, people said they wanted privacy, that going to an abortion clinic was too expensive, or that they preferred to try it themselves first. Nearly 13 percent said they were worried about clinic protesters.
Four in 10 people who have ever self-performed an abortion were under 20 when they did it, and 9 percent of people who have attempted a self-performed abortion were concerned about the need for parental consent. Many states that tolerate abortion still have parental involvement laws, which require minors to tell their parents about their plans to have an abortion or get their consent to the procedure. If a minor cannot or will not do this, he or she must go to court and convince a judge to let him or her have an abortion without the parents’ knowledge or permission – which can be quite a challenge.
Ralph was not surprised that so many people who try to end their own pregnancies are so young.
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“Given things like parental involvement requirements, things like difficult access to transportation, things like not having a bank account of your own or having a consistent source of income in the same way that a young adult does, I think young people are more likely to self-initiate an abortion than their older counterparts,” Ralph said. Young people’s experiences with abortion, she added, have long been understudied.
Because people who perform abortions themselves can face criminal charges, Ralph and her fellow researchers used statistical analyses to account for people who may not accurately report their experiences with the phenomenon. Only one state—Nevada—bans self-performed abortions, but legal experts have long warned that if a prosecutor wants to punish someone for attempting one, they’ll find a law lenient enough to do so. Earlier this year, an Ohio grand jury considered whether to indict a woman accused of abusing a corpse after she miscarried in a bathroom. (The jury ultimately declined to indict her.)
Ralph found that around a third of people in both 2021 and 2023 said their self-managed abortion was successful, while a fifth said they later had an abortion in a clinic. Another quarter of people said nothing happened and they may never have been pregnant. Fourteen percent continued their pregnancies.
