User:DataNerdMPH/Self-induced abortion

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Women have historically used many different methods to self-induce an abortion. Some are safe and effective, while others are dangerous to the health of the woman and/or ineffective at terminating a pregnancy.

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, ingesting a combination of mifepristone and misoprostol pills, ingesting misoprostol pills alone, using alcohol and drugs in an attempt to end the pregnancy, and ingesting other substances and mixtures. There are no known effectiveness studies for plants, herbs, drugs, alcohol, or other substances. These methods are more likely to cause bodily harm to the pregnant woman than to be effective in terminating a pregnancy. 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.

The only scientifically studied effective self-induced abortion method is ingesting a combination of mifepristone and misoprostol or misoprostol alone. Both of these medications are on the World Health Organization's list of Essential Medicines. In some countries, these pills may be available in over-the-counter in pharmacies, although some pharmacists do not provide accurate instructions on use. In Latin America, women have reported self-inducing abortions with misoprostol alone since the 1980s. The history of women self-managing abortion with pills includes projects such as the Socorristas in Argentina and Las Libres in Mexico. 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. Some women use online abortion pill help services such as Women Help Women and Aid Access to order mifepristone and/or misoprostol, with reported effectiveness and safety in pregnancy termination and satisfaction in the service.

For pregnancies before 12 weeks, the World Health Organization recommends 200 mg (usually one pill) of Mifepristone, taken by mouth, followed one to two days later by 800 mg (usually four pills) of misoprostol, which can be swallowed or left in the cheek or under the tongue to dissolve. If using misoprostol alone and the pregnancy is under 12 weeks, the World Health Organization recommends taking 800 mg (usually 4 pills), which can be swallowed or left in the cheek or under the tongue to dissolve. If the pregnancy is over 12 weeks, the World Health Organization recommends 200 mg (usually one pill) of Mifepristone, taken by mouth, followed one to two days later by 400 mg (usually two pills) of misoprostol, which can be swallowed or left in the cheek or under the tongue to dissolve, and repeating this every three hours until the abortion is complete. If using misoprostol alone, the World Health Organization recommends taking 400 mg (usually 2 pills) which can be swallowed or left in the cheek or under the tongue to dissolve, and repeating this every three hours until the abortion is complete.

These instructions are widely available on the website of the World Health Organization as well as reputable public health health organizations, including Gynuity and International Women's Health Coalition.

First trimester medical abortion is a highly safe and effective. 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. In the rare case of a complication, a woman can access to a clinician skilled in miscarriage management, which is available in all countries.

Women choose to self-induce an abortion for many reasons, including perceiving that having an abortion at home is more private, wanting to have someone with her during the abortion, not being able to afford the cost of an abortion in a health facility, or not being able to access an abortion in a clinic because of legal restrictions.

Studies confirm a correlation between the increase in the self-administration of medical abortion with misoprostol, and a reduction in maternal morbidity and mortality. Some studies argue that unfettered access to medication abortion is a key tenant of public health, human rights, and reproductive rights.

Rates
An estimated fifty-six million abortion occurred worldwide, of which twenty-five million are less safe or least safe. "Induced abortion is medically safe when World Health Organization 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." Self-induced abortions can be safe or unsafe depending on the methods used.

It is difficult to measure the prevalence or rate of self-induced abortions. In the United States, the estimate is that one in 10 abortions is self-induced.

Law
In the United States, experts report that self-induced abortion can be medically safe but legally risky. The 1973 Supreme Court decision Roe v. Wade 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. 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, and Kenlissia Jones. 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. As of 2019, there are seven states with laws directly criminalizing self-induced abortion, 11 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. Both the National Lawyers Guild and the American Medical Association passed resolutions condemning the criminalization of self-induced abortion.

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