With Abortion Restrictions On The Rise, Some Women Induce Their Own
September 19, 201912:00 PM ET
When Arlen found out she was pregnant this year, she was still finishing college and knew she didn't want a child.
There's a clinic near her home, but Arlen faced other obstacles to getting an abortion.
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"I started researching about prices, and I was like, 'Well, I don't have $500,' " said Arlen, who is in her 20s and lives in El Paso, Texas. We're not using her full name to protect her privacy.
"So I was like, 'OK, there's gotta be other ways.' "
Her research led her to information about self-induced abortion using pills.
"For me it was ... like taking my power back. Like, 'I'm going to do this, some way or another,' " Arlen said. "I don't want silly people and the government making silly laws."
Abortion, using pills
The Food and Drug Administration has an approved two-drug protocol for medication abortions, a combination of misoprostol and mifepristone. Mifepristone is especially heavily regulated in the U.S., and the combination is typically prescribed by a doctor during the first 10 weeks of pregnancy to cause what's essentially a medically induced miscarriage.
That two-drug combination is most effective, but the World Health Organization says misoprostol alone can also be used to safely induce abortion, provided patients get follow-up care.
Arlen learned online that she could get misoprostol — sold to treat ulcers — at a pharmacy across the border in Juárez, Mexico.
"Even my friend that was with me, she was kind of shocked about how easy it was," she said.
Arlen didn't want to take the pills alone. So back in El Paso, she went to a friend's home and followed instructions in a manual she'd found online. After a lot of cramping and some vomiting, she said, she'd passed both blood and tissue within several hours.
"The first time I saw blood I was so relieved," Arlen said. "Because I wasn't happy about it, but I was just like, 'Ah, it worked!' "
At a time when getting an abortion at a clinic is becoming more difficult in many places, a network of reproductive rights advocates is working to share information about self-induced abortion, both in person and over the Internet.
Planning ahead for a post-Roe world
In a downtown St. Louis storefront last month, Michele Landeau, of the Gateway Women's Access Fund, addressed a small group of activists who gathered for an information session on self-induced abortion.
A sticker handed out at a recent forum in St. Louis on self-induced abortion.
"We are trying to plan ahead for the possibility that abortion might not be available in the state of Missouri," Landeau told them.
The last clinic in Missouri that provides abortions could soon be forced to stop offering the procedure because of a dispute with state regulators. Missouri is among a growing number of states where lawmakers have passed bans on abortion early in pregnancy. Missouri's law is one of several currently tied up in legal challenges and that anti-abortion activists hope will end up before the U.S. Supreme Court.
Self-induced abortion used to be seen as dangerous and taboo; reproductive rights advocates often have raised the specter of back-alley procedures or women using grisly, dangerous methods such as a coat hanger to end a pregnancy at home.
But Landeau said people seeking abortions now — even in a restrictive environment — are living in a different world than before 1973, when the Roe v. Wade decision legalized abortion nationwide.
"The days of coat hangers and dying on the floor of a hotel room — the Internet has happened since them, and a lot of advances in medical science have happened since then," she said. "So it's not going to look the same as it did pre-Roe."
Self-induced abortion isn't new; women have always found ways to end unwanted pregnancies, though not always safely. But interest in information about the practice appears to be growing, though data on how common it is are limited.
"It's difficult to collect data on self-managed abortion precisely because it's self-managed," said Megan Donovan, senior policy manager at the Guttmacher Institute, which supports abortion rights. "And there's no easy way of identifying or tracking who's doing it and where or when."
A new report from Guttmacher suggests an upward trend in women trying to self-induce; the organization's latest survey on abortion rates, from 2017, found that 18% of nonhospital facilities said they had treated at least one person for an attempted self-induced abortion, up from 12% when the data were last collected, in 2014.
Susan Yanow, with the international reproductive advocacy group Women Help Women, is training activists from around the country to provide information about self-induced abortion. She said one project that focuses on self-induced abortion has seen its Web traffic spike in the past couple of years, especially around the time of the confirmation of President's Trump's most recent Supreme Court nominee.
"There was a huge jump during the Kavanaugh hearings, when I think people started to really realize that access to clinic-based abortion might be going away in many places," Yanow said. "There has been steady growth even since last summer, when those hearings were taking place."
Bypassing doctors, going online
For women who can't cross the border to Mexico, the Internet is reshaping their options.
A student and stay-at-home mom in Roanoke, Va. — who asked us to call her by her first initial, S. — said she ordered abortion pills online without seeing a doctor about three years ago, through a pharmacy based outside the United States. S. said she could have gone to a clinic in her area, but she didn't want to wait weeks for an appointment, like she had for a previous medication abortion.
"With a credit card," she said. "It showed up within two weeks. So by five weeks [pregnant], I was able to take the pills and start the abortion."
S. went with a two-drug combination she was able to get online. It's not the one preferred by the American College of Obstetricians and Gynecologists, because it's less effective.
But S. said it worked for her. Still, she had some fears about taking the pills herself.
"I couldn't get it out of my head: 'What if this happens? What if this happens, and I leave my children on their own?' " she said.
S. said she had a plan to call an ambulance or go to a nearby hospital if she had any complications."