Self-Managed Abortions Have Gone Up 40% — And They're Not All Being Done Safely
We knew this would happen.
Just this past week, Iowa’s six-week abortion ban went into effect. Some of those who need abortions in that state will come to Illinois to get them safely. Others may make different decisions. What we do know is that making abortion illegal does not and will never really mean fewer abortions.
In fact, a Guttmacher study published earlier this year found that there were actually more abortions in 2023 than there had been in over a decade — and they only counted legal abortions.
What it will mean, unfortunately, is that many of the abortions that do happen will not be especially safe.
According to a study published this week in the Journal of the American Medical Association (JAMA) Network Open, self-managed abortions (abortions performed without any medical supervision) have increased by 40 percent since the Supreme Court overturned Roe v. Wade. While that’s not a bad thing entirely — for reasons of “abortion pills are now more accessible even for those who can’t get a legal prescription” — it’s certainly not ideal.
The authors of the study administered the survey to different cohorts in December 2021 and January 2022 before Roe was overturned, and then again in June and July of 2023 after the Dobbs decision. They found that “the proportion of the US female population of reproductive age reporting having ever self-managed an abortion increased from 2.4% to 3.3%” — which is a pretty big leap in such a short period of time, especially given that not all of the anti-abortion laws had gone into effect at that point.
The most common method chosen was emergency contraception (Plan B) prior to confirming pregnancy, with 29 percent having chosen that option. Great choice! However, the second most common method was herbs like pennyroyal and mugwort, with 25 percent having chosen that potentially dangerous option.
The study reports:
The most common methods for SMA included herbs (29.8% in 2021 and 25.9% in 2023), emergency contraception before confirming the pregnancy (with another method) (28.6% in 2021 and 29.7% in 2023), hitting themselves in the stomach (22.7% in 2021 and 21.6% in 2023), and alcohol or other substances (17.9% in 2021 and 18.6% in 2023). Fewer reported using misoprostol (13.7% in 2021 and 15.7% in 2023) and mifepristone (6.6% in 2021 and 11.0% in 2023). One-half (52.4% in 2021 and 48.4% in 2023) of the participants reported using more than 1 method. One-third (37.5% in 2021 and 37.7% in 2023) used a pregnancy test with a positive result before their SMA attempt.
And, unfortunately, there were some complications.
Nearly 1 in 5 (18.5% in 2021 and 14.9% in 2023) reported experiencing a complication requiring treatment by a physician or nurse with fewer (7.1% in 2021 and 4.7% in 2023) reporting seeking care at a hospital, emergency department, or urgent care. The complications most often reported were bleeding (8.3% in 2021 and 5.5% in 2023) and pain (8.3% in 2021 and 5.5% in 2023).
I don’t like the idea of being an alarmist when it comes to self-managed abortions, because I think that given these circumstances, we need to really work on making them as safe as possible and increasing access to the abortion pill in areas where abortion is illegal or not accessible. We need to consider options like teaching people who are not doctors how to perform menstrual extractions. We want to educate people on doing self-managed abortions safely, not scare them into having kids they don’t want.
That being said, just because something is “natural” doesn’t mean that it is safe. Pennyroyal and black cohosh can damage your liver. Mugwort and wormwood can cause seizures. Even parsley, taken in a dose strong enough to potentially cause a miscarriage, can cause organ damage.
The most frequently cited reasons for [self-managed abortions] included being early in the pregnancy (33.3% in 2021 and 31.8% in 2023) and privacy (30.4% in 2021 and 32.2% in 2023). Almost 1 in 5 participants reported that the clinic was too expensive (16.7% in 2021 and 18.2% in 2023) or they preferred trying something on their own first before going to a clinic (20.8% in 2021 and 19.1% in 2023). Some cited concerns about encountering protestors at a clinic (13.7% in 2021 and 12.7% in 2023) or needing a parent’s consent (11.3% in 2021 and 8.9% in 2023).
Only 5.9 percent said it was because abortion was illegal in their state, which means we still have a whole lot of work to do when it comes to ensuring it’s accessible and affordable in the states where it isn’t. (Of course, the study authors note that those who live in states where abortion is illegal may have been less likely to disclose that they self-managed an abortion for fear of being prosecuted).
We know, however, that people in these states are going to have illegal abortions. We know they will happen no matter how hard people try to make abortion illegal or what punishments Republicans come up with to punish those who have them, because if someone is desperate to not be pregnant, they will find a way — and we are going to have to work to ensure that the ways they find are, at the very least, safe.
That brings me back to this bumper sticker: Don't like abortions? Ignore them like you do school shootings.
So, this is sorta OT but still interesting, and I previously did not know all the details (from Salon's Amanda Marcotte) . . .
'In the days following Vance being named running mate, a silly meme exploded across the internet, falsely claiming that he had written about having sex with a couch in his book "Hillbilly Elegy." The person who concocted this rumor meant it as a joke and, as far as I can tell, everyone who has repeated it also means it as a joke. Even though no one believes the couch story is literally true, the meme spread like wildfire. As the guy who wrote the joke told Business Insider, he was inspired by filmmaker Werner Herzog's concept of "ecstatic truths," which can both be technically false but "make some essence of the man visible." In this case, the "essence" of Vance is that he's got some weird and inhumane views on human sexuality and gender relations. He was a poor pick as running mate for this reason, and yet Trump's choice was its own "ecstatic truth," revealing how deeply screwed up MAGA is about sex and gender.'
https://www.salon.com/2024/07/31/kamala-harris-is-wise-to-target-jd-cat-lady-vance--the-gops-incel-platform-repels/