No one should ever be punished for providing their own medical care. Yet, from 2000 to 2020, at least 61 people who have self-managed an abortion or have helped someone else are known to have been arrested or prosecuted. It is unknown how recent changes in abortion laws will affect future criminalization of people who self-manage their abortions. Those who are already at greater risk of criminalization because of their race, gender identity, economic status, or other factors may have a higher risk of prosecution. People who live in very conservative states also may face a higher risk of prosecution. A few states even have laws that say that self-managing an abortion is illegal.
Plan C believes that each person should have access to information to make their own decisions about risk, including legal risk. The information below is not intended to endorse self-managed use nor is it legal advice. It is what we know from the experiences of people who have self-managed their abortions.
The Repro Legal Helpline provides free and confidential legal advice that can help people better understand the laws and legal risk they may face. Contact them online or call 844-868-2812.
Self-managed abortion is not a criminal act, and restricting abortion access is considered by leading justice organizations to be a human rights violation. However, some people who have used abortion pills on their own have gotten in legal trouble in the United States. Between 2000 and 2020, there have been at least 61 cases where people have been prosecuted for self-managing their abortions (charges have varied from concealing a birth to homicide) or helping someone else self-manage an abortion. During that same time, research suggests that a hundred thousand (or likely more) people have self-managed their abortions. We do not know how new laws about abortion will affect the criminalization of people for self-managing an abortion.
Example 1: “I went to urgent care because I was scared about the bleeding, and my doctor reported me to the police.”
Everyone should be able to access urgent care when they are concerned about their health. But, in a few cases urgent care staff have called the police on people who have taken abortion pills that they purchased online. This is not ethical and should not happen. When seeking urgent or emergent care, people are not required to report to clinicians that they have used abortion pills. The symptoms after taking abortion pills are the same as a miscarriage. Blood tests do not reveal any differences between a miscarriage and a medication abortion. Medical providers can safely and effectively care for patients who have used abortion pills without needing to know their full medical history.
Federal law (EMTALA) also says that clinicians must provide abortion care to address a medical emergency for all patients who present at a hospital emergency department. This applies even in states that have restrictions on abortion.
People can often avoid the need for urgent care by consulting with a knowledgeable clinician by phone. The Miscarriage and Abortion Hotline offers free text and phone assistance to anyone who has medical questions.
Example 2: “The tissue that came out was bigger than I expected and I didn’t know what to do with it.”
Sometimes people have been reported to the police because of the way in which they disposed of the miscarriage tissue. Most early abortion tissue is just blood and clots (like a heavy period) that can be flushed down the toilet. But sometimes when abortion pills are taken later in pregnancy there is more tissue. It can be hard to know how to dispose of it (this is true when someone has a miscarriage, too). Some people have been discovered when tissue has been found in the public sewer system, when they have told friends about their situation and the friends have reported them to the police, or when they have shared information with their medical provider and been reported.
Example 3: “My boyfriend found information in my search history and reported me.”
Digital communications (like email and texts) can be used as evidence against someone who has done an abortion on their own (without a prescription). People often use Incognito Mode (also called a Private Window) when searching for sensitive information. Most private browser settings/incognito window searches won’t retain your cookies, browsing history, search records, passwords, or personally identifiable information. Some people protect their digital privacy by using free VPNs (Virtual Private Networks) like Proton VPN or by using the TOR Browser. VPNs can be used on computers and phones. When used in combination with Private Windows or Incognito Mode, they can keep your identity and location private when you search for information and make purchases (like buying abortion pills online), as long as you aren’t logging into accounts which are linked to you. People also use encrypted email (like Proton Mail) and secure texting (like Signal) to keep online communications private. Some people use a public library computer to avoid a data trail (ask your library if they delete search histories and have systems in place to protect your confidentiality). Some people try to keep online purchases discreet by using online currency such as Bitcoin, but without some complicated additional steps those purchases can still be linked to an individual person. The Electronic Frontier Foundation has some additional tips about data privacy here.
Example 4: “I told my friend and she reported me to the police.”
When facing an unplanned pregnancy or self-managing an abortion, it is reasonable to want support from friends. Unfortunately, sometimes people have been criminalized for self-managing an abortion when a friend or acquaintance has reported them to the police. Reports by friends and acquaintances accounted for more than a quarter of the 61 known criminalizations between 2000 and 2020.
Once someone has decided to have an abortion, they should be able to do so safely, effectively, and with dignity. No one should be arrested or jailed for ending their own pregnancy. But, if someone who chooses to use abortion pills outside of the established medical system gets into trouble it is important for them to get legal help. Organizations that can help people get legal help are: