Significantly more women chose to terminate their pregnancies themselves — using unsupervised and potentially dangerous at-home methods — in the year following the Supreme Court’s abolishment of federal abortion protections, a study finds.
An estimated 3.4 percent of all women of reproductive age reported having attempted some form of at-home abortion in the year following the Dobbs v. Wade decision. Jackson Women’s Health Organization of 2022, according tofindings published Tuesday in the open network of the Journal of the American Medical Association (JAMA).
This represents an increase from 2.4% of all women the previous year – a trend that researchers predicted would continue to grow.
“As barriers to abortion in healthcare facilities grow, [self-managed abortion] may increasingly become an individual’s only or preferred option for terminating a pregnancy,” the study authors wrote.
In a worrying trend, around three-quarters of women who attempted home abortions did not use the misoprostol or mifepristone pills recommended by the World Health Organization.
Instead, they opted for “ineffective” methods such as herbs, Plan B emergency contraception or punches to the stomach, the study found.
The discovery comes amid a historic national crackdown on abortion. Since the Dobbs decision,22 states have bannedor significantly restricted the procedure, with 14 total bans passed.
A 2023 estimate by the Family Planning Society concluded that if the Supreme Court had not struck down federal protections, there would have beenapproximately 150,000 additional abortionsonly in those 14 states – even with the strict anti-abortion laws already in place in states prior to the Dobbs decision.
Some of these abortions occurred in states without outright bans, which sawan average of 11 percent more abortionsafter the 2022 decision, according to the Guttmacher Institute.
New Mexico, for example,more than doubledits number of abortions since 2020, with almosttwice as many women from out of state– asTexas Mom Kate Coxwhose state prohibits abortion in almost all circumstances after five or six weeks of pregnancy – traveling to access the procedure.
But out-of-state abortions are expensive, and many women have also reported concerns about encountering protesters or needing parental consent. Those who do not have access to in-clinic abortions are “increasingly relying on self-produced methods to terminate a pregnancy,” the JAMA Network Open authors wrote.
About a quarter of those who did so in 2023 used misoprostol or mifepristone, while the rest tried less safe or effective methods.
About a quarter turned to herbal remedies. Around 30% resorted to “physical methods” such as punching themselves in the stomach, lifting heavy objects or “inserting an object into the body”. And about a third consumed alcohol or other drugs or medication.
In about two-thirds of cases, the attempted abortion did not work. Those who tried misoprostol or mifepristone had a slightly higher success rate than the group as a whole.
Some of the women who resorted to ineffective home remedies were relatively young and did not have access to health care.
About 40 percent of women who attempted an at-home abortion were under the age of 20, and the majority — 55 percent — had not taken a pregnancy test before trying to terminate what they believed to be a pregnancy, investigators found.
In total, about 1 in 5 women ended up in clinics to deal with complications caused by the attempt, mainly pain and bleeding. About 1 in 20 ended up in emergency care.
Of the women whose self-managed abortions failed, about 20 percent had the abortion in a clinic and about 13 percent continued the pregnancy.
The researchers noted that their numbers likely represented an underestimate, given the well-documented underreporting of abortion in self-administered surveys.
If people underestimated self-managed abortions at the same level as facility-based abortions, the percentage of women of reproductive age who attempted them could have increased “from approximately 5% before Dobbs to 7% after Dobbs,” the authors of the paper wrote. study.
As self-managed attempts are likely to increase as abortion access becomes increasingly restricted in the US, doctors and nurses need to be aware of the trend, they argued.
And, they wrote, it is a public health imperative “to connect people who are pregnant with safe and effective methods of [self-managed abortion] with medical abortion pills.”
Doing so, they wrote, “may help mitigate some of the legal and health risks for people trying to [self-managed abortions] can face.”
Republican Party state and federal legislatorssought to ban access to abortion pillswhich now account for more than 60% of abortions in the US.
In June, the Supreme Court unanimously rejected a challenge to a post-Dobbs Food and Drug Administration policy that made access to pills easier — although Justice Brett Kavanaugh’s opinion for the courtalso included language that couldprotect doctors who refusing to provide care, even in a “health care desert.”
The growing use of abortion pills is reflected in open data from the JAMA Network, which revealed that the number of women using misoprostol or mifepristone between 2021 and 2023 increased by around a third, from 18% to 24%.
This story originally appeared on thehill.com read the full story
