USA – Self-managed medication abortion: expanding the available options for US abortion care

by Megan K Donovan

Guttmacher Policy Review, Vol 21, October 2018


  • People should have affordable access to the full range of safe and effective options for abortion care, including self-management with medication.
  • In addition to existing barriers that limit access to abortion care overall, there are unique obstacles that must be overcome before self-managed medication abortion can be available to all in a meaningful way.
  • It is essential that individuals seeking to self-manage an abortion have a source of accurate information and access to medical care if necessary.

Self-managed abortion is not a new phenomenon, but many long-standing biases and Instead, many forward-looking thinkers—including providers, researchers and advocates—are working toward a future in which everyone seeking abortion care has access to the full range of safe and effective options, including self-managed methods. In this scenario, all who opt to pursue self-management would have access to the information they need and to a provider of their choice if they need or want one at any stage. They would not be outside of the health care system, but rather supported by it in a new way. This vision is not as far-fetched as it might sound. Medication abortion, in particular, holds great promise for the future of self-managed abortion care in the United States, and understanding the steps and barriers to achieving a fully independent model of self-managed medication abortion is critical to normalizing and advancing this vision.