An Exploration of Self-Managed Abortion in the United States: Incidence, Behavior, Knowledge, and Preferences

Abstract

Background: In the past decade, there has been an unprecedented wave of new abortion restrictions. This wave of anti-abortion legislation has coincided with decreased national abortion rates. However, there is disagreement on whether the recent rise in abortion restrictions is the main driver in the declines. Some scholars have argued that one of the potential drivers in the national decline of abortion is the rising trend of women turning to self-sourcing and self-administering their medical abortions outside of a clinical setting. As abortion is at the crux of public health, human rights, and reproductive justice, it is critical to investigate the role of self-managed abortion in the national abortion landscape.

Objectives: This thesis aimed to investigate the rising trends of self-managed abortion in the United States. In particular, this study examined the prevalence of self-managed abortion, the extent to which women are informed on the process, safety and risks associated with self-managed medical abortion, women’s preferences for accessing information and medication for self-managed abortion, and women’s ability to effectively navigate the resources available for self-managed abortion on the internet.

Methods: To address the objectives of this thesis, a nationally representative study of women aged 18 to 50 was conducted. The surveying techniques used in this study implemented nuanced and niche alternative measures to overcome the challenges and limitations associated with studying sensitive abortion behaviors.

Results: There are three key findings in this thesis. The first key finding is that a significant amount of women who consider having an abortion also consider having a self-induced abortion. Secondly, a significant amount of women are concerningly misinformed and under-informed about medical abortion. The third and final finding is that the internet serves as a central resource for women who are considering self-managing their medical abortions. However, there is an unmet need for an online resource that offers sufficient information to make a safe and effective abortion decision in addition to offering affordable abortion medication in the correct dosage.

Conclusion: The primary conclusion of this thesis is that self-managed abortion is a relevant and significant part of the national abortion landscape and needs to be further studied. For this reason, efforts must be made to disseminate knowledge and information to women on how to access safe and legal abortions. Furthermore, policymakers, public health professionals, reproductive rights advocates, clinicians, and researchers must collaborate on ensuring the establishment of a mainstream resource to support women who are seeking to self-manage their medication abortion. Lastly, the potential of telemedicine for abortion care, especially for those who face barriers to in-clinic access, should be examined in light of the boom in telemedicine during the current COVID-19 pandemic.