Self-induced abortion

{{short description|Abortion performed by a pregnant person themselves outside the recognized medical system}} {{Use dmy dates|date=March 2024}} {{cs1 config|name-list-style=vanc|display-authors=6}} [[Image:RussianAbortionPoster.jpg|thumb|right|[[Soviet Union|Soviet]] poster circa 1925. Title translation: "Abortions induced by either self-taught [[midwives]] or obstetricians not only maim the woman, they also often lead to death"]] A '''self-induced abortion''' (also called a '''self-managed abortion''', or sometimes a '''self-induced miscarriage''') is an [[abortion]] performed by the pregnant woman herself, or with the help of other, non-medical assistance. Although the term includes abortions induced outside of a clinical setting with legal, sometimes [[over-the-counter medication]], it also refers to efforts to terminate a pregnancy through alternative, potentially more dangerous methods.<ref>{{cite journal | vauthors = Harris LH, Grossman D | title = Complications of Unsafe and Self-Managed Abortion | journal = The New England Journal of Medicine | volume = 382 | issue = 11 | pages = 1029–1040 | date = March 2020 | pmid = 32160664 | doi = 10.1056/NEJMra1908412 | s2cid = 212678101 | doi-access = free | veditors = Campion EW }}</ref> Such practices may present a threat to the health of women in the case that they are incorrectly used.<ref name="Haddad 2009 122–126">{{cite journal | vauthors = Haddad LB, Nour NM | title = Unsafe abortion: unnecessary maternal mortality | journal = Reviews in Obstetrics & Gynecology | volume = 2 | issue = 2 | pages = 122–126 | year = 2009 | pmid = 19609407 | pmc = 2709326 }}</ref>

Self-induced (or self-managed) abortion is often attempted during the beginning of pregnancy (the first eight weeks from the last [[menstruation|menstrual period]]).<ref>{{cite web|url=https://www.womenonweb.org/en/page/511/about-the-i-need-an-abortion-project|title=About the 'I need an abortion' project – people on Web| vauthors = Worrell M }}</ref><ref>Sage-Femme Collective, ''Natural Liberty: Rediscovering Self-Induced Abortion Methods'' (2008).</ref> 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").<ref>{{cite journal | vauthors = Costa SH | title = Commercial availability of misoprostol and induced abortion in Brazil | journal = International Journal of Gynaecology and Obstetrics | volume = 63 | issue = S1 | pages = S131–S139 | date = December 1998 | pmid = 10075223 | doi = 10.1016/S0020-7292(98)00195-7 | s2cid = 22701113 }}</ref><ref>{{cite journal | vauthors = Faúndes A, Santos LC, Carvalho M, Gras C | title = Post-abortion complications after interruption of pregnancy with misoprostol | journal = Advances in Contraception | volume = 12 | issue = 1 | pages = 1–9 | date = March 1996 | pmid = 8739511 | doi = 10.1007/BF01849540 | s2cid = 32526547 }}</ref> This medication is a synthetic [[prostaglandin E1]] that is inexpensive, widely available, and has multiple uses, including the treatment of [[Postpartum bleeding|post-partum hemorrhage]], [[peptic ulcer|stomach ulcers]], [[Cervical dilation|cervical preparation]] and [[Labor induction|induction of labor]].<ref>{{cite journal | vauthors = Goldberg AB, Greenberg MB, Darney PD | title = Misoprostol and pregnancy | journal = The New England Journal of Medicine | volume = 344 | issue = 1 | pages = 38–47 | date = January 2001 | pmid = 11136959 | doi = 10.1056/NEJM200101043440107 }}</ref> 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.<ref name="WHO 978-92-4-155040-6">{{cite book|title=Medical management of abortion|isbn=978-92-4-155040-6|oclc=1084549520|year=2018|publisher=[[World Health Organization]]|hdl=10665/278968|location=Geneva}}</ref> 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.<ref name="gynuity selfguide">{{cite web|url=https://gynuity.org/resources/abortion-with-self-administered-misoprostol-a-guide-for-women |title=Abortion with Self-Administered Misoprostol: A Guide for Women | date=November 2010 |website=Gynuity Health Projects }}</ref>

==Methods attempted== Women can use many different methods to self-manage (or self-induce) an abortion.<ref>{{cite journal| vauthors = Tuttle L, Riddle JM |year=1995|title=Contraception and Abortion from the Ancient World to the Renaissance.|journal=Sixteenth Century Journal|volume=26|issue=4|page=1033|doi=10.2307/2543870|issn=0361-0160|jstor=2543870}}</ref> 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 === {{main|Medical abortion}} The only scientifically studied effective self-induced abortion method is ingesting a combination of [[mifepristone]] and [[misoprostol]] or misoprostol alone.<ref name="WHO 978-92-4-155040-6" /> The combination of these medications is on the [[WHO Model List of Essential Medicines|World Health Organization's List of Essential Medicines]].<ref name="WHO21st">{{cite book | title = World Health Organization model list of essential medicines: 21st list 2019 | year = 2019 | hdl = 10665/325771 | publisher = [[World Health Organization]] | location = Geneva | id = WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO | hdl-access=free }}</ref> In some countries, these pills may be available over-the-counter in pharmacies, although some pharmacies do not provide accurate instructions on use.<ref>{{cite journal | vauthors = Footman K, Keenan K, Reiss K, Reichwein B, Biswas P, Church K | title = Medical Abortion Provision by Pharmacies and Drug Sellers in Low- and Middle-Income Countries: A Systematic Review | journal = Studies in Family Planning | volume = 49 | issue = 1 | pages = 57–70 | date = March 2018 | pmid = 29508948 | pmc = 5947709 | doi = 10.1111/sifp.12049 }}</ref> In Latin America, women have reported self-inducing abortions with misoprostol alone since the 1980s.<ref name=":1">{{cite journal | vauthors = Zamberlin N, Romero M, Ramos S | title = Latin American women's experiences with medical abortion in settings where abortion is legally restricted | journal = Reproductive Health | volume = 9 | issue = 1 | page = 34 | date = December 2012 | pmid = 23259660 | pmc = 3557184 | doi = 10.1186/1742-4755-9-34 | doi-access = free }}</ref> The history of women self-managing abortion with pills includes projects such as the Socorristas in Argentina and Las Libres in Mexico.<ref>{{cite journal | vauthors = Zurbriggen R, Keefe-Oates B, Gerdts C | title = Accompaniment of second-trimester abortions: the model of the feminist Socorrista network of Argentina | language = en | journal = Contraception | volume = 97 | issue = 2 | pages = 108–115 | date = February 2018 | pmid = 28801052 | doi = 10.1016/j.contraception.2017.07.170 | url = https://www.contraceptionjournal.org/article/S0010-7824(17)30393-1/abstract | doi-access = free }}</ref><ref>{{cite web | vauthors = Singer EO |url=http://www.safeabortionwomensright.org/las-libres-guanajuato-a-feminist-approach-to-abortion-within-and-around-the-law/|title=Las Libres, Guanajuato: A feminist approach to abortion within and around the law – Safe Abortion: Women's Right | date = 28 April 2016 |access-date=24 August 2019}}</ref> 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.<ref>{{cite journal | vauthors = Gerdts C, Jayaweera RT, Baum SE, Hudaya I | title = Second-trimester medication abortion outside the clinic setting: an analysis of electronic client records from a safe abortion hotline in Indonesia | journal = BMJ Sexual & Reproductive Health | volume = 44 | issue = 4 | pages = 286–291 | date = July 2018 | pmid = 30021794 | pmc = 6225793 | doi = 10.1136/bmjsrh-2018-200102 }}</ref><ref>{{cite journal | vauthors = Drovetta RI | title = Safe abortion information hotlines: An effective strategy for increasing women's access to safe abortions in Latin America | journal = Reproductive Health Matters | volume = 23 | issue = 45 | pages = 47–57 | date = May 2015 | pmid = 26278832 | doi = 10.1016/j.rhm.2015.06.004 | hdl = 11336/107662 | s2cid = 3567616 | hdl-access = free }}</ref> Some women use online abortion pill help services such as [[Women on Web]] and [[Aid Access]] to order mifepristone and/or misoprostol, with reported effectiveness and safety in pregnancy termination and satisfaction in the service.<ref name="Regional differences in surgical in">{{cite journal | vauthors = Gomperts R, Petow SA, Jelinska K, Steen L, Gemzell-Danielsson K, Kleiverda G | title = Regional differences in surgical intervention following medical termination of pregnancy provided by telemedicine | journal = Acta Obstetricia et Gynecologica Scandinavica | volume = 91 | issue = 2 | pages = 226–31 | date = February 2012 | pmid = 21950492 | doi = 10.1111/j.1600-0412.2011.01285.x | s2cid = 9829216 | doi-access = free }}</ref><ref name = "Gomperts_2008">{{cite journal | vauthors = Gomperts RJ, Jelinska K, Davies S, Gemzell-Danielsson K, Kleiverda G | title = Using telemedicine for termination of pregnancy with mifepristone and misoprostol in settings where there is no access to safe services | journal = BJOG | volume = 115 | issue = 9 | pages = 1171–5; discussion 1175–8 | date = August 2008 | pmid = 18637010 | doi = 10.1111/j.1471-0528.2008.01787.x | s2cid = 29304604 | doi-access = free }}</ref> Instructions on abortion pill use are widely available on the websites of the [[World Health Organization]] (WHO), Gynuity Health Projects,<ref name="gynuity selfguide" /> and the International Women's Health Coalition.<ref>{{cite web | title=Abortion Using Misoprostol Pills: A Guide For All Pregnant People Seeking to Self-Manage Their Abortion | url=https://iwhc.org/resources/abortion-self-administered-misoprostol-guide-women | website=International Women's Health Coalition}}</ref>

First trimester medical abortion is highly safe and effective.<ref>{{cite journal | vauthors = Kapp N, Eckersberger E, Lavelanet A, Rodriguez MI | title = Medical abortion in the late first trimester: a systematic review | journal = Contraception | volume = 99 | issue = 2 | pages = 77–86 | date = February 2019 | pmid = 30444970 | pmc = 6367561 | doi = 10.1016/j.contraception.2018.11.002 }}</ref> 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 pregnancy|ectopic]].<ref name="Regional differences in surgical in"/> In the rare case of a complication, a woman can access a clinician skilled in miscarriage management.<ref name = "Gomperts_2008" />

Studies confirm a correlation between the increase in the self-administration of medical abortion with misoprostol, and a reduction in [[maternal morbidity]] and mortality.<ref name="auto">{{cite journal|vauthors=Singh S, Maddow-Zimet I|date=August 2016|title=Facility-based treatment for medical complications resulting from unsafe pregnancy termination in the developing world, 2012: a review of evidence from 26 countries|journal=BJOG|volume=123|issue=9|pages=1489–98|doi=10.1111/1471-0528.13552|pmc=4767687|pmid=26287503}}</ref> Some studies argue that unfettered access to medication abortion is a key tenet of public health, human rights, and reproductive rights.<ref>{{cite journal|vauthors=Jelinska K, Yanow S|date=February 2018|title=Putting abortion pills into women's hands: realizing the full potential of medical abortion|journal=Contraception|language=en|volume=97|issue=2|pages=86–89|doi=10.1016/j.contraception.2017.05.019|pmid=28780241|doi-access=free}}</ref>

=== Physical trauma, herbs, and other substances === Self-induced abortion methods vary around the world. The most commonly recorded are ingestion of plants or herbs, ingesting toxic substances, causing trauma to the [[uterus]], causing physical trauma to the body, using [[Alcohol (drug)|alcohol]] and drugs in an attempt to end the pregnancy, and ingesting other substances and mixtures.<ref>{{cite journal |vauthors=Moseson H, Herold S, Filippa S, Barr-Walker J, Baum SE, Gerdts C |year=2020 |title=Self-managed abortion: a systematic scoping review |url=https://escholarship.org/uc/item/1mj5832t |journal=Best Practice & Research. Clinical Obstetrics & Gynaecology |volume=63 |pages=87–110 |doi=10.1016/j.bpobgyn.2019.08.002 |pmid=31859163 |doi-access=free}}</ref> These methods vary from simply being ineffective to creating bodily harm to the pregnant woman.

Self-induced abortion involving physical trauma to cause an abortion is never considered safe. These methods may include direct trauma to the abdomen or uterus, insertion of objects into the cervix, or self-inflicted injury. 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.<ref name="auto" /> Such actions can lead to long-term reproductive damage, or even death. Rather than inducing abortion, these attempts frequently lead to emergency medical situations and represent a significant public health concern in regions lacking access to safe reproductive care.

There are no known effectiveness studies for plants, herbs, drugs, alcohol, or other substances. However, there have been records of indigenous and rural populations using these methods more successfully than in urban regions. For thousands of years, humans have been performing abortions via herbs in indigenous communities and rural areas. These regions have less means to track the success, yet they are an important factor to consider when discussing herbal abortion.

A [[descriptive study]] of women seeking to induce abortion in Cape Town, South Africa found that the women used abortifacients from three major sources: traditional healers, illegal abortion providers, and home remedies prepared using over-the-counter ingredients. The abortifacients included assorted pills (some that were likely misoprostol, others included [[Antiviral drug|antiviral drugs]], [[hypertension]] medication, and [[izifozonke]]), herbal blends of unclear origin, commercial herbal blends (including [[Stametta]]), "Dutch remedies" (including [[Vornokroy]], [[Helmin]] drops, and [[potassium permanganate]]), abrasive substances, alcohol, bleach, ammonia, other household cleaners, and laxatives.<ref>{{cite journal | vauthors = Gerdts C, Raifman S, Daskilewicz K, Momberg M, Roberts S, Harries J | title = Women's experiences seeking informal sector abortion services in Cape Town, South Africa: a descriptive study | journal = BMC Women's Health | volume = 17 | issue = 1 | page = 95 | date = October 2017 | pmid = 28969631 | pmc = 5625615 | doi = 10.1186/s12905-017-0443-6 | doi-access = free }}</ref>

==Rates== {{As of|2025}}, an estimated 73 million abortions occur worldwide each year, of which 45% are considered by the WHO to be less or least safe.<ref>{{cite web|url=https://www.who.int/news-room/fact-sheets/detail/abortion|title= Fact Sheet: Abortion| publisher = World Health Organization|url-status=live|archive-url=https://web.archive.org/web/20260308222349/https://www.who.int/news-room/fact-sheets/detail/abortion|archive-date=2026-03-08}}</ref> Induced abortion is considered safe when WHO recommended methods are used by trained persons, less safe when only one of those two criteria is met, and least safe when neither is met.<ref name=":0">{{cite journal | vauthors = Ganatra B, Gerdts C, Rossier C, Johnson BR, Tunçalp Ö, Assifi A, Sedgh G, Singh S, Bankole A, Popinchalk A, Bearak J, Kang Z, Alkema L | title = Global, regional, and subregional classification of abortions by safety, 2010-14: estimates from a Bayesian hierarchical model | language = en | journal = Lancet | volume = 390 | issue = 10110 | pages = 2372–2381 | date = November 2017 | pmid = 28964589 | pmc = 5711001 | doi = 10.1016/S0140-6736(17)31794-4 }}</ref> Self-induced abortions can be safe or unsafe depending on the methods used.<ref>{{cite journal | vauthors = Ngo TD, Park MH, Shakur H, Free C | title = Comparative effectiveness, safety and acceptability of medical abortion at home and in a clinic: a systematic review | journal = Bulletin of the World Health Organization | volume = 89 | issue = 5 | pages = 360–70 | date = May 2011 | pmid = 21556304 | pmc = 3089386 | doi = 10.2471/blt.10.084046 }}</ref><ref>{{cite journal | vauthors = Kiran U, Amin P, Penketh RJ | title = Self-administration of misoprostol for termination of pregnancy: safety and efficacy | journal = Journal of Obstetrics and Gynaecology | volume = 24 | issue = 2 | pages = 155–6 | date = February 2004 | pmid = 14766452 | doi = 10.1080/01443610410001645451 | s2cid = 31782566 }}</ref>

It is difficult to measure the prevalence or rate of self-induced abortions. {{As of|2018}}, in the United States, the estimate was that one in 10 abortions is self-induced.<ref>{{cite journal| vauthors = Grossman D, Ralph L, Raifman S, Upadhyay U, Gerdts C, Biggs A, Foster DG |date=1 May 2018|title=Lifetime prevalence of self-induced abortion among a nationally representative sample of U.S. women |journal=Contraception |volume=97|issue=5|page=460|doi=10.1016/j.contraception.2018.03.017 }}</ref> While maternal morbidity and mortality from unsafe abortion has continued to increase due to population growth, in Latin America, from 2005 to 2012, there was a 31% decrease in the number of complications from unsafe abortion, from 7.7/1,000 to 5.3/1,000. Researchers believe that this may be due to the wide availability of misoprostol in Latin America.<ref>{{cite journal | vauthors = Singh S, Maddow-Zimet I | title = Facility-based treatment for medical complications resulting from unsafe pregnancy termination in the developing world, 2012: a review of evidence from 26 countries | journal = BJOG | volume = 123 | issue = 9 | pages = 1489–98 | date = August 2016 | pmid = 26287503 | pmc = 4767687 | doi = 10.1111/1471-0528.13552 }}</ref>

In late 2019, it was reported that rates of self-induced abortion in the United States were rising, partly due to fears that more conservative policies would limit access to clinical abortion, and partly due to the increased availability and convenience of [[telehealth]] medical supervision and prescriptions and mail-order drugs.<ref>{{cite web|url=https://www.npr.org/2019/09/19/759761114/with-abortion-restrictions-on-the-rise-some-women-induce-their-own |title=With Abortion Restrictions on the Rise, Some Women Induce Their Own| vauthors = McCammon S |publisher=NPR|date=19 September 2019}}</ref> Between December 2021/January 2022 and June/July 2023, before and after the May 2022 overturing of [[Roe v. Wade]] in [[Dobbs v. Jackson Women's Health Organization]], reported rates of self-managed abortions in the US rose from 2.4% to 3.3%, adjusted for underreporting to 10.1%.<ref>{{cite web|url=https://pmc.ncbi.nlm.nih.gov/articles/PMC12312524/|title= Self-Managed Abortion Attempts Before vs After Changes in Federal Abortion Protections in the US| publisher = JAMA Netw Open|url-status=live|archive-url=https://web.archive.org/web/20260322032659/https://pmc.ncbi.nlm.nih.gov/articles/PMC12312524/|archive-date=2026-03-22}}</ref>

Rates of self-induced abortion are higher among those who experience greater barriers to abortive care, "including people of color, people with lower incomes, and people who live in states that have restrictive abortion laws." Rates were found to have been particularly higher among non-Hispanic Black people vs people of other racial and ethnic groups, as well as higher among sexual and gender minorities vs heterosexual or cisgender people.<ref>{{cite web|url=https://pmc.ncbi.nlm.nih.gov/articles/PMC12312524/|title= Self-Managed Abortion Attempts Before vs After Changes in Federal Abortion Protections in the US| publisher = JAMA Netw Open|url-status=live|archive-url=https://web.archive.org/web/20260322032659/https://pmc.ncbi.nlm.nih.gov/articles/PMC12312524/|archive-date=2026-03-22}}</ref> One study found that 19% of transgender, nonbinary, and gender-expansive people who have ever been pregnant have attempted self-managed abortion.<ref>{{cite web|url=https://srh.bmj.com/content/48/e1/e22|title= Abortion attempts without clinical supervision among transgender, nonbinary and gender-expansive people in the United States| publisher = BMJ Sexual & Reproductive Health|url-status=live|archive-url=https://web.archive.org/web/20250905103246/https://srh.bmj.com/content/48/e1/e22|archive-date=2025-09-05}}</ref>

==History== The practice of attempted self-induced abortion has long been recorded in the United States. Turn-of-the-20th-century [[birth control]] advocate and founder of Planned Parenthood [[Margaret Sanger]] wrote in her autobiography of a 1912 incident in which she was summoned to treat a woman who had nearly died from such an attempt.<ref>{{cite book | vauthors = Sanger M | title = An Autobiography | location = New York | publisher = W. W. Norton & Company | date = 1938 }}</ref> [[File:Protest against abortion restriction in Kraków, 20201027 1806 4618.jpg|thumb|A symbolic coat hanger on a [[October 2020 Polish protests|protest against abortion restriction]] in [[Kraków]], Poland]] In a letter to ''[[The New York Times]]'', gynecologist Waldo L. Fielding wrote:

{{quote|The familiar symbol of illegal abortion is the infamous "coat hanger" — which may be the symbol, but is in no way a myth. In my years in New York, several women arrived with a hanger still in place. Whoever put it in – perhaps the patient herself – found it trapped in the cervix and could not remove it...However, not simply coat hangers were used. Almost any implement you can imagine had been and was used to start an abortion – darning needles, crochet hooks, cut-glass salt shakers, soda bottles, sometimes intact, sometimes with the top broken off.<ref name="Fielding">{{cite web | vauthors = Fielding WL | veditors = Cenicola T | url = https://www.nytimes.com/2008/06/03/health/views/03essa.html | title = Repairing the Damage, Before Roe | work = [[The New York Times]] | date = 3 June 2008 }}</ref>}}

Charles Jewett wrote ''The Practice of Obstetrics'' in 1901. In it, he stated, "Oil of tansy and oil of rue are much relied on by the laity for the production of abortion, and almost every day one may read of fatal results attending their use. Oil of tansy in large doses is said to excite epileptiform convulsions; quite recently one of my colleagues met such a case in his practice."

In the 1994 documentary ''Motherless: A Legacy of Loss from Illegal Abortion'', Louis Gerstley, M.D., said that, in addition to knitting needles, some women would use the spokes of bicycle wheels or umbrellas. "Anything that was metal and long and thin would be used," he stated. He stated that a common complication from such a procedure was that the object would puncture through the uterus and injure the intestines, leading to subsequent death from [[peritonitis]] and infection. Later in the film, he mentioned that [[potassium permanganate]] tablets were sometimes used. The tablets were inserted into the vagina where they caused a chemical burn so intense that a hole may be left in the tissue. He claimed the tablets left the surrounding tissue in such a state that doctors trying to stitch up the wound couldn't do so because "the tissue was like trying to suture butter." Dr. Mildred Hanson also described the use of potassium permanganate tablets in the 2003 documentary ''Voices of Choice: Physicians Who Provided Abortions Before Roe v. Wade''. She said, "the women would bleed like crazy because it would just eat big holes in the vagina."

Dr. [[David Reuben (sex author)|David Reuben]] mentions that many African women use a carved wooden "abortion stick" to induce, which has often been handed down.<ref>{{cite book|title=Everything You Always Wanted to Know About Sex* (*But Were Afraid to Ask)|title-link=Everything You Always Wanted to Know About Sex* (*But Were Afraid to Ask) (book)| vauthors = Reuben D |date=c. 1971|publisher=Bantam|isbn=0-553-05570-4<!-- from SBN -->|edition=17th|pages=323–324|chapter=Abortion|author-link=David Reuben (sex author)}}</ref>

A study concluded in 1968<ref>{{cite book | vauthors = Schwarz R | title = Septic Abortion | location = Philadelphia | publisher = JB Lippincott Co. | date = 1968 }}</ref> determined that over 500,000 illegal abortions were performed every year in the United States, a portion of which were performed by women acting alone. The study suggested that the number of women dying as a result of self-induced abortions exceeded those resulting from abortions performed by another person. A 1979 study noted that many women who required hospitalization following self-induced abortion attempts were admitted under the pretext of having had a [[miscarriage]] or [[spontaneous abortion]].<ref name="pmid546995">{{cite journal | vauthors = Bose C | title = A comparative study of spontaneous and self-induced abortion cases in married women | journal = Journal of the Indian Medical Association | volume = 73 | issue = 3–4 | pages = 56–9 | date = August 1979 | pmid = 546995 }}</ref>

[[World Health Organization|WHO]] estimates that approximately 25 million abortions continue to be performed unsafely each year both clinically and self-induced.<ref name=":0" /> Around 7 million women are admitted to hospitals every year in developing countries<ref>{{cite journal | vauthors = Singh S, Maddow-Zimet I | title = Facility-based treatment for medical complications resulting from unsafe pregnancy termination in the developing world, 2012: a review of evidence from 26 countries | journal = BJOG | volume = 123 | issue = 9 | pages = 1489–1498 | date = August 2016 | pmid = 26287503 | pmc = 4767687 | doi = 10.1111/1471-0528.13552 }}</ref> and between 4.7% – 13.2% of all pregnancy-related deaths can be attributed to unsafe abortion.<ref>{{cite journal | vauthors = Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, Gülmezoglu AM, Temmerman M, Alkema L | title = Global causes of maternal death: a WHO systematic analysis | journal = The Lancet. Global Health | volume = 2 | issue = 6 | pages = e323–e333 | date = June 2014 | pmid = 25103301 | doi = 10.1016/S2214-109X(14)70227-X | hdl-access = free | doi-access = free | hdl = 1854/LU-5796925 }}</ref> Almost every one of these deaths and disabilities could have been prevented through sexual education, family planning, and the provision of safe abortion services.<ref name="Haddad 2009 122–126"/> Abortion pills, which were first used by Brazilian women in the 1980s, can prevent many of these deaths from unsafe abortion.<ref>{{cite journal | vauthors = Zordo SD | title = The biomedicalisation of illegal abortion: the double life of misoprostol in Brazil | journal = Historia, Ciencias, Saude--Manguinhos | volume = 23 | issue = 1 | pages = 19–36 | year = 2016 | pmid = 27008072 | doi = 10.1590/S0104-59702016000100003 | doi-access = free }}</ref>

==Law== {{Globalise|subsection|the United States|date=February 2022}} ===Iran=== While positions regarding [[Islam and abortion|abortion in Islam]] is one open to varied interpretation by Muslim scholars, in [[Iran]], self-induced abortion, as with other forms of abortion in general, is considered to be a ''[[haram]]'' act, in accordance a declaration by [[Ayatollah Khomeini]] that all forms of abortion are forbidden, mirroring a common position held under Shi'ite interpretation of [[Sharia|Sharia law]]. As a result, a ''[[Blood money in Islam|diyya]]'' of approximately 1000 [[dinar]] is issued for the abortion of male fetuses and half of that amount for female ones, though the ''diyya'' is lowered to 60 dinar, the parent must pay the diyya to child's kin{{clarify|1=See [[Talk:Self-induced abortion#Reduction of diyya]]|date=November 2024}}.<ref>{{cite web|url=https://cyber.harvard.edu/population/abortion/iran.abo.html |title=IRAN, ISLAMIC REPUBLIC OF. Law on Islamic Penalties 1991, Law No. 586. (Translation provided by the International Labour Organisation.)|access-date=24 November 2024|language=en}}</ref><ref>{{cite web | url=https://www.isna.ir/news/96062514365/%D8%A7%D8%AD%DA%A9%D8%A7%D9%85-%D8%B3%D9%82%D8%B7-%D8%AC%D9%86%DB%8C%D9%86-%D8%A7%D8%B2-%D9%85%D9%86%D8%B8%D8%B1-%D9%85%D9%82%D8%A7%D9%85-%D9%85%D8%B9%D8%B8%D9%85-%D8%B1%D9%87%D8%A8%D8%B1%DB%8C | title=احکام "سقط جنین" از منظر مقام معظم رهبری | date=17 September 2017 }}</ref><ref>{{cite web | url=https://www.isna.ir/news/91091206108/%D8%AF%DB%8C%D9%87-%D8%B3%D9%82%D8%B7-%D8%AC%D9%86%DB%8C%D9%86-%DA%86%D9%87-%D9%85%D9%82%D8%AF%D8%A7%D8%B1-%D8%A7%D8%B3%D8%AA-%D9%88-%D8%A8%D9%87-%DA%86%D9%87-%DA%A9%D8%B3%DB%8C-%D9%85%DB%8C-%D8%B1%D8%B3%D8%AF | title=دیه سقط جنین چه مقدار است و به چه کسی می‌رسد؟ | date=2 December 2012 }}</ref>

===United States=== In the United States, experts report that self-induced abortion can be medically safe but legally risky.<ref>{{cite web|url=https://www.vox.com/the-highlight/2019/7/1/18638649/abortion-pill-internet-misoprostol-mifepristone|title=A boom in at-home abortions is coming| website=Vox| date=9 July 2019| access-date=12 September 2019| vauthors = North A }}</ref> The 1973 Supreme Court decision ''[[Roe v. Wade]]'', which was overturned in the 2022 case [[Dobbs v. Jackson Women's Health Organization]], made abortion more readily available throughout the U.S., yet women who have abortions with pills ordered online or through non-clinical means may face risk of arrest.<ref>{{Cite web|title=ACOG Position Statement: Decriminalization of Self-Induced Abortion|url=https://www.acog.org/en/Clinical%20Information/Policy%20and%20Position%20Statements/Position%20Statements/2017/Decriminalization%20of%20Self%20Induced%20Abortion|access-date=15 July 2020|website=acog.org|language=en}}</ref><ref>{{Cite web|last=SIA Legal team|title=Making abortion a crime (again): how extreme prosecutors attempt to punish people for abortions in the U.S.|url=https://docs.wixstatic.com/ugd/aa251a_09c00144ac5b4bb997637bc3ac2c7259.pdf}}</ref>

It is not common for women in the United States to be charged for the crime of self-inducing an abortion. However, a small number of people in the U.S. have been arrested for ending their own pregnancies with pills ordered online, including [[Purvi Patel]], Jennie Linn McCormack,<ref>{{Cite web|url=https://www.npr.org/templates/story/story.php?storyId=150312812|title=Idaho Woman Arrested For Abortion Is Uneasy Case For Both Sides|website=NPR.org|publisher=NPR|language=en|access-date=12 September 2019}}</ref> and Kenlissia Jones.<ref>{{cite journal|vauthors=Paltrow LM, Flavin J|date=April 2013|title=Arrests of and forced interventions on pregnant women in the United States, 1973-2005: implications for women's legal status and public health|journal=Journal of Health Politics, Policy and Law|volume=38|issue=2|pages=299–343|doi=10.1215/03616878-1966324|pmid=23262772|doi-access=free}}</ref><ref>{{Cite news|url=https://www.washingtonpost.com/news/morning-mix/wp/2015/06/10/woman-charged-with-murder-didnt-have-any-money-to-get-an-abortion-the-legal-way-brother-says/|title=Murder charges dropped against Georgia woman jailed for taking abortion pills| vauthors = Phillip A |newspaper=The Washington Post}}</ref> These women were prosecuted under a variety of laws including laws directly criminalizing self-induced abortions, laws criminalizing harm to fetuses, criminal abortion laws misapplied to people who self-induce, and various laws deployed when no other legal authorization could be found.<ref>{{cite web|url=https://www.guttmacher.org/gpr/2018/10/self-managed-medication-abortion-expanding-available-options-us-abortion-care|title=Self-Managed Medication Abortion: Expanding the Available Options for U.S. Abortion Care| vauthors = Donovan MK |date=12 October 2018|work=Guttmacher Institute n}}</ref> In 2022, Lizelle Herrera of Texas was charged with murder after the authorities alleged that she caused "the death of an individual by self-induced abortion".<ref>{{Cite web|url=https://www.wric.com/news/u-s-world/texas-woman-charged-with-murder-for-self-induced-abortion/|title=Texas woman charged with murder for 'self-induced abortion'| vauthors = Puente N |publisher=Nexstar Media|date=9 April 2022}}</ref> It was unclear whether she had an abortion herself or helped someone else with it. According to [[University of Texas]] law professor [[Stephen Vladeck]], the state law exempts the mother from criminal homicide charges for aborting their own fetus.<ref>{{cite news |title=Texas woman, 26, charged with murder over 'self-induced abortion' |url=https://www.theguardian.com/us-news/2022/apr/09/texas-woman-26-charged-murder-self-induced-abortion |work=The Guardian |agency=Associated Press |date=9 April 2022 |language=en}}</ref> On 10 April 2022, the district attorney of Texas announced that the murder charges would be dismissed.<ref>{{Cite news|url=https://www.nytimes.com/2022/04/10/us/texas-self-induced-abortion-charge-dismissed.html|title=Texas Will Dismiss Murder Charge Against Woman Connected to 'Self-Induced Abortion'| vauthors = Heyward G, Kasakove S | newspaper=The New York Times |date=10 April 2022}}</ref>

As of 2022, there are seven states with laws directly criminalizing self-induced abortion, 38 states with laws criminalizing harm to fetuses that lack adequate exemptions for the pregnant woman, and 15 states with criminal abortion laws that could be applied to women who self-induce an abortion.{{Citation needed|date=July 2025}} Both the [[National Lawyers Guild]] and the [[American Medical Association]] passed resolutions condemning the criminalization of self-induced abortion.<ref>{{cite web|url=https://www.acog.org/About-ACOG/News-Room/News-Releases/2018/Criminalization-of-Self-Induced-Abortion-Intimidates-and-Shames-Women-Unnecessarily?IsMobileSet=false|title=Criminalization of Self-Induced Abortion Intimidates and Shames Women Unnecessarily|publisher=American College of Obstetricians and Gynecologists|access-date=10 August 2019}}</ref><ref>{{cite web|url=https://www.nlg.org/wp-content/uploads/2018/11/Reproductive-Justice.pdf|title=Resolution Opposing the Criminalization of People's Reproductive Lives|website=National Lawyers Guild|access-date=10 August 2019}}</ref>

== See also == * [[Abortion debate]] * [[Feminist Abortion Network]] * [[Gerri Santoro]] * [[Menstrual extraction]] * ''[[Our Bodies, Ourselves]]'' * [[Plan C]] * [[Reproductive rights]] * [[Unsafe abortion]]

== References == {{reflist}}

== Further reading == {{refbegin}} * {{cite journal |url= http://www.guttmacher.org/pubs/journals/2709601.html |title= Incidence of Induced Abortion in Southern Ghana | vauthors = Ahiadeke C |journal= International Perspectives on Sexual and Reproductive Health |volume= 27 |issue= 2 |date= June 2001 |pages= 96–108 |doi= 10.2307/2673822 |jstor= 2673822 |access-date= 20 October 2017|url-access= subscription }} * {{cite web |url= http://www.indmedica.com/ijcm/pindex1.cfm?cmid=43&cmiid=5 |work= [[Indian Journal of Community Medicine]] |title= Profile of Induced Abortions in Women from an Urban Slum of Delhi |vauthors = Khokhar A, Gulati N |volume= 25 |number= 4 |date= October 2000 |access-date= 20 October 2017}} * {{cite journal | vauthors = Ellertson C | title = History and efficacy of emergency contraception: beyond Coca-Cola | journal = Family Planning Perspectives | volume = 28 | issue = 2 | pages = 44–48 | date = March 1996 | doi = 10.2307/2136122 | jstor = 2136122 | pmid = 8777937 | url = http://www.guttmacher.org/pubs/journals/2804496.html | url-access = subscription }} * * {{cite web |url= https://www.nytimes.com/2016/03/06/opinion/sunday/the-return-of-the-diy-abortion.html |title= The Return of the D.I.Y. Abortion | vauthors = Stephens-Davidowitz S |work= [[The New York Times]] |date= 5 March 2016 |access-date= 20 October 2017}} {{refend}}

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