Experiences self-managing an abortion using medication in India (provider factsheet)

Background
In 2015, approximately 73% of 15.6 million abortions in India took place outside of clinic settings by people using abortion medication to self-manage their abortions. A self-managed medication abortion is when a person takes pills to end a pregnancy without supervision from a healthcare provider. Research has found that when people have access to information and support during their abortion process, self-managing an abortion with medication is as safe and effective as when a person takes abortion medications (MA) with clinical supervision. In 2022, the World Health Organization recommended self-managed medication abortion as a safe and effective model of abortion care.

What we did
To explore and understand the experiences of those who self-manage a medication abortion at all stages of their journey, we conducted in-depth interviews with 43 people over the age of 18 who had a self-managed medication abortion in the past 5 years. We recruited these participants across more than six states in India, including Tamil Nadu, Jharkhand, Bihar, West Bengal, Maharashtra, and Madhya Pradesh. Interview participants were primarily women from rural and poor, marginalized communities.

We also recruited 156 clients seeking post-abortion care after self-managing using MA from three Family Planning Association of India (FPAI) clinics in West Bengal, Maharashtra, and Madhya Pradesh to take a survey. The survey measured expectations around bleeding and cramping, experiences with side effects and symptoms, reasons for care seeking, and MA outcomes. Quantitative results were analyzed using Stata 15; interview transcripts were coded and analyzed thematically in MAXQDA. In this brief, all statistics come from the survey, all quotes come from in-depth interviews, and the key findings emerged from both studies.

This research was conducted in partnership between Ibis Reproductive Health, Rural Women’s Social Education Center (RUWSEC), Sanitation and Health Rights (SHRI), and Family Planning Association of India (FPAI).