In light of the findings, researchers recommended that “self-administered abortion should continue to be closely monitored as barriers to facility-based care widen.”

Self-directed abortion methods have involved taking the oral drugs mifepristone and misoprostol, as well as ingesting herbs, alcohol or other substances, or even “punching oneself in the stomach,” the authors wrote.

They noted that “with the Supreme Court’s decision in Dobbs vs. Jackson Women’s Health Organization in June 2022 striking down federal protections against abortion, the landscape of access to abortion in the (United States) has changed significantly.”

Access to abortion is prohibited or severely restricted in 21 states. At the same time, there has been an increase in travel for abortion to states where legal protections still exist.

“Making abortion more difficult to access does not mean that people want or need an abortion less often,” the study’s lead author, Lauren Ralph, associate professor of obstetrics, gynecology and reproductive sciences at the University of California-San Francisco, told UPI.

“In fact, in our study, we see that since the Dobbs decision, there has been an increase in attempts to self-manage abortion outside of the formal health care system.”

Ralph, who has a doctorate in epidemiology, added that other studies have also found increases in requests for abortion pills virtually or by mail during the same time period.

“It’s up to the health care system and policy makers to make sure we can connect people with safe and effective abortion methods,” she said.

So far, researchers noted, no other studies have looked at changes in the prevalence of self-directed abortion amid the changing political climate.

To examine changes in prevalence, they administered surveys nationwide from December 10, 2021, to January 11, 2022, and June 14, to July 7, 2023.

Participants were female at birth and spoke English or Spanish. They were between 15 and 49 years old. Those between the ages of 15 and 17 were recruited through adult participants.

Researchers asked if participants had “ever taken or done anything on their own, without medical help, to try to end a pregnancy.” If they answered yes, the researchers asked for details about their experiences.

The proportion of participants who ever attempted self-assisted abortion was 2.4% in 2021 to 2022 and 3.4% in 2023.

Adjusted for underreporting of abortion, the lifetime rate of self-induced abortion was 10.1%, the researchers said.

Self-administered abortion rates were higher among non-Hispanic blacks than other racial and ethnic groups. And about 4 out of 10 self-directed abortion attempts occurred before the age of 20.

“Our data reflect the experiences of a nationally representative sample of American women of reproductive age. People of all ages, races and ethnicities, socioeconomic statuses, geographies, and sexual and gender identities report experiences with self-directed abortion,” Ralph said.

“However, we are observing an increased incidence of self-directed abortion attempts among people of color, LGBTQ and gender non-conforming people, and those born outside the United States.”

In the study, few participants sought emergency care for a complication. Still, Ralph said, some self-abortion methods can cause harm or be ineffective in ending a pregnancy.

“It is therefore critical that physicians in multiple specialties, but especially those in emergency and primary care settings, are aware of the potential complications associated with self-induced abortion as well as its usual clinical course,” she said.

“It is also imperative that doctors protect the privacy of patients and ensure that they are not criminalized for their actions.”

The study’s findings suggest that more American women are seeking to terminate their pregnancies through self-directed abortion, said Patty Skuster, associate director of the master of public health program at the University of Pennsylvania Perelman School of Medicine in Philadelphia. She was not involved in the study.

“This is a groundbreaking and important study that helps us understand—for the first time—changes in self-directed abortion prevalence following the 2022 Supreme Court decision that eroded the right to abortion in the United States.”

Skuster, an attorney who has researched the legal issues surrounding abortion globally and in the United States, said that “abortion can be a safe and effective option for terminating a pregnancy.”

She added that “supportive physicians will be key to helping people who need follow-up care without risking legal consequences.”

A deep stigma against abortion forces some women to resort to unsafe methods, says Jenny Higgins, a professor of obstetrics and gynecology at the University of Wisconsin School of Medicine and Public Health in Madison.

“Someone may drink heavily, use illicit substances, or engage in certain physical activities such as over-exercising or lifting heavy boxes, hoping that will cause a miscarriage,” Higgins said.

Confusion exists over what is legally allowed in a particular state, says Dr. Jamila Perritt, president and CEO of Physicians for Reproductive Health and an obstetrician-gynecologist in Washington, DC

“The best thing for people to do is to educate themselves about what laws and policies are in place in their own communities that put their access to safe and necessary care at risk,” Perritt said, adding that the number of self-directed abortions “is likely to be high underreported.”

While people choose self-abortion for a variety of reasons, said Tara Shochet, director of programs and grants at the Family Planning Council of Iowa in West Des Moines, “all individuals should have access to the full range of birth control, as well as abortion methods that are safe and effective .”