Now that Roe v. Wade has gone from canon to a likely fatality of the Trump administration, reproductive justice proponents are hustling to get better laws on the books at the state level—and to repeal the laws that Roe made moot, as they’d otherwise go back into effect if Roe falls. They’re also thinking ahead in another way: They’re anticipating the need to provide information about self-managed abortion.
A 2015 article from the Guttmacher Institute reported that between 2011 through August 2015 states enacted a total of 287 new restrictions on abortion care. These laws have been used to persecute women aggressively. Women of color and women living in poverty are most likely to be targeted under such laws. The violations—a.k.a. pretexts—range from failure to report an abortion to fetal homicide. Women who insist they miscarried have nonetheless been convicted and jailed. Mistrust of health care providers and law enforcement both will only get worse if we lose Roe, with good reason.
Women—especially young women—have already turned to the internet for self-abortion information. During a 32-day period between May and June 2017, people in the United States searched for information about self-abortion more than 200,000 times.
Those searches likely yielded the only current workaround for self-managing a medical abortion: ordering misoprostol online. Misoprostol is available OTC in many countries and is also prescribed here to treat a variety of conditions. Of course, it’s only one part of the two-drug regimen—mifepristone and misoprostol both—recommended by the American College of Obstetricians and Gynecologists. The combination is 98 percent effective, but mifepristone is highly regulated; misoprostol alone is 85 percent effective in the first 12 weeks of pregnancy. It’s also safe. And far better than nothing.
Does this scenario sound crazy yet? It’s not; it’s just not something we’ve experienced here in the United States yet.
The World Health Organization has declared misoprostol an essential medication and developed a protocol for self-managed abortion without a provider’s involvement. WHO did that in recognition of women in countries, especially in Latin America, who would have no other safe means of inducing an abortion.
Finding a way to give women in the United States the information needed to safely and affordably end a pregnancy is critical. As the Guttmacher Institute notes, women have taken measures as extreme as self-inflicting a gunshot wound to the abdomen and paying someone to beat them to the point of miscarriage. And that’s what’s happened while abortion is legal.
Fortunately, several organizations have already stepped forward to take on the task of making information for how to self-manage an abortion in the United States clear and accessible. Check out Self-Managed Abortion: Safe and Supported, which spun off from Women Help Women:
The primary goal of SASS is to provide information and support to women in the USA around self managed abortion, to reduce any negative health impact associated with unsafe abortion methods, and to ensure that self-managed abortions are medically and legally as safe as possible.
SASS directs visitors to resources for protecting internet research and even text messages that could betray interest in abortion. If you submit a question or request contact you’ll be put in touch with a trained counselor. In other words, they’re ready. And it’s a tough road ahead.
The flip side of women’s readiness to search for information about abortion online is the risk that anti-abortion zealots will attempt to sabotage their research. That’ll be even easier online than it has been via fake crisis pregnancy centers attempting to delay women’s decisions and bombarding them with pseudo-science. It’s a chilling notion, but we need to begin preparing to fight for women’s continued access to information and care—and to defend those efforts—post-Roe now.