In states that ban abortion, some women with unwanted pregnancies pursue unconventional workarounds. They are “self-administering” abortions, searching online for the know-how they need, and obtaining medicines without the supervision of a clinic or doctor.
At first glance, you might recall the days before Roe v. Wade. At that time, women were forced to take risky steps to terminate unwanted pregnancies. However, the advent of medical abortion is transforming reproductive her care and posing a major challenge to anti-abortion legislation, as it is performed using drugs rather than an office procedure.
Even before the Supreme Court overturned the Roe v. Wade case, drug abortions accounted for more than half of all abortions in the United States. Federal regulators have made access to pills even easier during the pandemic by removing the requirement for in-person visits and allowing drugs to be mailed to patients after a virtual appointment.
However, many states have never allowed telemedicine abortion, and new laws banning abortion apply to all forms of procedures, including medication. So women in areas with increasingly strict national regulations source the pill any way they can, often online, despite state bans.
there is not a reliable estimate According to the Guttmacher Institute, which studies and supports access to abortion, it is among the number of women who self-medicate.
According to a database maintained by The New York Times, the overturn of Roe v. Wade has banned abortion in at least 10 states. Kansas voters on Tuesday rejected a bill that would remove abortion rights protections from the state constitution.
Nonetheless, both sides of the divide are preparing for an increase in self-administered abortions, as at least half of the states in the United States expect some type of restriction.
Critics of any form of abortion argue that medical abortion is more risky than claimed, and even more dangerous without medical supervision. It is not always possible to accurately date a pregnancy, so do not perform this procedure beyond 10 weeks of gestation or without medical attention.
Other medical complications, such as ectopic pregnancy, in which a fertilized egg implants outside the uterus, may be missed, they say.
Claims that medical abortion is safe “are based on flawed and incomplete data, prioritizing convenience and cost over patient health and safety,” says American Pro-Life Obstetrician and Dr. Christina Francis, president of the Association of Gynecologists, said. All abortions except to prevent permanent harm or death to the mother.
Doctors who advocate abortion tell a different story. There is plenty of evidence that medical abortion is safe. A woman performs abortions almost entirely alone in her home, even if she sees a doctor to get medication. Proponents argue that self-management is not much different.
Dr. Beverly Winnikov, Founder of Gynuity Health Projects, said: A study of medical abortions approved in the United States over 20 years ago.
Read more about abortion in America
The procedure usually involves taking two drugs: mifepristone, which blocks a hormone called progesterone to stop pregnancy, and misoprostol, which causes the uterus to contract a day or two later.
Studies show that more than 500,000 women in the United States will have a medical abortion in 2020, and less than 1% will experience serious complications.Medical interventions such as hospitalization and blood transfusions Fewer than 0.4% of patients neededaccording to a 2013 review of dozens of studies involving tens of thousands of patients.
Medical abortion “is non-invasive, doesn’t cause sepsis, doesn’t cause visceral rupture,” Dr. Winnikov said, like illegal abortion pre-Roe days.
“That doesn’t mean people can’t bleed excessively and need occasional medical attention, but it’s not the dire situation people were in 50 years ago.
However, these drugs are regulated by the Food and Drug Administration and are intended to be taken under a doctor’s supervision. In a statement, officials discouraged patients from purchasing mifepristone online because it would “bypass important protective measures.”
However, the FDA does not recommend buying misoprostol (brand name Cytotec) online, which is used to treat many medical conditions. Recent studies show that misoprostol can terminate a pregnancy by itself.
No treatment is 100% safe, but “taking the pill yourself at home doesn’t affect your risk of complications,” says a professor of obstetrics and gynecology at Columbia University and editor of the journal Contraception. Dr. Carolyn Westhoff, Director, said.
But self-management also means that women don’t have close-knit medical professionals nearby they can call in case of emergencies or complications. Dr. Westhoff and other experts are concerned that in states where abortion is criminalized, women who have self-imposed abortions may be reluctant to seek medical help.
Kathy, 20, uses the pronouns ‘they’ and ‘them’ and asked to use only her first name because she lives in Texas. Texas bans most abortions after about 6 weeks of pregnancy, but I had my own abortion in January.
Already having children and struggling financially, Cassie filled out an online request form for abortion pills from Europe-based Aid Access. Her medication took longer than expected to arrive and when it arrived she was already 12 weeks pregnant with Cassie.
“I took them in and prayed for the best,” Kathy said.
“I was crying. I was curled up in the middle of my bed in pain,” they said.
When the bleeding didn’t stop, Cassie’s partner took them to the hospital where the remaining tissue was removed.
“It was a terrifying experience in itself, praying that they didn’t know or suspect that I had caused it myself,” Kathy said.
Know-how and tools for performing abortions are becoming increasingly accessible.
Women living in states where abortion is legal can turn to US-based telemedicine providers. abortion on demand When Hey Janeprovides detailed information to women seeking abortions and offers pills via email after a video visit in states where these services are legal.
For women in states where abortion is prohibited, Plan C We offer a few workarounds, including a list of online pharmacies that sell organization-tested abortion pills and a tutorial on setting up email forwarding in another state to receive your medication.
This site also refers to people aid accessScreen women online and order abortion pills from overseas pharmacies. Abortion pills are sent in an envelope with no return address, even in states where abortion is illegal. Depending on your income, groups charge $150 or less.
Hannah, 26, of Oklahoma, said she managed an abortion herself using Aid Access pills late last year when her local clinic, overwhelmed with patients from Texas, couldn’t accommodate her. I’m here.
Hannah, who spoke on condition of anonymity because her state currently bans abortions, said she struggled with depression at times before she got pregnant but then plummeted to her lowest level and had suicidal thoughts. rice field.
“I couldn’t afford it, I wasn’t physically or mentally fit enough to get pregnant,” she said. It wasn’t worse than
A medical abortion is indistinguishable from a miscarriage and no trace of the pills can be found when taken orally, says Dr. Rebecca Gomperts, a Dutch physician who founded Aid Access.
If a woman needs care after taking the pill, “we always tell her to say she had a miscarriage,” she said. ”
Study of thousands of US women who received abortion pills from providers without in-person visits during pandemic found practice was safe.
Complications are the rare exception. Another recent study looked at self-administered abortions in Nigeria, where abortions are banned except to save the mother’s life, and Argentina, which legalized abortions for up to 14 weeks for her in late 2020. did.
20% of the approximately 1,000 women who participated in the study Received treatment in hospital after surgery, but most just wanted to make sure the abortion was complete. About 4% reported ongoing pain, fever, or bleeding. A study published in The Lancet Global Health in late 2021 found that 17 people required the procedure, 12 were hospitalized overnight, and 6 required a blood transfusion to complete the abortion.
A surprising finding was that while some women took a combination of mifepristone and misoprostol, women who took misoprostol alone had a higher success rate. A combination of two drugs.
Most state laws restricting abortion make it a crime of the doctor, not the patient, to perform it. Only three of her states—South Carolina, Oklahoma, and Nevada—have laws that specifically criminalize terminating one’s pregnancies.
However, some states have enforced child-endangering and other laws against women suspected of having an abortion.
In Indiana, Purvi Patel was sentenced to 20 years in prison for inducing a self-administered abortion in 2015. Her conviction she was overturned in 2016. In Texas earlier this year, Lizelle Herrera was charged with murder in connection with a self-administered abortion, but prosecutors said they would not pursue the case.
According to Dana Sussman, deputy executive director of the National Advocates for Pregnant Women, at least 11 states have laws containing broad personality expressions that apply to unborn children. At least six states—Kentucky, Louisiana, Ohio, South Dakota, Texas, and Wyoming—define a fetus as a person throughout their criminal statutes, making it easier to prosecute women who terminate their pregnancies themselves.
Both the American Medical Association and the American College of Obstetricians and Gynecologists support abortion as an integral part of health care and oppose the criminalization of self-administered abortion.
Currently, according to abortion advocacy group If/When/How, health care providers are not legally required by any state to report patients suspected of having self-administered abortions. Hmm. But the law is in flux.