As many as 8% of Texas women may have self-managed their abortions, according to a new study published in BMC Women’s Health. The study suggests that women may already be pursuing less safe abortions in the wake of increasing abortion restrictions.
Texas Women Are Inducing Their Own Abortions
The authors of the study hypothesized that women might not report self-induced abortions, and that official data on the topic might underestimate the numbers. So they administered surveys to 790 Texas women of reproductive age in 2015. The surveys asked about various health experiences. Self-managed abortion was included in half of the surveys.
The team then used the difference between the average number of items reported by participants between the two lists to devise an estimate of self-managed abortions. This analysis estimated that 8% of Texas women had self-managed their own abortions.
In 2017, researchers interviewed some participants to better understand their answers and dig deeper into the data. These interviews suggested that some participants may have interpreted questions about self-managed abortion to mean “undergoing an abortion alone” rather than “self-inducing an abortion.” So the 8% figure may slightly overestimate the number. However, based on their data analysis and the interviews, researchers conclude that self-induced abortion is a common experience in Texas.
As of 2015, when the survey was conducted, Texas had enacted numerous abortion restrictions—some of which were subsequently struck down by federal courts.
The Link Between Abortion Restrictions and Self-Induced Abortion
The study supports previous research suggesting that women become more interested in self-managed abortion when they believe their rights are under attack. A 2018 Guttmacher Institute survey points to 200,000 Google searches for home or self-induced abortion procedures in the wake of the Trump election. Data from 2015 linked tighter abortion regulations to more searches for self-induced abortion. Mississippi led the nation in home abortion searches that year.
Abortion clinics offer a continuum of care to abortion seekers. They get pre-abortion counseling, follow-up care, and emergency assistance if they need it. This expert care has made abortion one of the safest medical procedures available. A person is more likely to die from having their tonsils removed than from an abortion. Indeed, abortion is so safe that medication abortions may not even require the presence of a doctor. Several recent studies suggest that telemedicine abortion is as safe as abortion managed in a clinic. Meanwhile, the U.S. maternal mortality rate is the worst in the wealthy world, and some states have maternal mortality rates higher than that of war-ravaged countries like Iraq.
But when abortion is illegal or heavily restricted, pregnant people are unlikely to seek out safe methods at abortion clinics or licensed telemedicine providers.
Unsafe Abortion, Abortion Restrictions, and Maternal Mortality
There are three distinct scenarios in which women may try to self-abort.
When abortion is prohibitively expensive—as is often the case in the U.S., where Medicaid is prohibited from covering abortion and many insurers won’t cover it either—the poorest women may seek the least safe abortions because they can’t afford to go to a clinic.
When abortion restrictions require waiting periods, multiple trips to a doctor, invasive medically unnecessary procedures, or potentially traumatic requirements such as that a woman view the ultrasound, women may delay their abortions or seek other options.
Finally, state-level abortion restrictions may remove access altogether for some women. Texas has repeatedly tried to ban or heavily restrict abortion, so it’s no wonder that Texas women are taking things into their own hands.
Worldwide, unsafe abortion is a leading cause of maternal mortality. Twenty-five million unsafe abortions, including self-induced home abortions, are performed each year. As abortion becomes more restricted in the United States, we may begin seeing deaths from unsafe abortion. Data from other nations shows that banning abortion doesn’t stop it. Indeed, in Latin America, where abortion is illegal, abortion rates are actually higher than in the United States.
Republican lawmakers know that abortion is safe. They know that the United States has a terrible maternal mortality rate. Their attempts to ban abortion have never been about women’s health. They don’t care if women die. Indeed, some may even hope they do.