A new study making the media rounds suggests that “self-managed” abortions (SMA) have risen 40% since the Supreme Court overturned Roe v. Wade in its 2022 decision in Dobbs v. Jackson Women’s Health Organization. If accurate, then the abortion industry has achieved increased “self-managed” abortions — which is exactly what it has wanted for over a decade.
Though there is a direct line between the abortion industry’s efforts to expand abortion access and the increased use of at-home abortion methods, the results of the study are being dishonestly used to attack pro-life laws as dangerous, as if they are the cause of the increase in self-managed abortion.
But the truth is that the abortion industry has been intentionally attempting to expand self-managed abortion for years.
The new study was authored by researchers affiliated with pro-abortion groups: the University of California, San Francisco (UCSF), Advancing New Standards in Reproductive Health (ANSIRH), and the Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences.
The gaslighting of the masses
Once Roe fell, the gaslighting began. After well over a decade of pushing for at-home, self-managed abortions, the abortion industry was handed two ‘gifts,’ so to speak. The first was the Covid-19 pandemic, which created an excuse to allow abortion to take place in the home. (It might seem unfair or shocking to say the pandemic was a gift to the abortion industry, but an industry insider once said the same of the horrific events on September 11, 2001). The second ‘gift’ was the fall of Roe, which allowed newly enacted pro-life laws to become the industry’s scapegoat when the number of at-home abortions began to rise — likely along with the number of abortion-related complications.
Though it is abortion supporters who are selling the abortion pill online, advocating for states and women to stockpile abortion drugs, and attempting to hide the fact that studies have shown that six percent (6%) of women who took the abortion pill required emergency care, the abortion industry’s allies in the media are ensuring that Americans blame pro-life laws enacted since the fall of Roe.
Case in point: this study on the ‘negative effects’ of self-managed abortion was carried out by researchers affiliated with the same pro-abortion groups behind previous studies in support of self-managed abortion.
These groups wanted self-managed abortions to expand, despite the known risks to women. They got what they wanted during the pandemic, and then they blamed any negative consequences on pro-life laws.
Meanwhile, their friends in the media appear willing to aid in the gaslighting. The Associated Press reported on the new study by saying, “A growing number of women said they’ve tried to end their pregnancies on their own by doing things like taking herbs, drinking alcohol or even hitting themselves in the belly, a new study suggests.”
It completely ignored that a major method of self-managed abortion in the study was the approved, no-test, at-home abortion drugs heavily promoted by the same groups now blaming “self-managed” abortions on pro-lifers.
Let’s take a look at that study.
Methods of and reasons for at-home abortion
The Hill reported about the study: “Significantly more women chose to end pregnancies themselves — using unsupervised and potentially dangerous at-home methods — in the year following the Supreme Court’s abolition of federal protections for abortion…” (emphasis added).
The findings of the study were published on Tuesday in the Journal of the American Medical Association (JAMA) Network Open. It found that when comparing two different cohorts of women — the first from December 2021 and January 2022 and the second from June and July 2023 — the number of women of reproductive age reporting “ever having a self-managed abortion increased from 2.4% to 3.3%” (emphasis added).
This should not be surprising, since great efforts were made among the abortion industry and its allies to increase the number of self-managed abortions.
The study found that the most common methods of SMA after Dobbs were 1) the use of emergency contraception before confirming pregnancy (and a different method after confirming pregnancy), 2) herbs, and 3) the use of mifepristone and/or misoprostol.
Eliminating emergency contraception (since another method of SMA was used but not specified by researchers) puts “herbs” and “mifepristone and/or misoprostol” at the top of the list of primary methods of SMA in 2023. However, while the use of herbs decreased from 2021 to 2023, the use of mifepristone and/or misoprostol increased. Other methods such as “Hit in the stomach,” “Taking a hot bath or shower,” and “Lifting heavy objects” as methods of self-managed abortion also decreased.
The study also revealed women’s “most frequently cited reasons” for using self-managed abortion, including being “early in pregnancy” (33.3% in 2021 and 31.8% in 2023), and a desire for privacy (30.4% in 2021 and 32.2% in 2023). In addition, nearly one in five women said “the clinic was too expensive” (16.7% in 2021 and 18.2% in 2023) or they wanted to try a DIY abortion before going to an abortion facility (20.8% in 2021 and 19.1% in 2023).
Only 5.9% of women cited “Abortion is illegal” (in other words, pro-life laws) as their reason for choosing self-managed abortion in 2023.
An abortion industry ‘win’, over a decade in the making
The findings of this study reveal that the abortion industry is achieving a goal it set years before Roe v. Wade was even on the chopping block.
As reported by Live Action Research Fellow Carole Novielli, “‘self-managed’ abortion basically involves no medical professional and by definition leaves women alone to ‘manage’ whether their abortions are complete (without retained tissue), whether they are bleeding too much (hemorrhage), or whether they are experiencing a potential emergency.”
Novielli found that between May 2009 and February 2011 — yes, 15 years ago — clinical trials “to assess the acceptability of home-use mifepristone” were sponsored by Gynuity Health Projects to expand access to the abortion pill. In 2015, Gynuity announced clinical trials for direct-to-consumer telemedicine abortion — also known as “mail order” abortion pills — through businesses like Planned Parenthood. Then in 2016, the pro-abortion Obama administration weakened the Food and Drug Administration’s (FDA) REMS safety regulations by removing the requirement that women take the first drug in the abortion pill regimen (mifepristone) in front of a clinician, in-person at the location of a certified prescriber. That year, a TelAbortion trial also began, and in 2017, the Tara Health Foundation (which pledged to fund the abortion pill on college campuses in California) published a 92-page strategy that included “self-managed” abortion.
The pro-abortion efforts to expand “self-managed” abortion continued into 2018, during which a consortium of pro-abortion groups — ANSIRH (which is part of this most recent study), Gynuity, and Ibis Reproductive Health — published a report that stated, “[M]edication abortion could be even further demedicalized through pharmacy dispensing and expansion of telemedicine models — or even making it available over the counter (OTC) — which have the potential to expand access greatly” (emphasis added).
The “no-test” abortion pill protocol
A 2018 report from the pro-abortion Guttmacher Institute revealed that the intent of abortion expansion efforts would include the “no-test” protocol for the abortion pill. The report explained:
To fully integrate self-managed medication abortion with existing abortion practices in the United States, misoprostol and mifepristone must first become available without a prescription…. Lifting the REMS on mifepristone would allow more convenient models to emerge in states that permit telemedicine abortion…. lifting the REMS on mifepristone and securing OTC status for medication abortion are advances that do not depend on state legislatures or the Supreme Court.
Let’s recap: Planned Parenthood’s former “special affiliate,” the Guttmacher Institute, recommended in 2018 making the abortion pill regimen available without a prescription and over the counter.
The so-called “no-test” abortion pill protocol was helped along in 2020 by the Covid-19 pandemic. Abortion businesses were given permission to skip all testing that once ensured that women met the criteria for taking the abortion pill — including all lab work and ultrasounds — so that women could continue to have abortions under Covid social distancing restrictions. Not testing women to determine gestational age or a possible ectopic pregnancy puts them at greater risk of abortion pill-related complications, but that didn’t matter to abortion allies.
By 2021, the Biden administration had approved abortion pill distribution by mail during the pandemic and expanded the REMS safety regulations to allow for mail-order pharmacy distribution. It later allowed the abortion pill to be shipped by mail even after the pandemic had ended.
At-home, no-test, self-managed abortion was here to stay well before the end of Roe, all pushed and promoted and applauded by abortion supporters.
But abortion industry insiders weren’t done.
At the end of 2021, the pandemic quickly fading in the rearview mirror, former NARAL board member Renee Bracey Sherman penned an op-ed along with abortionist and UCSF professor Daniel Grossman (a co-author of this study) in which they, too, advocated for over-the-counter sales of the abortion pill. And in a whiplash narrative switch, advocates of abortion began claiming that “illegal” abortion could be “safe.”
In 2022, a study out of UCSF doubled down on that claim. It was unsurprisingly authored by four abortionists, an affiliate of Gynuity, and three researchers associated with UCSF (an abortion training facility with over 100 training programs).
As Live Action researcher Bettina di Fiore explained, “Every single author on this [2022 UCSF] study has a vested interest in promoting abortion, either by virtue of their direct participation therein, or consequent to their financial ties to pro-abortion organizations. Every single author on this study is biased in favor of abortion.”
So biased, in fact, that they shrugged their shoulders at the understanding that some women could likely die as a result. Concerning ectopic pregnancy, they wrote (emphasis added):
In this study, the ectopic pregnancy rate of 2 per 1000 suggests that the screening procedures used by the participating clinics will not triage all patients with ectopic risks to ultrasonography before the abortion. However, the potential benefits of expanded access, increased convenience, and earlier treatment conferred by removing testing requirements may outweigh potential risks of delayed identification of ectopic pregnancies.
In other words, explained di Fiore, “They are literally suggesting that the nearly 1,000 annual ectopic pregnancies that would go undiagnosed if the no-test protocol became standard — every one of which would be potentially fatal — might be an acceptable sacrifice if it means they can expand abortion.”
The bottom line is this: Any negative consequences of at-home, no-test, self-managed abortion pill use lie squarely at the feet of the abortion industry and its media allies, who continue to gaslight the public into believing otherwise.