As Access to Abortion Facilities Diminishes Following the Supreme Court’s Revocation of Federal Abortion Rights, New Research Reveals a Surge in Self-Managed Abortions—Many of Which Involve Unsafe and Ineffective Methods.
According to a recent study published in JAMA Network Open, the percentage of women who report having self-managed an abortion has surged by approximately 40% since the Dobbs decision. The rate increased from 2.4% at the end of 2021 to 3.4% by the summer of 2023. The study, which surveyed over 14,000 women under 50, including hundreds of teenagers, highlights a significant rise in self-managed abortions in the year following the Supreme Court ruling.
Survey data likely underrepresents the prevalence of self-managed abortions, as the study’s authors note that such sensitive, stigmatized, and increasingly criminalized behaviors are prone to underreporting. The impact of criminalization on women’s willingness to disclose their experiences is unclear, with some possibly less inclined to share due to fear of legal repercussions, while others might feel more open due to heightened public discourse.
The researchers estimate that, when factoring in underreporting, over 10% of women will attempt a self-managed abortion at some point in their lives. These abortions occur outside the formal healthcare system and without medical supervision. In this study, women were asked if they had “ever taken or done something on their own, without medical assistance, to try to end a pregnancy.”
Following the Dobbs decision, earlier research has highlighted a notable increase in requests for abortion pills from sources outside the formal healthcare system. Many of these sources also offer information and support through online help desks or peer networks. The safety and effectiveness of medication abortion are well-documented, with recent studies showing that it is as safe via telehealth as it is through in-person clinics and similarly so when self-managed.
The latest study indicates a rise in the use of abortion pills for self-managed abortions, climbing from approximately 18% of attempts before the Dobbs decision to 24% afterward. Despite this, many women still resort to other, often less effective or unsafe methods. Over a quarter of women who attempted self-management reported using herbs, more than 20% mentioned physically harming themselves, and nearly 20% used alcohol or other substances.
Additionally, other research has shown an increase in formal healthcare abortions in the US post-Dobbs, largely due to a rise in medication abortions, particularly those provided via telehealth.
Privacy concerns are a major factor driving women to self-manage their abortions, with nearly a third citing this reason in 2023, a slight increase from 2021. Around 20% mentioned the cost of clinic visits as a barrier, and about 13% were concerned about encountering protestors at clinics.
Despite these challenges, around 15% of women who self-managed an abortion reported experiencing complications such as bleeding or pain that necessitated medical attention, with approximately 5% seeking care at hospitals, emergency rooms, or urgent care centers.
The study also found that Black women and those from low-income backgrounds were more likely to report having self-managed an abortion compared to others.
The researchers noted, ‘As barriers to facility-based abortions increase, self-managed abortions may become a more prevalent or necessary option for individuals seeking to end a pregnancy.’ They emphasized the need to expand access to safe and effective alternative abortion care models and to ensure that individuals who seek medical care following self-managed abortions do not face legal repercussions.
