We aimed to understand Indiana residents’ experiences and preferences regarding self-managed
abortion in a highly restrictive state.
Between June 2021 and April 2022, we recruited pregnant people who lived in Indiana
and were considering abortion through Google advertisements, online posts, abortion
clinics, and abortion funds. Respondents completed a self-administered online survey
at baseline and a second survey one month later. We analyzed reported self-managed
abortion experiences at baseline and endline, and characteristics of those who self-managed
Among 370 baseline respondents, 66 (18%) reported a preference for self-managed medication
abortion over clinical care, while 33 (9%) participants reported an actual attempt
to self-manage an abortion for the current pregnancy, and an additional four (1%)
were in the process of self-managing. Most who self-managed identified as White (58%),
33% as Black, and 6% as Asian; and were aged 16–37, with pregnancies from 4 to 13
weeks’ gestation. Sixteen (49%) respondents used herbs, six (18%) used misoprostol
and/or mifepristone, six (18%) used other medications, two (6%) took emergency contraception
after confirming the pregnancy, and 12 (37%) used other methods (eg, caffeine, physical
exertion). At endline, 13 (3%) respondents reported ending their pregnancy using self-managed
medication abortion. The most common reason given for self-managing an abortion was
the inability to pay for clinical care.
Indiana residents need financial support to access clinical abortion care when that
is their preference, and need information on safe, effective methods of self-managed
medication abortion as an option, particularly in light of anticipated further restrictions
on abortion access in the coming year.