P016Experiences of self-managed abortion in indiana: Financial barriers to clinical care and a need for information on self-managed medication abortion

Abstract

<h3>Objectives</h3> We aimed to understand Indiana residents' experiences and preferences regarding self-managed abortion in a highly restrictive state. <h3>Methods</h3> 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 an abortion. <h3>Results</h3> 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. <h3>Conclusions</h3> 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.