Self-managed abortion with pills: Medically safe, legally risky
yourlocalepidemiologist.substack.com
Abortion has been severely restricted or altogether banned in 28 states, with more to come. A national ban was proposed last week in the Senate. This, coupled with stigma around abortion care altogether, has created a big gap between rhetoric and reality around abortion options, like pills.
We will have to fight for our reproductive rights on 2 fronts. We must continue to ensure that pregnancy termination technology continues to be accessible for those who need it, regardless of state of residency. More importantly, we must work to elect lawmakers on every level of government who will keep abortion care, contraception and women's health practices safe, legal and accessible. It is time for health care workers to step off the political sidelines and engage.
Just in case anyone who is considering a self-managed abortion in a restricted setting comes across this post , please know that if you take abortion medication, there is no way for a clinician to tell a spontaneous abortion (miscarriage) from an induced abortion unless you tell them. Usually, I would recommend being honest with your health care providers, but in places where your or their liberty or livelihood is at risk, the risk is great. If you self-manage an abortion and have any questions or concerns about the process or what is happening, first contact the hotline linked above. If you do end up needing to see a doctor in the rare case of complication, I would personally tell no one how your pregnancy loss came about, since it does not change the course of treatment at all. Again - they cannot tell and you do not have to tell them.
Thank you so much for this article. I am an abortion provider and work with women seeking pregnancy termination in MA. We are fortunate here as our laws protect women's reproductive rights. We are already seeing many medical refugees and in more rural areas of MA there are no abortion providers. The situation is really grave and I appreciate your article as well as the work Ibis does worldwide. I am 63 and never imagined we would be back here. Ugh! The world is a hostile and dangerous place for women.
Thanks for your comprehensive evidence based summary on safety of medical abortion and access issues, legal and political issues and all the links to resources. This erosion of our human rights for political control is frightening and enraging. It is helpful to highlight all of this with factual information. I admire how you have continued to use your science based approach and weave it into social political context. Thanks for your work.
Do any of you have any recognition or concern for the reality of the reborn persons? Why is infanticide in the womb considered "health care"? We live in strange times when inconvenient reality is simply ignored and not acknowledged.
It is a credit to medical science and technology that pregnant people are able to overcome their unwanted pregnancies with these safe and effective and safe medications. I am certain safety is at the top of the list of concerns of the manufacturers and always will be, and the effectiveness is testament to that.
I am so deeply disappointed that you care so much for the health all each human being, but not those that are still in the womb. Why should we punish those who injure or kill a child in the womb by violence, and not those that are killed by the will of the mother? And why is it still illegal to kill a baby after it is removed from the womb?
Once again, you are doing a great job. As a physician for the past 40+ years, I am appalled at the state of our national treatment of women and children. Thanks for keeping the information coming.
I do appreciate the data you include with your posts. It separates fact from opinion. In this post you quote an author whose opinions are not supported by data. I suppose this is an effective way to frame the discussion, but not helpful in holding to your brand of data supported science.
The statements refer to banning abortion as “unprecedented, catastrophic, inhuman, irrational, and a judicial endorsement of state control over women.” None of these statements is supported by data. In fact, you could just as easily find someone who felt that abortion was inhuman, irrational and catastrophic… especially to the baby.
I’d like to ask you and your readership to consider this one simple question. “Is the baby being aborted a human being?” All of the other questions that surround this issue have answers that fall neatly into place based on the answer to that question being yes or no.
Important and balanced. Thanks for the evidence based perspective. A concern that will grow in importance over time is knowledge about the shelf life of the two medications. With “just in case” provision of these, is there valid data, as opposed to the regulatory “expiration date,” routinely of one year, regarding stability of these medications? Does refrigeration or freezing increase the time?
This is a great article. A good friend of mine, a teacher, shared this website with me . The epidemiological stuff is great, and I agree with you, the fact that you need to seek legal advice to put this info out there about abortion. I am a retired pediatrician. We are in bad times, but thank you for what you do.
Thank you Katelyn. Always clear and helpful. Terribly sad that we are forcing women to navigate this experience without medical care. It is great that these medications work with relatively few complications. But some do require surgical intervention. And in any case, clinicians often provide more than pills and procedures. The emotional support can also be helpful. Clinicians can assist patients in their understanding of the health and social context of the experience.
Very timely and important topic. But under the heading of "Medication Options" did you truly mean to say from 0-24 weeks? My understanding of the evidence (including what you cited) is that medication abortion is absolutely safe and effective <12 weeks, but less effective and presumably with more complications outside of that time frame. I'd be interested to read evidence to the contrary, if it exists, and update my understanding.
We will have to fight for our reproductive rights on 2 fronts. We must continue to ensure that pregnancy termination technology continues to be accessible for those who need it, regardless of state of residency. More importantly, we must work to elect lawmakers on every level of government who will keep abortion care, contraception and women's health practices safe, legal and accessible. It is time for health care workers to step off the political sidelines and engage.
www.vote411.org
Just in case anyone who is considering a self-managed abortion in a restricted setting comes across this post , please know that if you take abortion medication, there is no way for a clinician to tell a spontaneous abortion (miscarriage) from an induced abortion unless you tell them. Usually, I would recommend being honest with your health care providers, but in places where your or their liberty or livelihood is at risk, the risk is great. If you self-manage an abortion and have any questions or concerns about the process or what is happening, first contact the hotline linked above. If you do end up needing to see a doctor in the rare case of complication, I would personally tell no one how your pregnancy loss came about, since it does not change the course of treatment at all. Again - they cannot tell and you do not have to tell them.
Thank you so much for this article. I am an abortion provider and work with women seeking pregnancy termination in MA. We are fortunate here as our laws protect women's reproductive rights. We are already seeing many medical refugees and in more rural areas of MA there are no abortion providers. The situation is really grave and I appreciate your article as well as the work Ibis does worldwide. I am 63 and never imagined we would be back here. Ugh! The world is a hostile and dangerous place for women.
Thanks for your comprehensive evidence based summary on safety of medical abortion and access issues, legal and political issues and all the links to resources. This erosion of our human rights for political control is frightening and enraging. It is helpful to highlight all of this with factual information. I admire how you have continued to use your science based approach and weave it into social political context. Thanks for your work.
Thank you for this factual, but frightening assessment of medical and legal aspects of abortion.
Do any of you have any recognition or concern for the reality of the reborn persons? Why is infanticide in the womb considered "health care"? We live in strange times when inconvenient reality is simply ignored and not acknowledged.
It is a credit to medical science and technology that pregnant people are able to overcome their unwanted pregnancies with these safe and effective and safe medications. I am certain safety is at the top of the list of concerns of the manufacturers and always will be, and the effectiveness is testament to that.
I admire your committment to science and, just as importantly, to the need for a rational and humane use of that science. Thanks again for writing.
I am so deeply disappointed that you care so much for the health all each human being, but not those that are still in the womb. Why should we punish those who injure or kill a child in the womb by violence, and not those that are killed by the will of the mother? And why is it still illegal to kill a baby after it is removed from the womb?
Once again, you are doing a great job. As a physician for the past 40+ years, I am appalled at the state of our national treatment of women and children. Thanks for keeping the information coming.
I do appreciate the data you include with your posts. It separates fact from opinion. In this post you quote an author whose opinions are not supported by data. I suppose this is an effective way to frame the discussion, but not helpful in holding to your brand of data supported science.
The statements refer to banning abortion as “unprecedented, catastrophic, inhuman, irrational, and a judicial endorsement of state control over women.” None of these statements is supported by data. In fact, you could just as easily find someone who felt that abortion was inhuman, irrational and catastrophic… especially to the baby.
I’d like to ask you and your readership to consider this one simple question. “Is the baby being aborted a human being?” All of the other questions that surround this issue have answers that fall neatly into place based on the answer to that question being yes or no.
Important and balanced. Thanks for the evidence based perspective. A concern that will grow in importance over time is knowledge about the shelf life of the two medications. With “just in case” provision of these, is there valid data, as opposed to the regulatory “expiration date,” routinely of one year, regarding stability of these medications? Does refrigeration or freezing increase the time?
A family physician who writes such scripts
This is a great article. A good friend of mine, a teacher, shared this website with me . The epidemiological stuff is great, and I agree with you, the fact that you need to seek legal advice to put this info out there about abortion. I am a retired pediatrician. We are in bad times, but thank you for what you do.
Thank you Katelyn. Always clear and helpful. Terribly sad that we are forcing women to navigate this experience without medical care. It is great that these medications work with relatively few complications. But some do require surgical intervention. And in any case, clinicians often provide more than pills and procedures. The emotional support can also be helpful. Clinicians can assist patients in their understanding of the health and social context of the experience.
Very timely and important topic. But under the heading of "Medication Options" did you truly mean to say from 0-24 weeks? My understanding of the evidence (including what you cited) is that medication abortion is absolutely safe and effective <12 weeks, but less effective and presumably with more complications outside of that time frame. I'd be interested to read evidence to the contrary, if it exists, and update my understanding.
Outstanding piece. Thank you for covering this.