Researchers found that self-managed abortion has increased since the U.S. Supreme Court overturned Roe v. Wade two years ago.
In the medical journal, Obstetrics and Gynecology, a new research study found an increase in self-managed abortion since the Supreme Court’s Dobbs decision. The researchers found that, nationally, between 2021 and 2023, the number of self-managed abortions across the U.S. increased by 1 percent. But when accounting for under reporting, researchers estimate that the number of self-managed abortions increased by 2 percent after the Dobbs decision.
Adrienne Mansanares, chief executive officer and president of Planned Parenthood of the Rocky Mountains, told NM Political Report that this research “absolutely aligns” with the organization’s experience in New Mexico.
“What we’re seeing are late night calls or emails to our call center from very scared patients, wanting to know if their bleeding or cramping is normal,” Mansanares said.
She said she hasn’t seen negative physical outcomes from self-managed abortions but she has seen negative psychological outcomes due to the fear the callers experience.
“Which could have been prevented,” she said.
Mansanares said the location for the most of these emergency calls and emails have come from patients located in Texas, where abortion is banned with few exceptions. She said the second largest volume of these emergency calls and emails to PPRM clinics in New Mexico come from patients in the state of Oklahoma, where abortion is also banned except to save the life of the pregnant person. Mansanares said in the last few weeks, PPRM clinics have also seen patients reach out in fear after a self-managed abortion from states as far away as Iowa, whose state supreme court upheld a six-week gestational ban in June. She said they’ve also heard from callers from Idaho, which has a near total ban on abortion.
Mansanares said such emergency requests are hard on healthcare providers.
“People in homes in states where we’re not licensed to provide clinical care, we can only say, go to the ER,” she said.
The researchers for the study, Self-Managed Abortion Attempts Before vs After Changes in Federal Abortion Protections in the US, queried over 7,000 individuals assigned female at birth who were of reproductive age and who were either English or Spanish-speaking. The researchers asked a series of questions both before the Dobbs decision and after, in order to gauge the rate of self-managed abortion care while Roe v. Wade was still in effect and the rate after the court overturned it.
The researchers defined self-managed abortion as one that includes any action taken to end a suspected or confirmed pregnancy without medical supervision. Currently more than half of all abortions are medical abortions, which involves a two-step regimen of two medications, mifepristone and misoprostol. Increasingly, patients seek abortion through telehealth, which allows them to take the abortion medication in their own homes. But a medication abortion through telehealth is still conducted with medical guidance.
A separate study found that in the first six months after the Dobbs decision, approximately 32,360 fewer abortions occurred within a formal health-care setting.
A self-managed abortion can include taking mifepristone and misoprostol but the patient does so without medical supervision. The new study published in Obstetrics and Gynecology found that self-sourcing medication abortion has increased since Dobbs with one telemedicine service reporting that requests for the medication have more than doubled since June 2022.
The survey found that the most common method of a self-managed abortion was not abortion medication but herbs. Other forms of a self-managed abortion also included taking emergency contraception and ingesting alcohol or other substances. Some used physical methods such as punching themselves in the stomach.
The researchers said in the study that they believe the one percent increase is likely a conservative estimate because people often under-report abortion care. The researchers believe the real number is closer to two percent and that, currently, up to seven percent of the female population of reproductive age are attempting a self-managed abortion.
The researchers also broke down the data to reflect race as a component in self-managed abortion care. The participants in the survey were 21 percent Hispanic, 14 percent Black and 54 percent white.
Self-managed abortion was higher for Black individuals than all other groups and lowest for white individuals. In addition, individuals who identified as being a member of a sexual or gender minority reported higher instances of self-managed abortion care than heterosexual or cisgender individuals.
One half of the participants who reported a self-managed abortion said they attempted more than one method. Nearly one in five reported requiring treatment in a medical setting for bleeding or pain.
