Self-Managed Medication Abortion: Can’t Live With It, Can’t Live Without It

For as long as people have been getting pregnant, they’ve also been figuring out how to get un-pregnant. A self-managed abortion (SMA) is when a person ends their pregnancy outside of the formal medical system. Most often, self-managed abortions are done as “medication abortions” — abortions induced by medication. In this episode of The Beautiful Idea, we talk about self-managed medication abortions done with a combination of the drugs misoprostol and mifepristone.

Guests Jane and Hazel are both abortion doulas (also known as abortion companions) with extensive experience supporting people completing self-managed medication abortions. Jane, based in Appalachia, works with the Mountain Area Abortion Doula Collective (MAADCO). Hazel, based in the Rust Belt, is a former abortion clinic worker, and wrote the zine “how to do it anyway: a guide to self-managing an abortion at home” after Roe v. Wade was overturned in 2022.

We discuss the history of reproductive justice, how self-managed abortion is often stigmatized and why that can be harmful, and the actual step-by-step details of what a medication abortion entails (how to measure pregnancy, which pills to take when, how it might feel physically in the body, what to look out for to determine if an abortion has been completed, pain management, and some of the ways that people sometimes emotionally or culturally process an abortion), among other topics.

There are many resources on self-managed medication abortion available. Here are just a few, mentioned in today’s show:

• How to Do It Anyway: A Guide to Self-Managing an Abortion at Home
• National Network of Abortion Funds — connects people to local abortion funds for financial aid and to resources that provide practical support (childcare, rides to clinics, etc).
• Abortion Finder — finds verified abortion clinics.
• Plan C Pills — educational website w resources on how to source abortion pills, how to dose them, what to look out for.
• Aid Access — provides access to medication abortion via mail.
• RX List — searchable database that provides information about general drug interactions.
• Miscarriage & Abortion Hotline— text hotline for medical advice, particularly if you are self-managing an abortion.
• The Mountain Area Abortion Doula Collective (MAADCO)
• Holler Health Justice
• The Yellow Hammer Fund
• The Janes — HBO documentary on the Jane Collective (1960s/70s underground network of abortion providers).
• Cool People Who Did Cool Stuff podcast episode about the Jane Collective

cover image: Ash J on Twitter