The troubling rise in DIY abortions

The notion of Mexico as a pharmaceutical utopia is enshrined in pop culture — evidently you can get anything you like if you know where to go in a country where legislation surrounding pharmaceuticals is much more lax. There’s some truth to that perception. Things that you need a prescription for in the US are available OTC in Mexico in some instances, and one of those things is misoprostol, one of two drugs used in medical abortions. While the drug can be used on its own, it’s not as effective without the partner drug, but that hasn’t stopped patients from using it in DIY abortions.

This is a direct consequence of the war on reproductive rights in the United States, which is hitting particularly hard in Texas. Patients have trouble accessing abortion procedures, even after changes to the FDA guidelines on medication abortion have made it usable later in pregnancy and with less supervision. In an ideal world, patients would be getting the abortion services under medical care that they need, and they wouldn’t have to resort to taking the drug without supervision, but in fact, the number of patients seeking DIY abortion is growing.

Clearly, restrictions on abortion clinics cause many clinics to close. It’s the strategy in use by conservative lawmakers across the country as they attempt to control what should be a private medical matter. Patients may not be able to travel to a clinic, or can’t get appointments in crowded clinics with busy schedules — even when staff are committed to providing abortion care to as many people as possible, there’s only so much they can do. Others may be ashamed of going to a clinic, filled with internalised fear and stigma that makes it hard for them to approach medical providers for abortion care even when they desperately want abortions.

This is, of course, the goal of the anti-abortion movement. They think that by closing clinics and narrowing opportunities to access legal abortion, and reinforcing that by building up a culture of shame around abortions, they’ll put a stop to abortion. Boom, magically everyone will stop seeking abortions if they can’t get them. But this isn’t like when the grocery store is out of oranges so you grab some apples instead, or decide to come back tomorrow when they’ll have new stock. This is a needed medical procedure that patients cannot afford to wait on.

And so they turn to another option: DIY abortion, following instructions from friends, from organisations that advocate for abortion rights and know that some people will try to take care of unwanted pregnancies on their own, from trusted advisers. That means seeking out medication, hoping they actually get the right medication in the correct dosage, and taking it — and hoping that their directions are accurate and won’t lead them astray, because the consequences could be extremely serious if the directions aren’t right or they don’t follow them carefully.

This, of course, also assumes that no other complications arise. Abortion, especially medical abortion, is an extremely low-risk procedure. One of the reasons that’s true, though, is because it takes place under supervision. A care provider can screen a patient for risk factors, accurately assess the age of a pregnancy, and make sure that patients get care appropriate to their needs. That’s not available when patients are going it alone, and they put themselves at very high risk when they decide to manage abortions independently. For many women, the procedure may be successful and safe.

But what about when it’s not? Incomplete abortions leading to infection and loss of fertility or even death can happen when you’re not using both drugs in a medication abortion. Patients can hemorrhage or develop other complications. They need to be able to go to a hospital for care, and that means needing to be open about the fact that they just performed a DIY abortion that clearly went wrong. Many patients may be afraid to do that, worried that they’ll get in trouble, or concerned that they may attract unwanted attention from friends and family — what happens when a conservative woman in an anti-abortion family performs a DIY abortion and then needs medical attention? Does she open up, even if it means that her family members might find out if her doctor doesn’t respect her privacy? What about a teen in a similar setting? Medical privacy is supposed to be a right, but terrified people may not be willing to count on the silence of their doctors, especially in the case of teens, who have very limited privacy and bodily autonomy under the law, relying on sympathetic doctors to make the right decisions for their patients.

DIY abortion is dangerous. In a climate where abortion access is restricted, I’m glad that organisations are taking the time to assemble guides to make it as safe as possible, but in an ideal world, people could go to the doctor for this most basic of needs just like everything else. It’s very worrying that the practice is on the rise, because this means that people are risking a great deal simply to get abortions, whether they can’t afford them, can’t get to a clinic, fear that their families might find out, or any number of other things.

The fact that people are willing to go to such lengths to get abortions highlights the fact that for all the right likes to tout how cutting off access ends abortions, it doesn’t. It just sends them underground, making them more dangerous, and it’s a grave injustice to people who rely on this vital service. I genuinely hope that conservatives who need abortions can access them, and that if they do, they reconsider their aggressive attempts to police the bodies of other people.

Image: Abortion R!ght, Sean Blackley, Flickr