In an October 31 article for Vice, Dr. Dara Kass urged emergency medicine providers to destigmatize -- and increase their understanding of -- self-managed abortion, a practice that “occurs when a person chooses to perform their own abortion outside a medical setting.” Amid unprecedented attacks on reproductive rights, including the passage of restrictive anti-abortion laws, the appointment of anti-choice Supreme Court justices, and the embrace of anti-choice policies and talking points by President Donald Trump’s administration, increasing numbers of individuals are choosing to end pregnancies from the privacy of their homes. As Kass explained, medical providers need to be better informed about self-managed abortions in order to properly support their patients in the face of dwindling abortion access:
Recently I decided to talk to my colleagues about a new category of pregnant patient. I was born in a post-Roe v. Wade era, training and living in New York City where hostilities toward reproductive health felt real but far away. Growing up, I thought that “protecting Roe” was enough, especially since that’s how the assault on reproductive rights was framed. But with the exponential rise of laws that target abortion providers with unnecessary regulations, the appointment of anti-choice Supreme Court justices, and this administration barring family planning clinics that get federal funds from telling their patients where they can get an abortion, it's clear that “protecting Roe” is not enough.
For me, that means knowing more about self-managed abortion using pills and encouraging my fellow emergency medicine doctors to do the same.
Medication abortions are rather simple. A patient takes two kinds of pills in the first 10 weeks of pregnancy. The first, mifepristone (RU-486) blocks progesterone, which prevents the pregnancy from continuing, and then a second medication, misoprostol, causes uterine contractions and bleeding, ending the pregnancy. It's medically indistinguishable from a miscarriage.
Medication abortions are also very common. A recent study from the Guttmacher Institute showed that about 40 percent of people who terminated their pregnancy choose medication abortion. It's effective 95 percent of the time, with a near-zero rate of serious complications.
Given the uncertainty around abortion access and the increase in individuals managing their own abortions, it is important for medical providers to treat self-managed abortions as a normal part of medical care. Similarly, journalists should strive to cover self-managed abortion in an informative and destigmatizing way.