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Scouring the internet for answers on “how to have an abortion at home” will dredge up answers that read like school-bus gossip: Some, like douching with Coca-Cola or taking a lot of vitamin C, are unlikely to be life-threatening, but they’re also extremely unlikely to end your pregnancy.
Other methods are blatantly unsafe. They include inserting anything into the vagina, which poses a high risk of infection and sepsis; ingesting toxic substances such as turpentine, bleach, and other household chemicals; and any type of physical trauma, such as hitting oneself in the abdomen or throwing oneself down the stairs. “These are all things that people heartbreakingly try to do to end their pregnancies due to lack of access to clinical care, or lack of information or awareness of safer methods,” says Heidi Moseson, a senior research scientist at Ibis Reproductive Health.
Between the states that have affirmatively safeguarded abortion access, abortion funds, and networks like Aid Access that get pills safely to those seeking to terminate a pregnancy, there will be medical options for abortion seekers even after Roe v. Wade. Still, there have always been people who turn to underground alternatives. There are two DIY techniques particularly likely to reemerge because they never totally went away. One is the at-home vacuum aspiration, and the other requires consuming a concoction of herbs.
For decades, many community abortion providers have used manual vacuum aspirators (MVAs) safely and effectively, according to Sarah Prager, a professor of obstetrics and gynecology at the University of Washington. The devices were designed as a way to empty the uterus outside of the clinic by non-clinicians, she says, and its design has evolved with each generation of community providers. While an MVA is a specific device that looks a bit like an oversize syringe, many devices function similarly — such as the Del-Em, which is an early model still in use, and is sometimes made with jars and tubing. The process, which lasts about ten minutes, creates a similar sensation to having an IUD placed, Prager says.
Experts stress the importance of engaging a community provider who can be trusted — not a friend, and definitely not just yourself and a mirror. Patients should ask the type of questions they would ask any other medical-care provider (like: How many successful abortions have you performed or assisted? What do we do in case of an emergency?), and if anything feels weird, patients should trust their gut. (The provider must be informed if the patient is taking any medications — like blood thinners — or if they have medical conditions like low blood iron.) The risks that come with not finding a skilled provider are high. If the person performing the abortion has no knowledge of sterilization, there’s a high chance of infection. In addition, the uterus can be perforated if the person doesn’t understand anatomy, which risks internal bleeding and damaging nearby organs. Manual vacuum aspiration “is a skill, and it takes trust. Most people aren’t going to want to commit to doing all of that,” says Laurie Bertram Roberts, the executive director of the Yellowhammer Fund. “Most people are not going to take that risk for something that has the same early use as a medical abortion when they can just do the pills.”
Herbal abortions are thought to be the oldest method of ending pregnancy, but little is documented in western research literature on the efficacy of herbal abortion, according to Moseson and Prager. This method also comes with bigger risks. An herbally managed abortion is a lengthier, more complex process that requires specific blends and preparations of herbs administered on a strict schedule. While it can indeed be safe and effective, Prager says, it’s imperative that this process be overseen by an herbalist and initiated early in pregnancy. Proper dosage can vary from person to person and herb to herb. And improper dosage or use can result in adverse outcomes, including death. (More routine side effects from both MVA and herbal abortions include bad cramps, bleeding, drowsiness, and nausea that should gradually reduce in the days following the procedure.) TikTokers have suggested concocting tea blends that incorporate herbs like mugwort, wormwood, or yarrow root, plants that, yes, have been historically used to induce abortion. However, if administered without proper dosing or ensuring an herb doesn’t interact with any prescription medications invites a real possibility of serious side effects. Large amounts of ginkgo biloba, for instance, could potentially increase the risk of bleeding for people taking blood thinners or ibuprofen.