Self-induced abortion

A self-induced abortion is an abortion that a pregnant woman causes herself to have without direct medical aid. Although the term can include abortions induced through legal, over-the-counter medication, it also refers to efforts to terminate a pregnancy through more dangerous means. Such practices are illegal in most places - even where abortion itself is legal - and present a grave threat to the life of the woman. Self-induced abortions nevertheless are performed in places where circumstances (legal constraints, cost, concerns about secrecy) discourage the pregnant woman from seeking a safer procedure.

In the United States
The practice of self-induced abortion by various means has long been recorded in the United States. Turn-of-the-century birth control advocate Margaret Sanger wrote in her autobiography of a 1912 incident in which she was summoned to treat a woman who had nearly died from such an attempt.

A study concluded in 1968 determined that over 1.2 million illegal abortions were being performed every year in the United States, some proportion of which were performed at home by the woman. The study suggested that the number of women dying as a result of self-induced abortions exceeded those resulting from abortions performed by another person. Such figures are necessarily dubious, however, as the results of illegal procedures would generally not be reported to authorities or to researchers. A 1979 study noted that many women who required hospitalization following self-induced abortion attempts were admitted under the pretext of having had a spontaneous abortion.

Although the decision in Roe v. Wade, 410 U.S. 113 (1973), made abortion more readily available throughout the U.S., it remains a crime in most jurisdictions for a woman to attempt to perform such an activity on herself. For example, in May of 2005, Gabriela Flores - a Mexican immigrant living in South Carolina - was charged under such a statute, under which those convicted could receive up to two years in prison. She had brought about an abortion by ingesting misoprostol, an ulcer medication known to also cause abortions. Mississippi classifies self-induced abortions as deaths which affect the public interest, requiring that physicians report them to the local medical examiner. By contrast, New Mexico's "Unborn Victims of Violence Act" exempts self-induced abortion from the criminal liability the act creates.

Methods
There are a number of anecdotally recorded and disseminated methods of performing a self-induced abortion. These may include:
 * physical exertion designed to bring about a miscarriage
 * abdominal massage
 * receiving blows to the abdominal area
 * attempted removal of the fetus with a coat-hanger or similar device inserted into the uterus through the vagina
 * attempted piercing of the fetus with a knitting needle or similar device inserted into the uterus through the vagina
 * ingesting abortifacients, high quantities of vitamin C, or other substances believed to induce miscarriage
 * douching with substances believed to induce miscarriage (beginning in the 1960s, many women used Coca Cola for this purpose, although its utility is at least dubious)

Many of the above named methods present significant dangers to the life or health of the woman. In particular, attempts to insert hazardous objects into the uterus can cause punctures leading to septicemia. Ingesting or douching with harmful substances can have poisonous results. Receiving blows to the abdomen, whether self inflicted or at the hands of another, can damage organs. Furthermore, the less dangerous methods - physical exertion, abdominal massage, and ingestion of relatively harmless substances thought to induce miscarriage - are less effective, and may result in the fetus developing birth defects. However, abdominal massage abortion is traditionally practised in Burma, Thailand, Malaysia, the Philippines, and Indonesia.

The cheap prescription drug Misoprostol is often used as an abortifacient in self-induced abortion in Latin American countries where legal abortions are unavailable, and its use has also been observed in immigrant populations in New York. Although abortion proponents deem this method to be safer than those using insertion of objects or chemicals into the uterus, they also note that failure to effect an abortion by this method can lead to the child being born with serious birth defects.

Current medical procedures are significantly safer than traditional at-home methods. In 1979, Bernard Nathanson, MD, an "abortion expert and an obstetrician-gynecologist who once presided over the largest abortion clinic in the world," wrote in his book Aborting America:


 * "The practice of abortion was revolutionized at virtually the same moment that the laws were revolutionized, through the widespread introduction of suction curettage in 1970. ... Even without a suction machine, a simple combination of catheter and syringe can produce enough suction to carry out a safe early abortion. As for the self-induced abortion, by thrusting a coat hanger or other dangerous object into the womb, this will also be a thing of the past."

Political impact
The possibility of self-induced abortion is an undercurrent within the larger abortion debate. Those who favor legal abortion are prone to argue that the prohibition of the procedure, or placement of burdens on its exercise, will lead pregnant women to return to the more hazardous self-induced abortions that occurred when abortion was illegal. Those who oppose abortion counter that societal conditions have changed since that time, and that women today would be unlikely to engage in such activities. Furthermore, they note that statutes banning abortion were laxly enforced, and that self-induced abortions would be deterred by severe penalties for women who perform them.