Throughout 2021, RHAP worked within the American Public Health Association’s (APHA) Sexual and Reproductive Health section to propose a policy statement urging APHA to publicly back decriminalizing and supporting self-managed abortion. In November, with support from a variety of APHA sections outside of reproductive health, the APHA adopted our policy statement, which is now available for all to access. The statement asks APHA and members, public health professionals, clinicians, and elected officials to denounce the criminalization of self-managed abortion and work toward guaranteeing safe and equitable access to the full range of safe abortion care options.

“Self-managed abortion is safe, effective, and empowering.” Self-managed abortion, or SMA, presents an important alternative to clinical care for those who face financial and logistical barriers due to state and federal abortion restrictions, or who prefer this method due to its privacy, comfort, or convenience. The prevalence of self-managed abortion is higher among Black and Hispanic women* compared to white women, indicating that they face greater barriers to accessing clinical abortion care or prefer self-managed abortion due to experiences of structural racism and discrimination in health care. Self-managed abortion with pills – mifepristone and misoprostol, or misoprostol alone – is extremely safe and effective. In fact, both methods are no less effective than medication abortion in clinical settings, according to the SAFE Study.

Self-managed abortion is an issue of human rights and reproductive justice: providing people with the tools and information to manage their abortion enables them to exercise their bodily autonomy and to be in control of their health and well-being. In response to issues of criminalization and the failure of governments to provide safe abortion care, feminist medication abortion accompaniment models have emerged around the world to provide people with the information, support, and resources they need to manage their abortion, free from stigma. These community-based, grassroots collectives have demonstrated time and time again that they effectively and compassionately support individuals to self-manage their abortions, and connect people to clinic-based care in the rare cases this may be needed. 

RHAP believes all people should have access to the full range of safe abortion options, including self-managed care, to end a pregnancy safely and with dignity on their own terms. RHAP is proud to offer educational resources on having an abortion with pills and looks forward to continued work and reflection on the role primary care clinicians play in the movement for self-managed abortion.

By: Silpa Srinivasulu, (She/Hers)

*Trans and nonbinary people get abortions. When we use gendered language in this article, it is in reference to data that only included cis-gender women.