Self-induction of abortion among women in the United States.
Recent media coverage and case reports have highlighted women's attempts to end their pregnancies by self-inducing abortions in the United States. This study explored women's motivations for attempting self-induction of abortion. We surveyed women in clinic waiting rooms in Boston, San Francisco, New York, and a city in Texas to identify women who had attempted self-induction. We conducted 30 in-depth interviews and inductively analyzed the data. Median age at time of self-induction attempt was 19 years. Between 1979 and 2008, the women used a variety of methods, including medications, malta beverage, herbs, physical manipulation and, increasingly, misoprostol. Reasons to self-induce included a desire to avoid abortion clinics, obstacles to accessing clinical services, especially due to young age and financial barriers, and a preference for self-induction. The methods used were generally readily accessible but mostly ineffective and occasionally unsafe. Of the 23 with confirmed pregnancies, three reported a successful abortion not requiring clinical care. Only one reported medical complications in the United States. Most would not self-induce again and recommended clinic-based services. Efforts should be made to inform women about and improve access to clinic-based abortion services, particularly for medical abortion, which may appeal to women who are drawn to self-induction because it is natural, non-invasive and private.
Ibis Reproductive Health, Oakland, CA, USA. dgrossman@ibisreproductivehealth.org
Daniel
D
Grossman
Kelsey
K
Holt
Melanie
M
Peña
Diana
D
Lara
Maggie
M
Veatch
Denisse
D
Córdova
Marji
M
Gold
Beverly
B
Winikoff
Kelly
K
Blanchard
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage; D000028:Abortion, Induced / Q000379:methods*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D016595:Misoprostol / Q000008:administration & dosage; D009042:Motivation; D011247:Pregnancy; D012646:Self Administration; D012648:Self Care; D014481:United States; D055815:Young Adult
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol