Self-Managed Abortion

Self-managed abortion is the term commonly used to describe when a person chooses to induce their own abortion outside a medical setting. Anyone who decides to end a pregnancy should be able to choose to self-manage an abortion at home or somewhere we feel safe—with the control in our hands, surrounded by the people we love, and with the support we want.

Self-managed abortion is not new; people have been having abortions for centuries, in many cases supported by community providers, doulas, partners, and lay people. Since Roe v. Wade made abortion legal in the U.S., abortions have also been available to people in clinics and other medical settings.

Research shows that with access to safe, effective methods and accurate information, people may safely self-manage an abortion on their own. Self-managed abortion may look different for different people. Safe and effective ways of self-managing an abortion can include:

  • Self-sourcing abortion pills and taking them at home or wherever someone feels safe and comfortable, with the support of loved ones.
  • Having an abortion supported by a home provider or doula who has knowledge and training.
  • Having an abortion that is mostly self-managed but may also begin or end with support from a physician or other licensed provider like Whole Woman’s Health.

No matter the method you may choose, we know that access to abortion care makes communities healthier, and that care delivered without delay, judgment or bias is what everyone deserves. Here’s what you need to know about self-managed abortion.

About Medication Abortion Care

Since it was first approved by the FDA in 2000, medication abortion, also referred to as the abortion pill, has transformed the practice of abortion care. It’s extremely safe and effective for pregnancies less than 12 weeks. In 2016, the FDA confirmed that medication abortion’s “efficacy and safety have become well-established by both research and experience, and serious complications have proven to be extremely rare.” In a 2015 guideline, the World Health Organization (WHO) identified three individual components of self-managing a medication abortion during the first trimester: self-assessing eligibility; managing the mifepristone and misoprostol medication without direct supervision of a health care provider; and self-assessing completeness of the abortion process using pregnancy tests and checklists.

The FDA-approved regiment for medication abortion consists of two medications currently available by prescription through a provider (not at a pharmacy): mifepristone, which works by blocking progesterone, a hormone needed for a pregnancy to continue; and misoprostol, taken 24-48 hours later, which induces contractions and ends the pregnancy. A person’s ability to self-administer mifepristone and misoprostol after receiving instructions from a provider is well established, and there is evidence that it is safe and effective for someone to do so without the direct supervision of a provider.

Medication abortion care is effective more than 95% of the time. In cases where the recommended dosage does not end the pregnancy, additional medication or aspiration (suction) abortion care may be needed to complete the abortion. Expected side effects are typically minor and similar to the symptoms of a miscarriage: bleeding, uterine cramping and pain.

Misoprostol-Only Abortion

Some providers in the U.S., and many internationally, use a misoprostol-only protocol to complete an abortion. Many people self-managing their own abortion care also follow these protocols. While not approved by the FDA, this regimen is common and is also effective. You can find more information on misoprostol-only protocols from the WHO at www.who.int/health-topics/abortion.

Legal Challenges

Anti-abortion politicians are standing in the way of all types of safe, effective, affordable methods of abortion care. In 2021, politicians have enacted over 100 anti-abortion restrictions that make access even more fraught. In many states, politicians have imposed regulations that specifically create barriers to the use of medication abortion. There are also five states with laws that make self-managing an abortion a crime. Forty different types of laws that exist in nearly every state have been used to arrest and put a person in jail who ends their own pregnancy. There is no role for the criminal punishment system or law enforcement in managing a person’s reproductive health care needs. Ending the criminalization of pregnancy, abortion, and all aspects of reproduction is essential to affirming the right to reproductive autonomy. Whole Woman’s Health stands firmly against criminalizing anyone for ending their own pregnancy. We believe all people should receive compassionate, medically-sound advice and support when seeking to end a pregnancy.

Resources for People who Self-Manage Abortion

  • If/When/How’s Repro Legal Helpline: Free, confidential legal support online or at 844-868-2812 for anyone who has been questioned by the authorities on suspicion of self-managing their abortion or supporting someone else to self-manage abortion, or who fears they will be questioned.
  • Miscarriage & Abortion Hotline: Operated by doctors who can offer expert medical advice. Available online or at 833-246-2632.
  • SASS (Self-Managed Abortion; Safe and Supported): Supports the rights of people around the world to have information about and access to safe abortion with pills.
  • Abortion On Your Own Terms: A website geared towards providing information, research, messaging and resources supporting self-managed abortion.