Self-managed abortion care using pills is very safe – the most dangerous aspect of it is not feeling able to go to the hospital for follow up care in the rare event that there is a complication. Again, medication abortion is remarkably safe, it is the legal rules and potential for arrest that make self-managing abortion care via medication “dangerous.”
- If you live in a state that allows telemed abortion access, you can obtain medication abortion through a local clinic. The costs will range between $400 and $700 and there funding options for those who qualify in order to make the price more manageable. Use the clinic finder option here to discern which clinic might be closest to you (it may not actually be in your state).
- AidAccess is offering medication abortion through their website, which can be accessed here. This medicine will cost $150 or less, depending on your financial need. Be aware that medication is taking anywhere from two to four weeks to arrive, and add that calculation into your plan. Medication abortion is at its most optimal when done prior to 10 weeks after your last period, although it will still be effective in many cases further into gestation. AidAccess is now offering medication for people who are worried they could become pregnant, too, so you no longer need a verified pregnancy to do this. People should consider getting medicine before they need it.
- PlanC offers a list of verified sites (including AidAccess) where pills can be obtained. Their recommendations are here.
- Do you have someone you can completely trust who lives in California or New York? Consider contacting Hey Jane. Medication costs $200, but can only be delivered to these two states currently. However, they arrive in three business days or less, providing time for someone to forward them to a different address in less time than it takes to receive an AidAccess package. (Hey Jane at this point does not require an ultrasound to verify a pregnancy, however do be aware that these partnerships are exactly what legislators refer to when they say “aiding and abetting an abortion.”)
- WHO (World Health Organization) protocols on how to manage an abortion using either misoprostol alone or misoprostol and mifepristone together can be found here at the Women Help Women website.
- Should a person be attempting to induce an abortion and have medical questions about the process as it is occurring, they can reach out to a secure, private channel for feedback here. They can also contact the ReproCare secure hotline to obtain a virtual doula to walk them through the process and support them along the way.
- A miscarriage induced by medications will look no different from a miscarriage that occurs naturally. There is no medical exam or drug test that can detect a self-managed abortion. If you have gone to a hospital because of any sort of pregnancy complication and are being threatened with an investigation, being asked questions you are not comfortable answering, or are in any other way being pressured by medical providers or other authorities who seem to be interested in something other than your physical well-being, reach out to the Repro Legal Helpline.
- Need legal support due to an investigation into your poor pregnancy outcome? If/When/How Lawyering for Reproductive Justice now has a bail fund and legal defense fund. Here’s all the info you need to get help.
- A medication abortion IS INDUCING A MISCARRIAGE. It will be a labor process. There will be quite a bit of blood, some tissue, likely a sac and even potentially debris that will have recognizable form. Be mentally, physically and emotionally prepared for that fact. Unless a person is experiencing a high fever (100.5 or higher) and/or bleeding through 2-3 pads per hour for more than 2-3 hours, that person is having a normal experience. More information on those complications and others are here.
- For extensive information about self-managed care in one place, including how to best spread this information with others, visit the ReproAction website, which is the best source for information sharing.
- We want you to be as comfortable and safe as possible when self-managing your care, however you obtain medicine. The DIY Doula zine is an extensive resource for tips for making the process easier. You can also prepare with this checklist from The New Handbook for a Post-Roe America.
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Chapter 8 Worksheet: Preparing for an At-Home Abortion
Regardless of whether you are using medications from a clinic, a telemedicine prescription, or another source, a home abortion is a process you want to prepare for ahead of time. Here’s how to get ready.
- Pick a day.
You will want to be sure to choose a day when you won’t be interrupted. The process could take as long as twenty-four hours from the time you start the procedure. Make sure you won’t have to deal with obligations like work, school, or child/eldercare if at all possible.
- Prepare your space.
Pull together anything you might want for comfort. Make sure you have enough food, plenty to drink (but not alcohol), plenty of pads (no tampons or cups), pain killers (no aspirin), and anti-nausea medicine. Pull together any distractions you might want, like music, candles, calming scents, movies, books, or magazines.
- Find a helper.
You probably don’t want to be alone during this process. If you have someone you can trust—a friend, a partner, a family member—invite them to stay with you, even if you don’t want them in the room with you. At the very least have someone who will periodically check in with you to anchor you and follow your progress. If you don’t have someone you trust, consider reaching out to an abortion doula.
- Pick out some clothes, blankets, and towels.
You want to be comfortable. You should also recognize that whatever you wear may end up unusable by the end of the day. Make sure you protect any furniture or other items ahead of time with blankets or towels. It’s always better to be safe than sorry.
- Prepare some DIY labor tools.
A tennis ball is great for squeezing when you have a cramp. A sock filled with rice that has been heated in the microwave for two minutes is a fabulous makeshift heating pad. A miscarriage is a mini-labor, so feel free to treat it like one and use every tool you can.
- Buy some extra pregnancy tests.
If you aren’t intending to follow up with a medical provider, be sure to have some pregnancy tests on hand to determine if the abortion was successful. You should no longer test positive four weeks after your abortion, although in rare cases some people still show a positive for another two to four weeks. If you are still having positive tests and experiencing pregnancy symptoms, be sure to see a doctor for testing.
- Have a plan for an emergency.
It is very, very unlikely that you will have a medical issue, but it’s always good to have a plan just in case. Should you have a fever over 102 degrees, bleed so much that you are soaking more than two pads an hour for more than two hours, or have severe pain that doesn’t respond to pain medication, you may need to visit a hospital. If you do and your abortion drugs were not from a legal provider, remember that all you need to say to a doctor is “I’m pregnant. I think I’m having a miscarriage,” and “I’m scared.” Medication will not show up in your bloodstream or in any urine tests, and your miscarriage looks no different from one that occurred naturally.
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FINAL NOTE
Medication Self-Managed Abortion care is most successful early in pregnancy. However, many medical professionals do use similar regimes when doing abortions past the first trimester. Information on how to induce after the first trimester can be found on the ACOG website, which reads: “Mifepristone followed in 24–48 hours by misoprostol is the most effective regimen for second-trimester medical abortion, with up to 91% efficacy within 24 hours of initiation of misoprostol and with a significantly shorter induction interval and fewer adverse effects than misoprostol alone (30, 33, 34). However, mifepristone may not be available in all settings, and misoprostol as a single agent is effective for medical abortion (Box 1).” REMINDER: Self-managing an abortion, especially in the second trimester or later, is a far more legally and medically fraught endeavor, especially as the pregnancy advances. It is always best to seek out a legal abortion provider whenever possible, but especially for later terminations.
