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Study offers dubious claim that 7% of Women Attempt Self-Abortion in their Lifetimes

by | Dec 23, 2020

By Randall K. O’Bannon, Ph.D. NRL Director of Education & Research

With a new year and possibly a whole new team heading the nation’s healthcare agencies, a team of all-star abortion researchers has published a study claiming that 7% of women attempt a “self-managed” or do-it-yourself [DIY] abortion at some point in their lives. 

There are significant problems with this study, as there always are from these advocates, but equally important is the reason for publishing this study when they did. This is simply the latest salvo in the abortion industry’s ongoing efforts to push for government approval for abortions by telemedicine, where women order their pills online, have a brief teleconference with a health care worker, and have the pills shipped to them by mail.

Survey Findings versus Researchers Projections

The study, “Prevalence of Self-Managed Abortion Among Women of Reproductive Age in the United States” appeared in the JAMA Network Open online journal on December 18, 2020.

Authors of the study included some of the top names in abortion research – Lauren Ralph, Diana Greene Foster, Ushma Upadhay, and Daniel Grossman. They are all connected to the University of California, San Francisco, particularly the Advancing New Standards in Reproductive Health (ANSIRH) program of the Bixby Center for Global Reproductive Health, and have been promoting abortion for some time.

The direct claim, that “approximately 7%of US women reported having attempted SMA in their lifetime, commonly with ineffective methods” is supposed to be the result of a survey of 7,022 women conducted between August 2nd to August 17th in 2017.  

But the data actually reported on in the survey deals with only 106 out of 6,953 women– 1.5% of respondents. (Apparently, 69 women skipped or refused to answer the question whether they had ever attempted SMA, or “self-managed abortion.”)

In a very familiar technique, the authors took that number and “adjusted for underreporting” to boost it to 2%. Where does the 7% come from? Projecting that percentage over a woman’s lifetime.

This 350% higher figure, of course, depends on authors’ assumptions about the prevalence of abortion and the continuation of past patterns into the future. It is difficult avoid the conclusion that these projections are more wishful thinking on the part of these SMA advocates than hard science, though that is a future they are aggressively pursuing.

Information on attempted self abortions

That being said, the study does provide some data on past attempts at “self-managed abortions” (SMAs). While the sample was a little tilted to the older side, with more three quarters of women over 30 years old, most of the SMAs were attempted by women when they were under 30 (61 out of 82 attempts where age was given). Most of these abortions were said to have happened in the 2000s or 2010s (68 out of 85 attempts) when the decade was reported.

“Herbs” (including parsley, vitamin C, different teas, spices) were the most prevalent method attempted (42 cases) followed by “emergency contraception” (30 cases). The listing of “emergency contraception” by authors is confusing; typically advocates present them as a non-abortifacient effort to prevent pregnancy. However, the authors say they were only counting those using emergency contraception after confirming pregnancy (9 cases) in their SMA totals.

An equal number, 15, attempted to use misoprostol, the prostaglandin normally used in conjunction with mifepristone in legal U.S. chemical abortions, or used physical force (e.g., blows to the belly) in some way to dislodge and abort the baby. A dozen women reported using some other unspecified means. Only 27 of the 92 known attempts were reported to have been “successful.” 

What were the reasons given for the attempted self-abortion? They varied, but were generally not surprising. Just over 40% (37 out of 92) simply said that “doing on [my] own seemed easier or faster.” Just a few less women (30 of 92) simply said the “Clinic [was] too expensive.” Another 15 women said the “Clinic [was] too far away” while10 answered they “Did not know where a clinic was.”

Thirteen claimed that “Doing on [my] own seemed natural,” and eleven simply reported that they “Use vitamins or herbs whenever sick.”  Ten “Thought they needed parent’s consent,” while 16 gave “Other” reasons. (The numbers add up to more than 92 because respondents could offer more than one reason.)

Minorities were much more likely to report an attempted self-managed abortion. Less than 1% of non-Hispanic whites reported such an attempt, compared to 2.3% of non-Hispanic blacks.* Hispanics reported the highest rates– 3%–of self-managed abortion attempts among survey respondents.

These results were not surprising, even to the authors. Black market sales and use of misoprostol among Latin women, particularly in border towns, has been widely reported here and elsewhere in the last few decades.

Why this study, why now?

Ralph and her colleagues declare, “As abortion clinics close owing to increased abortion restrictions, a reduced demand for facility based abortions, and a growing demand for convenience, privacy, and the comfort of self-managed abortion and self-care more broadly, it is likely that SMA will become more prevalent in the US, as it is today in other countries.”

They claim they are only trying to establish a “baseline” for those tracking these abortions in the future. But the obvious message is to assert that self-managed abortions are already here; that there is a demand for them; and that the government ought to facilitate the use of SMAs since such abortions are supposedly broadly and safely offered in other countries.

It is no coincidence that this article appears while advocates– including some of the researchers publishing here–have been petitioning the FDA to abandon Risk Evaluation and Mitigation Strategies (REMS) regulations imposed on the prescription of mifepristone.  By making sure that prescribers and patients fill out and sign forms that ensure women are aware of the risks and by requiring that the drugs be dispensed at the facility by a certified prescriber, the REMS regulations are intended to try to ensure that the drugs are used safely.  

Although you’d never know it from the likes of these researchers, as of 2018, thousands of mifepristone patients had suffered serious complications and at least two dozen had died from complications such as hemorrhages, infections, and ruptured ectopic pregnancies. 

To this point the FDA has resisted efforts to modify or jettison the REMS requirements, which would have opened the door to these “self-managed” abortions. However, abortion advocates have used the coronavirus as an excuse to argue that the FDA should “temporarily” suspend the regulations, obviously hoping to prevail permanently under a new more sympathetic Biden/Harris administration.

Advocates act as if the legalization of do-it-yourself abortion will suddenly make such abortions safer for women. Instead what it will mean is that more women facing the pain, the bleeding, the risk of infection, the possibility of a ruptured ectopic pregnancy, as well as a gruesome encounter with her aborted child, all alone, far from qualified, accountable medical help.

That’s the dream of these researchers, but a nightmare for the women who heed their assurances. 

* Our percentages may differ slightly, as we are using the actual percentages of the unweighted sample rather than the recalculated percentages the authors report for weighted samples.

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