Self-managed abortion

Self-managed abortion, also referred to as self-induced, self-sourced, self-administered, self-care, or, colloquially, “DIY” abortion, can be defined as any action a person takes to end a pregnancy without clinical supervision or support. Self-managed abortion occurs across settings, including where abortion is legally available and possibly preferred over clinic-based models of abortion care for reasons of autonomy, privacy, confidentiality, and perceived mistreatment by formal health systems. In other instances, self-managed abortion may be someone’s only option due to social and legal barriers.

Despite evidence of its occurrence, much is still unknown about self-managed abortion, including its global incidence and the experiences, outcomes, and characteristics of those who pursue it as an option. Challenges to studying self-managed abortion include: obtaining ethical approval to study what is often an illegal practice; recruiting participants who are willing to disclose their experiences; and concerns about communicating results publically due to fear of placing participants and/or research partners at risk of criminalization. Of the research that has been done, particular attention has been paid to self-use of medication abortion, a promising avenue for safe, self-managed abortion.

Since 2011, researchers at Ibis have collaborated with accompaniment groups, safe abortion hotlines, clinic-based harm reduction models, and other community organizations around the world to document the experiences of people who self-manage their abortions and those who support them. In 2020, in partnership with the University of California San Francisco, we published a systematic scoping review of peer-reviewed, public health literature on methods, procurement, and characteristics of those who self-managed their abortions, along with reasons for self-managed abortion, emotional and physical experiences of self-managed abortion, and the safety and effectiveness of self-managed abortion.

In addition, Ibis has led or collaborated on a range of related projects, including a focus on the safety and effectiveness of self-managed medication abortion, health care seeking and complications assessments following self-managed abortion, the effectiveness of self-managed medication abortion later in pregnancy, a model for in-person accompaniment of self-managed medication abortion, self-managed abortion experiences of transgender, nonbinary, and gender-expansive people in the United States, incidence of self-managed abortion in Texas,and experiences with self-managed abortion (with partnerships in Europe, India, Africa, Latin America, and the United States mobilizing activists for medication abortion in Africa).

Data from these multinational studies have the potential to transform the global conversation about self-managed abortion in legally permissive and restrictive settings. This data may also help expand access to safe models of abortion care that grant people full bodily autonomy and control of their reproductive lives, and open the door to broader liberalization of abortion provision models across the board.