Self-managed abortion is a critical reproductive justice issue, and yet it is commonly misunderstood in this country. In order to help separate the facts from fiction, Reproaction hosted our first community forum on self-managed abortion on April 17 in Washington, D.C. This forum brought together three leaders central to the movement to spread awareness of self-managed abortion with pills: Erin Matson, co-director of Reproaction; Francine Coeytaux, co-founder of Plan C; and Renee Bracey Sherman, senior public affairs manager at the National Network of Abortion Funds. The event drew a crowd of about 40 people consisting primarily of social justice activists, reproductive health specialists, medical providers, legal professionals, and students.
Self-managed abortion is a broad term that includes all methods a pregnant person may use to end her own pregnancy. Different methods vary in safety and effectiveness, but this forum focused on self-managed abortion with pills, which is both safe and effective. This understanding of self-managed abortion is a shift away from conventional associations of coat hangers and back alleys. Matson explained, “Self-managed abortion is often framed as a choice of last resort – that there is something inherently wrong and terrible about self-managed abortion. Now, I do not mean to discount that there are people choosing self-managed abortion who are absolutely in that space. But that is not true of everyone who is choosing self-managed abortion. And as we move into the future that is not going to be the case.”
There is no evidence to suggest that abortion medications need to be administered in the physical presence of a clinician. In fact, the World Health Organization (WHO) has created protocols for the self-administration of abortion medications to manage one’s own abortion outside a medical setting. Matson emphasized how women are capable of managing their own abortion when she described, “Self-managed abortion is nothing new. It draws upon long-held traditions within communities throughout this country and throughout the world – particularly within communities of color – of women and people taking their health care into their own hands. Women have always been able and had the wherewithal to do what they need for their own lives.”
There are many reasons why one may manage their own abortion outside a clinic setting. It may be because abortion care at a clinic is unavailable, inaccessible, or simply not a good option for the individual. Renee Bracey Sherman of the National Network of Abortion Funds described one scenario when she explained, “In California [ICE agents] are standing outside clinics because they know they can pick up young women who are undocumented. So if someone is able to take a pill and have the abortion at home without risking their entire lives – that’s important.”
There were two main issues with self-managed abortion with pills that were discussed during this forum. First, there is the lack of information about self-managed abortion with pills. However, that is changing. Groups like Plan C are creating websites and materials that describe the WHO protocol for taking abortion medications in simple and easily digestible language, and you can also find that information here on the Reproaction website.
Second, while abortion itself is legal, those who end their own pregnancies and those who assist them may risk unjustified arrest and imprisonment. Francine Coeytaux of Plan C summarized the unjust political climate in this country when she said, “Here were are: The country that believes we are at the forefront of technology, has made sure that this technology [abortion medications] is not known in the U.S., is not available in the U.S., and if you do figure out how to get it, you may end up in jail.” As one may predict, low-income people and people of color are at greater risk of prosecution for self-managed abortion. As Sherman so acutely described, “Because of racism and xenophobia, [when people of color seek help at a hospital] instead of [hospitals] offering them the health care that they need, they are calling the police.”
This country is at a turning point, and “self-managed abortion offers massive opportunities to increasing abortion access,” explains Matson. The way forward is to share the knowledge that self-managed abortion with pills is safe and effective and to work together to change unjust laws that are designed to keep women from being able to make the best choice for their circumstances.