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

7 Dec

Cross-posted from RH Reality Check, by both Steph Herold and Susan Yanow.

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  

 

2 Responses to “Abortion is Legal: So Why is Self-Abortion Care a Crime?”

  1. Oubli December 11, 2011 at 9:00 am #

    But herbs can be a safe and effective way to end a *very early* pregnancy! Just because there no one is willing to study the safety and efficacy of herbs in this regard doesn’t mean that it doesn’t work. See http://www.SisterZeus.com and http://www.scribd.com/doc/22321349/Natural-Liberty-Rediscovering-Self-Induced-Abortion-Methods
    and http://www.NaturalMiscarriage.org

    Having said that, my own personal experience (and anecdotal evidence, which is all we have until somebody studies this) tells me that terminating a pregnancy with herbs is for all practical purposes is IMPOSSIBLE at such a late gestation. Which makes me wonder what really happened? What did this women ingest that supposedly caused an abortion so late in her pregnancy? It is far more likely she ingested Misoprostol/Mifepristone or some other medication.

    Also, the problem seems to me with women terminating their own pregnancies is appropriately disposal of the products of conception. Women are only getting caught for terminating their own pregnancies when the fetus is too large to flush down the toilet like a miscarriage or medically terminated pregnancy (using Miso and Mife). If Jennie McCormack and this women in New York had buried (properly disposed of) their fetus’, their would be no proof, they wouldn’t have been caught, ect, ect . . .

    Just some food for thought.

    Ps – I keep apprised of these self-abortion cases because I have used herbs for birth control, to provoke periods and to induce abortions.

  2. Oubli December 20, 2011 at 6:28 pm #

    Ah ha! The herb she used is called Ruta (Ruta Graveolens) commonly called Rue it is mainly used in the Caribbean and Europe, which explains why even a well educated herbalist from N. America like me has never heard of it.

    Using any herb so late in pregnancy for termination purposes can be quite dangerous, in my herbology practice I never suggest a women try an herbal method of abortion past 10 weeks LMP or 8 weeks pregnant. After 8 weeks pregnant the placenta has become too firmly entrenched in the uterus and complications from incomplete abortion and hemorrhage are far more likely.

    I am relieved Yaribely Almonte survived something as dangerous as a self induced later term herbal abortion but quite appalled that she is being prosecuted for taking charge of her own fertility.

    Women Resort to Over-the-Counter Remedies to End Pregnancies
    http://ec2-174-129-17-40.compute-1.amazonaws.com/20111220/washington-heights-inwood/women-resort-overthecounter-remedies-end-pregnancies-wahi

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