At-home abortions may be the future of reproductive care

Updated April 22 at 3:38 p.m.

As more state governments ponder bills that would ban or restrict abortions, interest in self-managed or at-home abortions has skyrocketed. Cambridge-based reproductive rights advocate Susan Yanow joined Boston Public Radio on Thursday to talk about the benefits of medically induced abortions, which can be done with two pills in a clinic or at home, and what the future of abortion care might look like.

“People make a decision about the method for a whole range of reasons,” Yanow said of the choice between medication and alternatives, such as the in-clinic aspiration abortions that are more well known.

“Some people can do it in the privacy of their home — they take the second dose [of the medication abortion] home with them,” Yanow said. “They feel it’s more private, they feel like it's more natural, because it’s like a miscarriage. Other people want to go into the clinic and get it over with and be done, and not have to worry about it.”

As abortion laws narrowed in many states and the Supreme Court may soon overturn the precedent set by Roe v. Wade, the FDA permanently lifted a restriction on how patients could receive abortion medications last December. Instead of having to meet in-person, patients can now use telemedicine appointments with prescribers and receive a two-pill abortion medication regimen by mail. And while the FDA’s move allows increased access to abortion pills for some, many southern and midwestern states now ban telemedicine visits for abortion pills or outlaw mailing the medication.

Part of Yanow’s work with Self-Managed Abortion, Safe and Supported, or SASS — the U.S. program of the international nonprofit Women Help Women, which Yanow co-founded in 2014 — is to educate the people seeking abortions that may not have easy access to a clinic that there’s another option available.

“You think of a young person who finds themselves with an unwanted pregnancy in Texas, Mississippi, Arkansas — they're not even going to know what to Google if they don't know that these pills exist,” Yanow said. “So that's our job: our job is to raise the visibility of these pills, knowing that people might not pay a lot of attention until they need it. But they need to know that they exist.”

Yanow pointed to the case of a woman in Texas who was recently charged with murder over an alleged “self-induced abortion” in early April. After miscarrying, the 26-year-old woman went to a Starr County hospital, where staff reported her to authorities. She was later released after an abortion rights group posted her $500,000 bail.

Although the charges have since been dropped, reproductive rights advocates are worried that the case could cause a chilling effect on people seeking out self-managed abortions. But Yanow hopes that the chilling effect will be minor.

“Putting these pills in the hands of people who need it is empowering. It breaks the stigma [around abortion],” Yanow said. “People can laugh about abortion, and that's a change in the whole framework for how everywhere — not just in this country — abortion has been talked about.”

Update: This story has been updated to clarify the methods of abortion available in the United States.