Home Medical profession Self-managed abortion may become more important than ever

Self-managed abortion may become more important than ever


In the Dobbs v. Jackson Women’s Health Organization decision, the conservative justices rejected the idea that it is a basic human right for women to have power over their own bodies and ruled that state lawmakers can exercise control over some of what is actually a spectrum of reproductive health care. It’s a spectrum because all reproductive health experiences are linked, and the accessibility and safety of abortion care is key to ensuring that pregnancy, childbirth, and miscarriage can also be safe. There are not people who have children and others who have abortions; we are the same people at different times in our lives.

I had an abortion, a miscarriage and a full term pregnancy which ended in a caesarean section and the birth of my son. None of these health issues should be treated in isolation – I know this because I have experienced it. My medical abortion kind of prepared me for my miscarriage of a planned and wanted pregnancy, as the care for both was similar. In both cases, my uterus contracted to expel the pregnancy about six weeks after conception. Some people who miscarry have additional treatment, such as a D&C, to remove the products of conception from the uterus. I didn’t need this care, but if my uterus hadn’t been completely emptied either way, I would have been at risk for infection or sepsis. Regulating or prohibiting procedures under one condition but not the other puts us all at risk of complications or death. This is not hyperbole, as providers, fearing criminal charges, may not help patients in need of life-saving care.

Decades of research, including a landmark 2018 report from the National Academies of Sciences, Engineering, and Medicine, found that abortion is extremely safe. Medical abortion is even safer than Tylenol and extractions of wisdom teeth. Yet in no other similar health care facility can judges, let alone state legislators, insert their objections. The short explanation is that patriarchy, misogyny and good old fashioned racism. But the longer explanation goes back to how abortion became an issue to legislate in this country – through the medical community.

It was not until the late 1800s that state legislatures began to pass criminal abortion laws, allowing abortions only if a doctor agreed it was necessary, not if the pregnant person simply did not want to be pregnant or had a medical reason to terminate the pregnancy. . It used to be legal to ‘bring back the rules’ before accelerating with the support of community midwives and their elders. Enter: Dr. Horatio Storer, who ushered in the century-long crusade against abortion at the American Medical Association and propelled the movement’s ideology about the beginning of “life” into the mainstream. Anti-abortion restrictions began to appear that allowed “therapeutic abortions” only if patients had the approval of their doctors and hospital boards.

This story makes the Jane Collective in 1970s Chicago all the more remarkable. Not only has this underground feminist health care network revolutionized the delivery of safe medical care before Roe vs. Wade became the law of the land, during their operations between 1969 and 1973, but when the Janes, as they called themselves, finally began performing abortions themselves, they were able to center the needs and desires of women receiving care through the collective. When the deer decision handed down in 1973, the Janes were relieved but also skeptical about the treatment of women in clinics that had come to model themselves on the services the collective had created. The deer decision, wrote Laura Kaplan in her 1995 book on the network, “written emphatically on physicians’ rights, not women’s rights, revalidated the medical profession’s control over women’s reproductive health.”

“Women would always be objectified as patients, removed from abortion as a life-defining experience. They would be followed by effects, not with which they would act,” Kaplan added. “Jane’s members knew the medical profession was not going to seize the opportunity to educate women. Roe vs. Wade had won the war, but the battle for decent care and respectful treatment was still far from over.

For some time now, abortion providers have been forced to build their practices not with their patients’ needs in mind, but with medically unnecessary regulations. As we begin this new post-deer chapter, it is even more important that we recognize the crucial role that self-managed abortion will play in allowing pregnant women to control when and how they receive their abortion care. A person wishing to have an abortion can order medication for their abortion from reliable online resources such as Aid Access, which helps people access medical abortion regardless of their postcode.

Certainly, beyond the physical discomforts of a medical abortion, there are significant legal risks associated with SMA without the protections of deer, especially in today’s criminalized environment and how people of color and undocumented people are already targets of imprisonment. But we need to provide those who seek this care with support and accurate information about available health care. services, as well as the legal assistance services that the lawyers have in place at the moment. History shows us that abortion bans do not stop abortions; they only make care more difficult and dangerous to obtain. SMA has the potential to minimize the number of preventable deaths associated with laws that criminalize abortion.

Self-managed abortion is not the only solution in this post-deer environment. Clinics are essential for communities, and there are instances where an in-clinic abortion is the only option for a patient, including for those facing incomplete miscarriages, as we have seen recently in Malta. But clearly too few people are aware of the safety of medical abortion, which now accounts for more than half of all abortions in the United States, where the majority of abortions occur within the FDA-approved window. for drugs inducing abortion (up to 70 days of pregnancy). So while we donate to abortion funds and support clinics, we must also champion self-managed abortion, both in principle and in practice.

Induced abortions are an important part of what is a spectrum of reproductive health care. As we fight to reopen abortion clinics in every state, let us continue to advance Janes’ vision for health care, which is not based on what doctors, lawmakers or judges allow us to do with our bodies, but about what we choose to do with our bodies, while ensuring that everyone has the resources they need, no matter where and how their care happens.