Abstract
IntroductionTwenty-four states have at least one law in place that could be used to prosecute people for self-managed abortion (SMA), or the termination of a pregnancy outside of the formal healthcare system. We investigated factors associated with public attitudes about SMA legality and legal access to abortion more generally.MethodsIn August 2017, we surveyed a nationally representative sample of English- and Spanish-speaking women ages 18–49 years in the United States (US) using Ipsos Public Affairs’ KnowledgePanel. Unadjusted and adjusted multinomial logistic regression estimates identify characteristics associated with believing that SMA should not be against the law, compared to should be against the law, with weighting to account for sampling into the panel.ResultsOverall, 76% (95% CI: 74.3%-77.1%) and 59% (95% CI: 57.3%-60.4%) of participants (n = 7,022, completion rate 50%) reported that abortion and SMA, respectively, should not be against the law; 1% and 19% were unsure. Among those living in a state with at least one law that could be used to prosecute an individual for SMA, the majority (55%, 95% CI: 52.7%-57.9%) believed SMA should not be against the law. Factors associated with believing SMA should not be against the law, compared to should be against the law, included prior abortion experience and higher levels of education and income.ConclusionMost reproductive age women in the US believe that SMA should not be criminalized. There is more uncertainty about SMA legality than about the legality of abortion more generally.Policy ImplicationsUS laws that criminalize SMA are not supported by the majority of the people living in their jurisdictions.
Highlights
Twenty-four states have at least one law in place that could be used to prosecute people for self-managed abortion (SMA), or the termination of a pregnancy outside of the formal healthcare system
We aimed to (1) provide a national estimate of the proportion of reproductive age women living in the United States (US) who think SMA should not be against the law, (2) identify factors associated with attitudes about the legality of SMA, and (3) assess how these factors compare to those associated with attitudes about the legality of abortion more generally
The majority of the sample believed that SMA (59%, 95% CI: 57.3%-60.4%) and abortion in general (76%, 95% CI: 74.3%-77.1%) should not be against the law (Table 3)
Summary
Twenty-four states have at least one law in place that could be used to prosecute people for self-managed abortion (SMA), or the termination of a pregnancy outside of the formal healthcare system. Results Overall, 76% (95% CI: 74.3%-77.1%) and 59% (95% CI: 57.3%-60.4%) of participants (n = 7,022, completion rate 50%) reported that abortion and SMA, respectively, should not be against the law; 1% and 19% were unsure Among those living in a state with at least one law that could be used to prosecute an individual for SMA, the majority (55%, 95% CI: 52.7%-57.9%) believed SMA should not be against the law. We define SMA as any attempt to end a pregnancy on one’s own without the supervision of a clinician This is in contrast to obtaining an abortion at a clinic or facility and in contrast to inducing an abortion at home by taking mifepristone and misoprostol prescribed by a registered provider. SMA may include self-sourcing mifepristone and misoprostol or misoprostol alone (online or in person), ingesting herbs or plants (such as parsley) or vitamins/supplements (such as vitamin C), taking over-the-counter pain relievers in high doses, using drugs and alcohol, or attempting physical harm, among other methods (Aiken et al, 2018; Moseson et al, 2020; Grossman et al, 2010)
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