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What you need to know

  • As state abortion restrictions expand in the wake of Roe’s fall, abortion rates have reached their highest level in over a decade.
  • Data shows that self-managed abortions are on the rise. While self-managed medication abortion is safe, many are resorting to other unsafe and unproven methods.
  • Resources are available for those seeking safe and discrete options for self-managed abortion.

A July 2024 JAMA study from the University of California, San Francisco found that self-managed abortions increased in the United States in 2023, the year after Roe was overturned. The findings line up with previous studies showing that a growing proportion of abortions are now self-managed, as opposed to under the care of a health care provider. 

Although self-managed medication abortions are safe and effective, some people are turning to riskier, less reliable methods as fears about abortion access spread nationwide. 

What is self-managed abortion?

A self-managed abortion is any abortion that happens outside of a traditional health care environment. The only safe, Food and Drug Administration-approved method of self-managed abortion involves taking a combination of the medications misoprostol and mifepristone. This method, called a medication abortion, is very safe and up to 98 percent effective.

Other self-managed abortion techniques have not been tested in clinical trials, are not regulated, and can be extremely dangerous and even life-threatening. These methods include herbal remedies, medications that are not approved for abortion, and physical trauma. 

Abortion landscape after Roe 

With abortion banned outright in more than a dozen U.S. states and severely restricted in at least half a dozen others, abortion access has radically changed post-Roe. 

Clinician-provided abortion rates have risen 11 percent since 2020, reaching the highest level in over a decade in the year after Roe. Between 2020 and 2023, the percentage of clinician-provided abortions that were medication abortions rose from 53 percent to 63 percent. 

The statistics on self-managed medication abortions are more difficult to determine, as they are typically underreported. However, the recent UCSF JAMA study found that the number of women in the U.S. who report seeking self-managed abortions increased from 2.4 percent to 3.4 percent in 2023. 

According to the study, adjusting for underreporting indicates that the rate rose from 5 percent in 2022 to 7.1 percent in 2023. 

A 2022 study found a 1.5-fold increase in anonymous requests for self-managed abortions in the months immediately after Roe was overturned. Nearly two-thirds of participants in states with total abortion bans and over a third of participants in states with pending bans cited concern about legal restrictions as their reason for seeking the service. 

The two studies underscore that abortions didn’t end after Roe; growing restrictions have just caused increased levels of fear and desperation in those seeking abortions. And, as the rate of safe abortions rose in the two years after the overturning of Roe, so did the use of unsafe abortion methods. 

The UCSF study found that only around a quarter of people seeking a self-managed abortion used the FDA-approved method, which is a medication abortion with misoprostol and mifepristone. 

Over a third used physical methods, including physical trauma, lifting heavy objects, and inserting objects in the body, to induce an abortion. One in four used herbal remedies; 19 percent used alcohol and other drugs; and 13 percent used other, non-approved medications. 

Attempted self-managed abortions using any type of medication or drug, including alcohol, increased between 2022 and 2023, while the use of physical methods decreased. Additionally, fewer than 5 percent of the study’s participants who experienced complications sought medical care. 

Resources for a safe self-managed abortion

Millions of people now live in states with complete or partial abortion bans. But there are still options for those who are seeking self-managed and clinician-provided abortions: 

This article is meant for informational purposes and does not substitute for professional medical advice or conversations with your health care provider.