Abortion is Legal: So Why is Self-Abortion Care a Crime?


Last week, a 20-year-old woman in New York City was arrested on charges of “self-induced abortion” and faces first-degree misdemeanor charges.  Initial news reports indicate that she intentionally caused the miscarriage/abortion of her 24-week fetus.  The woman disposed of the fetus in what was probably the only way she could think of: wrapped in plastic bags and placed in the trash receptacle of her apartment building.

The prosecution of this woman echoes similar cases in Idaho, Massachusetts and South Carolina.  In spite of ever-increasing restrictions, abortion is legal through the second-trimester throughout the United States, although it is inaccessible to many women.  Yet if women safely end their pregnancies without medical supervision, they face criminal penalties.

The key word here is “safely.” There are many misconceptions about what happens during a non-surgical abortion.  In fact, abortion with medications (such as misoprostol alone or in combination with mifepristone) causes a miscarriage.  The symptoms of abortion with medicines in the first trimester are exactly the same as a miscarriage, and as safe.  Rarely do women who have a miscarriage need medical attention; the same is true for women having a medication abortion.

In the second trimester, the risks of a complication after a miscarriage, whether occurring spontaneously or provoked by medicines, is somewhat higher.  However, it is notable that the woman in New York City, like the women prosecuted in three other states, was in the second trimester and did not require any kind of medical intervention after her abortion.  We have to ask then – is the outcry when women choose to self-induce truly driven by the need to protect the health and safety of the woman?  Or is this another example of over-regulation because of the politics of abortion?

The choice to self-induce an abortion in New York City raises important questions.  The most recent prosecution of a woman for making this choice was in Idaho, in the spring of this year.  Jeanne McCormack was between 20 and 24 weeks pregnant, obtained medicines over the Internet and ended her pregnancy.  She was charged under an Idaho law that forbids abortions unless performed by an Idaho physician, and the original charges carried a possible five-year prison term.  Ms. McCormack, a low-income mother of three, said she ordered the medicines because the closest abortion provider was in Utah, and she had no money for travel or for the procedure.

Women in New York City have much better access to abortion care than Ms. McCormack did.  New York State allows state Medicaid funds to cover abortion services, and there are a number of clinics in New York City that provide abortion care through 24 weeks.  New York also does not have the restrictions, such as waiting periods and parental consent, that are insurmountable barriers for women in many other states.  So why would a woman in New York City decide to end her pregnancy by herself?

We don’t have details about why this particular woman chose this method.  Is it possible that the relentless headlines about new abortion restrictions across most states have confused some women, who may think that these laws are national?  Or is the (successful) effort by anti-abortion forces to stigmatize abortion effective enough that some women feel too much shame and fear to seek medical care when faced with an unwanted pregnancy? Or did this woman have no trusted health care provider who could direct her to a clinic?

Ultimately, it doesn’t matter what her reasons were for self-inducing an abortion. Not every woman wants clinicians involved in her health care, especially if she feels that she can take care of it herself. We each have different ways of dealing with our bodies, our sexuality, and our health care.

We do not have enough information to guess whether or not this woman fell through the gaps in the social support and health net, or made a conscious choice to end her pregnancy in a way that she felt most comfortable.  But why is self-treating an unwanted pregnancy a crime?

We certainly should do everything possible to provide excellent information to women about services and fight to keep abortion care widely available and accessible.  But if a woman decides that the best thing for her to do is to self-induce an abortion, she should have access to the best information available on how to do this safely (ie with medicines, NOT herbs) and know where to go in case of a complication.  Criminalizing her choices does not protect her health. If we believe that women have the right to control their fertility, then we must also trust women with the right to choose the methods that make the most sense for them.

Endnote: There are no scientific studies that identify any herbs as effective for ending a pregnancy, and some herbs are dangerous.  There are numerous studies documenting the efficacy and safety of mifepristone plus misoprostol, and misoprostol alone, for ending a pregnancy.

For more information on self-induction, see these studies:

- Self-induction of abortion among women in the United States

- How commonly do US abortion patients report attempts to self-induce?

- Re-emergence of self-induced abortions

- Misoprostol and attempted self-induction of abortion

- The knowledge, acceptability, and use of misoprostol for self-induced medical abortion in an urban US population  

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  • rachel-roth

    Thank you, Susan and Steph, for this thoughtful discussion of women who self-induce abortions.

     

    In the interest of making abortion information and care available, here are a couple of places to turn to for help:

     

     

    Backline has volunteers to talk about pregnancy, abortion, adoption – when you’re trying to figure out what to do or if you need someone to talk with after you make a decision.

     

    The National Network of Abortion Funds can help women who need financial assistance to obtain an abortion.

     

    Criminal prosecution is definitely not the answer to women’s need for care or women’s decisions to take care into their own hands.

     

  • cmarie
  • elizabeth-d

    Pregnancy is not a disease, and killing an unborn baby is not health care.

    This story is just incredibly sad. A mom took poison to abort her baby and then threw her in a dumpster.

  • prochoiceferret

    Pregnancy is not a disease,

     

    Technically, it’s more of a “medical condition.” Is this an important distinction for you?

     

    and killing an unborn baby is not health care.

     

    (Note: An “unborn baby” is technically a “fetus.” Kind of like how you are an “undead corpse”—it’s less misleading to just call you a “person.”)

    It is if it improves the medical prognosis of the woman in whose body it resides. (Along with safely removing the fetus, of course.)

     

    This story is just incredibly sad. A mom took poison to abort her baby and then threw her in a dumpster.

     

    Poison? What story are you referring to?

    I do agree that the lack of better options available to the woman in the above-posted story is sad indeed.