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Self-Managed Abortion

Overview: Self-Managed (Non-Clinical) Abortion

Self-managed abortion is the use of medicines such as mifespristone and misoprostol, herbs, Vitamin C or other means and methods without clinical supervision to induce an abortion. Self-managed abortion may be referred to as self-induced, self-sourced, self-administered, or “DIY” abortion. Moseson, Heidi et al. “Self-managed abortion: A systematic scoping review.” Obstetrics and Gynecology, vol. 63, 2020, pp. 87-110. https://www.ibisreproductivehealth.org/publications/self-managed-abortion-systematic-scoping-review.

The American College of Obstetricians and Gynecologists (ACOG), Opposition to the Criminalization of Self-Managed Abortion, Position Statement 6 July 2022, https://www.acog.org/clinical-information/policy-and-position-statements/position-statements/2022/opposition-to-the-criminalization-of-self-managed-abortion 

American Bar Association, Resolution 107A, Opposes Criminal Prosecution for Abortion, Miscarriage, Stillbirth or Other Pregnancy Outcome, 22 February 2021,See Resolution and Report at: https://www.americanbar.org/content/dam/aba/directories/policy/midyear-2021/107a-midyear-2021.pdf

American Medical Association, Opposes the Criminalization of Self-Induced Abortion: Resolution 007 (A-18), 1 May 2018. http://www.ospd.ms.gov/2021%20Criminilization%20of%20Pregnancy/a18-wps-resolution-007.pdf

Physicians for Reproductive Health, Self-Managed Abortion Policy Statement, Approved June 2017, reviewed November 2018. https://prh.org/wp-content/uploads/2018/12/Self-Managed-Abortion-Position-Statement-2018.pdf

American College of Obstetricians and Gynecologists (ACOG), Decriminalization of Self-Induced Abortion, Policy Statement December 2017. https://www.acog.org/clinical-information/policy-and-position-statements/statements-of-policy/2020/abortion-policy#:~:text=ACOG%20is%20opposed%20to%20abortion,survival%20outside%20the%20woman’s%20uterus

Exploring Attitudes About the Legality of Self-Managed Abortion in the US: Results from a Nationally Representative Survey. Download a Copy at:
https://www.researchgate.net/publication/350565079_Exploring_Attitudes_About_the_Legality_of_Self-Managed_Abortion_in_the_US_Results_from_a_Nationally_Representative_Survey

Self-Managed Abortion in the United States
https://www.ansirh.org/sites/default/files/2023-01/Self-Managed%20Abortion%20Issue%20Brief.pdf

A cross-sectional study examining consideration of self-managed abortion among people seeking facility-based care in the United States
https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-022-01486-8

Self-managed abortion via the internet: Analysis of one year of service delivery data from Women Help Women
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10130357/#:~:text=Most%20

Safety and effectiveness of self-managed abortion using misoprostol alone acquired from an online telemedicine service in the United States
https://pubmed.ncbi.nlm.nih.gov/36744631/
DOI: https://onlinelibrary.wiley.com/doi/10.1363/psrh.12219

Aiken, Abigail R. A., Romanova, Evdokia P., Morber, Julia R., et al., “Safety and effectiveness of self-managed medication abortion provided using online telemedicine in the United States: A population based study,” The Lancet Regional Health Americas, Volume 10, 17 February 2022, https://doi.org/10.1016/j.lana.2022.100200

Raifman, S., Biggs, M.A., Ralph, L. et al. Exploring Attitudes About the Legality of Self-Managed Abortion in the US: Results from a Nationally Representative Survey, Sexuality, Research and Social Policy, 16 March 2021, download a copy at: https://www.ansirh.org/research/search?ongoing%5B0%5D=14195

Ralph, Lauren, Foster, Diana G., Raifman, Sarah; Biggs, M. Antonia, Samari, Goleen, Upadhyay, Ushma, Gerdts, Caitlin, Grossman, Daniel, Prevalence of Self-Managed Abortion Among Women of Reproductive Age in the United States, JAMA Network Open, 18 December 2020; download a copy at: https://jamanetwork.com/, enter search term self-managed abortion

Barriers to abortion care and incidence of attempted self-managed abortion among individuals searching Google for abortion care: A national prospective study, Contraception, 2021 by Upadhyay, Cartwright and Grossman https://www.sciencedirect.com/science/article/pii/S0010782421003851?via%3Dihub#sec0007

JAMA Open Network: Research Letter Health Policy,  Abigail R. A. Aiken, MD, MPH, PhD1 et al.  February 25, 2022 Association of Texas Senate Bill 8 With Requests for Self-managed Medication Abortion

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789428

“This cross-sectional study analyzes a data set provided by Aid Access containing the date and state of origin of requests between October 1, 2020, and December 31, 2021, to assess whether requests from Texas increased after SB 8 went into effect.”

See data below;

“Between October 1, 2020, and December 31, 2021, Aid Access received 45, 908 requests for medication abortion from all 50 US states. Between October 1, 2020, and May 9, 2021, there was a mean (SD) of 10.8 (3.7) requests per day to Aid Access from Texas (Figure, panel B). A small increase occurred in mid-May, when SB 8 was returned from the House for final passage (Figure, panel A). Then, in the first week after SB 8 went into effect (September 1-8, 2021), mean (SD) daily requests increased by 1180% over baseline, from 10.8 (3.7) to 137.7 (85.7) requests per day (Figure, panel B) (95% CI, = 47.7-206.2; P = .008). During the subsequent 3 weeks (September 9-30, 2021), requests decreased from their peak, but remained 245% higher than the pre–SB 8 baseline at a mean (SD) of 37.1 (9.1) vs 10.8 (3.7) requests per day (Figure, panel B) (95% CI, = 22.4-30.27; P < .001). Overall, Aid Access received 1831 requests from Texas for self-managed abortion in September 2021. Over the following 3 months (October 1 to December 31, 2021), there was a mean (SD) of 29.5 (8.2) requests per month, 174% higher than the pre–SB 8 baseline (Figure, panel B) (95% CI, = 17.0-20.5; P < .001). During the same periods, mean daily requests from the other 49 US states showed much smaller increases (Figure, panel C), perhaps because of increased awareness of the service and other restrictive legislation.”

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