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A self-induced abortion (or self-induced miscarriage or self-managed abortion) is an abortion performed by the pregnant person alone or with the help of other, non-medical assistance. Although the term includes abortions induced with self-use of pills commonly used for medical abortion, it also refers to efforts to terminate a pregnancy through alternative, sometimes more dangerous means.[1] Such practices may present a threat to the health of women.[2]

Self-managed (or self-induced) abortion is often attempted during the beginning of pregnancy (the first eight weeks from the last menstrual period).[3][4] In recent years, significant reductions in maternal death and injury resulting from self-induced abortions have been attributed to the increasing availability of misoprostol (known commercially as "Cytotec")[5][6]. This medication is a synthetic prostaglandin E1 that is inexpensive, widely available, and has multiple uses, including the treatment of post-partum hemorrhage, stomach ulcers, and induction of labor.[7] The World Health Organization (WHO) has endorsed two regimens for abortion up to 12 weeks of pregnancy using misoprostol: a standardized regimen of mifepristone and misoprostol and a regimen of misoprostol alone.[8] The regimen with misoprostol alone has been shown to be up to 83% effective in terminating a pregnancy but is more effective combined with mifepristone.[9]

200 mg mifepristone and 800 mcg misoprostol, the typical regimen for early medical abortion.


(proposed reformatting of the next section):

Methods used[edit]

Women can use many different methods to self-induce (or self-manage) an abortion.[10] Some are safe and effective, while others are dangerous to the health of the woman and/or ineffective at terminating a pregnancy.  

Mifepristone and/or misoprostol[edit]

The only scientifically studied effective self-induced abortion method is ingesting a combination of mifepristone and misoprostol or misoprostol alone.[11] The combination of these medications is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system.[12] In some countries, these pills may be available over-the-counter in pharmacies, although some pharmacists do not provide accurate instructions on use.[13] In Latin America, women have reported self-inducing abortions with misoprostol alone since the 1980s.[14] The history of women self-managing abortion with pills includes projects such as the Socorristas in Argentina and Las Libres in Mexico.[15][16] Other countries have "safe abortion hotlines," which facilitate access to pills, provide instructions on proper use of the pills, and provide emotional, logistical, and/or financial support.[17][18] Some women use online abortion pill help services such as Women on Web, Women Help Women, and Aid Access to order mifepristone and/or misoprostol, with reported effectiveness and safety in pregnancy termination and satisfaction in the service.[19][20] Instructions on abortion pill use are widely available on the websites of the World Health Organization (WHO), Gynuity Health Projects,[21] and the International Women's Health Coalition.[22]

First trimester medical abortion is highly safe and effective.[23] The side effects of medication abortion include uterine cramping and prolonged bleeding, and common side effects include nausea, vomiting and diarrhea. The majority of women who use abortion pills on their own do not need an ultrasound or a clinician, although one may be recommended to ensure that the pregnancy is not ectopic.[24] In the rare case of a complication, a woman can access a clinician skilled in miscarriage management, which is available in all countries.[25]

Studies confirm a correlation between the increase in the self-administration of medical abortion with misoprostol, and a reduction in maternal morbidity and mortality.[26] Some studies argue that unfettered access to medication abortion is a key tenet of public health, human rights, and reproductive rights. [27]

Physical trauma, herbs, and other substances[edit]

Other commonly recorded methods of self-inducing an abortion are ingestion of plants or herbs, ingesting toxic substances, causing trauma to the uterus, causing physical trauma to the body, using alcohol and drugs in an attempt to end the pregnancy, and ingesting other substances and mixtures.[28] There are no known effectiveness studies for plants, herbs, drugs, alcohol, or other substances. These methods are more likely to cause bodily harm to the pregnant woman than to be effective in terminating a pregnancy. Causing physical trauma to a woman's body or uterus may also result in physical harm or even death to the woman instead of causing an abortion.[29]

  1. ^ Harris, Lisa H.; Grossman, Daniel (2020-03-12). Campion, Edward W. (ed.). "Complications of Unsafe and Self-Managed Abortion". New England Journal of Medicine. 382 (11): 1029–1040. doi:10.1056/NEJMra1908412. ISSN 0028-4793.
  2. ^ Haddad, Lisa B; Nour, Nawal M (2009). "Unsafe Abortion: Unnecessary Maternal Mortality". Reviews in Obstetrics and Gynecology. 2 (2): 122–126. ISSN 1941-2797. PMC 2709326. PMID 19609407.
  3. ^ Worrell M. "About the "I need an abortion" project — Women on Web".
  4. ^ Sage-Femme Collective, Natural Liberty: Rediscovering Self-Induced Abortion Methods (2008).
  5. ^ Costa, S. H. (1998). "Commercial availability of misoprostol and induced abortion in Brazil". International Journal of Gynecology & Obstetrics. 63 (S1): S131–S139. doi:10.1016/S0020-7292(98)00195-7. ISSN 1879-3479.
  6. ^ Faúndes, A.; Santos, L. C.; Carvalho, M.; Gras, C. (1996). "Post-abortion complications after interruption of pregnancy with misoprostol". Advances in Contraception. 12 (1): 1–9. doi:10.1007/BF01849540. ISSN 0267-4874.
  7. ^ Goldberg AB, Greenberg MB, Darney PD (January 2001). "Misoprostol and pregnancy". The New England Journal of Medicine. 344 (1): 38–47. doi:10.1056/NEJM200101043440107. PMID 11136959.
  8. ^ World Health Organization (2018). Medical management of abortion. Geneva: World Health Organization. hdl:10665/278968. ISBN 978-92-4-155040-6. OCLC 1084549520.
  9. ^ "Abortion with Self-Administered Misoprostol: A Guide for Women" (PDF). Gynuity Health Projects. November 2010. {{cite web}}: Unknown parameter |lay-url= ignored (help)
  10. ^ Tuttle L, Riddle JM (1995). "Contraception and Abortion from the Ancient World to the Renaissance". Sixteenth Century Journal. 26 (4): 1033. doi:10.2307/2543870. ISSN 0361-0160. JSTOR 2543870.
  11. ^ World Health Organization (2018). Medical management of abortion. Geneva: World Health Organization. hdl:10665/278968. ISBN 978-92-4-155040-6. OCLC 1084549520.
  12. ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  13. ^ Footman K, Keenan K, Reiss K, Reichwein B, Biswas P, Church K (March 2018). "Medical Abortion Provision by Pharmacies and Drug Sellers in Low- and Middle-Income Countries: A Systematic Review". Studies in Family Planning. 49 (1): 57–70. doi:10.1111/sifp.12049. PMC 5947709. PMID 29508948.
  14. ^ Zamberlin N, Romero M, Ramos S (December 2012). "Latin American women's experiences with medical abortion in settings where abortion is legally restricted". Reproductive Health. 9 (1): 34. doi:10.1186/1742-4755-9-34. PMC 3557184. PMID 23259660.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  15. ^ Zurbriggen R, Keefe-Oates B, Gerdts C (February 2018). "Accompaniment of second-trimester abortions: the model of the feminist Socorrista network of Argentina". Contraception. 97 (2): 108–115. doi:10.1016/j.contraception.2017.07.170. PMID 28801052.
  16. ^ Singer EO. "Las Libres, Guanajuato: A feminist approach to abortion within and around the law – Safe Abortion : Women's Right". Retrieved 2019-08-24.
  17. ^ Gerdts C, Jayaweera RT, Baum SE, Hudaya I (July 2018). "Second-trimester medication abortion outside the clinic setting: an analysis of electronic client records from a safe abortion hotline in Indonesia". BMJ Sexual & Reproductive Health. 44 (4): 286–291. doi:10.1136/bmjsrh-2018-200102. PMC 6225793. PMID 30021794.
  18. ^ Drovetta RI (May 2015). "Safe abortion information hotlines: An effective strategy for increasing women's access to safe abortions in Latin America". Reproductive Health Matters. 23 (45): 47–57. doi:10.1016/j.rhm.2015.06.004. PMID 26278832.
  19. ^ Gomperts R, Petow SA, Jelinska K, Steen L, Gemzell-Danielsson K, Kleiverda G (February 2012). "Regional differences in surgical intervention following medical termination of pregnancy provided by telemedicine". Acta Obstetricia et Gynecologica Scandinavica. 91 (2): 226–31. doi:10.1111/j.1600-0412.2011.01285.x. PMID 21950492.
  20. ^ Gomperts RJ, Jelinska K, Davies S, Gemzell-Danielsson K, Kleiverda G (August 2008). "Using telemedicine for termination of pregnancy with mifepristone and misoprostol in settings where there is no access to safe services". BJOG. 115 (9): 1171–5, discussion 1175–8. doi:10.1111/j.1471-0528.2008.01787.x. PMID 18637010.
  21. ^ "Abortion with Self-Administered Misoprostol: A Guide for Women" (PDF). Gynuity Health Projects. November 2010. {{cite web}}: Unknown parameter |lay-url= ignored (help)
  22. ^ "Abortion Using Misoprostol Pills: A Guide For All Pregnant People Seeking to Self-Manage Their Abortion". International Women's Health Coalition.
  23. ^ Kapp N, Eckersberger E, Lavelanet A, Rodriguez MI (February 2019). "Medical abortion in the late first trimester: a systematic review". Contraception. 99 (2): 77–86. doi:10.1016/j.contraception.2018.11.002. PMC 6367561. PMID 30444970.
  24. ^ Gomperts R, Petow SA, Jelinska K, Steen L, Gemzell-Danielsson K, Kleiverda G (February 2012). "Regional differences in surgical intervention following medical termination of pregnancy provided by telemedicine". Acta Obstetricia et Gynecologica Scandinavica. 91 (2): 226–31. doi:10.1111/j.1600-0412.2011.01285.x. PMID 21950492.
  25. ^ Gomperts RJ, Jelinska K, Davies S, Gemzell-Danielsson K, Kleiverda G (August 2008). "Using telemedicine for termination of pregnancy with mifepristone and misoprostol in settings where there is no access to safe services". BJOG. 115 (9): 1171–5, discussion 1175–8. doi:10.1111/j.1471-0528.2008.01787.x. PMID 18637010.
  26. ^ Singh S, Maddow-Zimet I (August 2016). "Facility-based treatment for medical complications resulting from unsafe pregnancy termination in the developing world, 2012: a review of evidence from 26 countries". BJOG. 123 (9): 1489–98. doi:10.1111/1471-0528.13552. PMC 4767687. PMID 26287503.
  27. ^ Jelinska K, Yanow S (February 2018). "Putting abortion pills into women's hands: realizing the full potential of medical abortion". Contraception. 97 (2): 86–89. doi:10.1016/j.contraception.2017.05.019. PMID 28780241.
  28. ^ Moseson H, Herold S, Filippa S, Barr-Walker J, Baum SE, Gerdts C (2019-08-14). "Self-managed abortion: a systematic scoping review". {{cite journal}}: Cite journal requires |journal= (help)
  29. ^ Singh S, Maddow-Zimet I (August 2016). "Facility-based treatment for medical complications resulting from unsafe pregnancy termination in the developing world, 2012: a review of evidence from 26 countries". BJOG. 123 (9): 1489–98. doi:10.1111/1471-0528.13552. PMC 4767687. PMID 26287503.
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