New study investigates women's reasons for self-induction

December 2, 2010 - Barriers to accessing clinical services and a preference for abortion self-induction were among the factors that contributed to women’s decisions to try to induce an abortion on their own, according to “Self-induction of abortion among women in the United States,” by Dr. Daniel Grossman et al. published in Reproductive Health Matters this month. The abstract of the article is available here.

Researchers at Ibis Reproductive Health and Gynuity Health Projects surveyed 1,425 women in waiting rooms of clinics serving low-income, predominantly Hispanic/Latina populations in Boston, New York City, San Francisco, and a city in Texas to identify women who had tried to induce their own abortions. Researchers interviewed 30 of the 57 women who reported having attempted self-induction (4.5% of women in the survey who had ever been pregnant). Twenty-five of the 30 women interviewed were living in the continental United States when they tried to self-induce their abortions. 

Women reported using a variety of methods to attempt self-induction, including medications, malta beverage, herbs, physical manipulation, and misoprostol. With the exception of misoprostol, none of the methods women used are known to be effective and some may be unsafe. Of the twenty-three women with confirmed pregnancies, only three reported a successful abortion not requiring clinical care. Only one woman who tried to self-induce while living in the US reported medical complications.

Many of the women interviewed were teenagers at the time they tried to induce their abortions and did not want to tell their parents they were pregnant. Many thought (either correctly or incorrectly) that they needed parental consent to obtain an abortion, and some did not know how to locate an abortion clinic. Financial barriers also prevented some women from seeking clinical services.

Some of the women expressed a preference for self-induction. Some wanted to avoid clinics or felt that self-induction was easier or faster than going to a clinic, and some desired the privacy of their homes and preferred a less medicalized procedure. Others felt self-induction was more “natural” and akin to “bringing down one’s period” rather than an actual abortion.

In a recent national survey of US abortion patients (Jones 2010), 1.2% reported having ever used misoprostol and 1.4% reported having used other methods to try to induce an abortion. However, neither study purports to measure the prevalence of self-induction in the general population, which also might vary in different areas of the country. In some parts of New York City and along the Texas-Mexico border, providers have reported seeing self-induction more frequently, particularly with misoprostol.

“This study provides insight into barriers women continue to face in accessing abortion care as well as their preferences around the type of care they receive,” said principal investigator Dr. Daniel Grossman, a senior associate at Ibis Reproductive Health and practicing obstetrician/gynecologist. “Women—especially young women and immigrants—need better education about state and federal abortion laws and the availability of clinical services. 

“We also need to expand access to medication abortion, which may appeal to women who seek a more natural, private, or less invasive abortion experience.”