airelle swernoff
Essay originally published
by Jewish Currents

Typeset in Caslon and
ALTEDIN 1451

Designed by Post Chicanx

baters

pdf available on haters.life
How to Give Yourself an
Abortion

by
Arielle Swernoff
DISCLAIMER

The decision to end a pregnancy is a personal one; this article does not
intend 1o influence or encourage any persons decision. 1 am neither a
lawyer nor a medical professional, and this guide should not be a substitute
for medical or legal advice. The information below has been compiled
from a variety of source, including the World Health Organization,
Women on Web, Women Help Women, Safe2Choose, the International
Women's Health Coaltion, and Robin Martys Handbook for a Post-
Roe America. Individuals who are considering self-managing abortion
should refer directly to these resources for medical or legal guidance.

Foraslongas people have gotten pregnant, people have given themselves abortions.
Historically,these methods have varied from the brutal to the toxic to the bizarre.
But history hasn't always gotten it wrong. From the Bronze Age until the st
or 2nd century BCE, silphium, a plant native to Libya, was used as 2 safe and.
effective contraceptive and abortifacient. It said the plant was so popular that it
was harvested to extinction. More recently, enslaved biack people in the American
South devised numerous herbal treatments to terminate unwanted pregnancies,
some of which are seill used today:

In 2020, however, the safest way to perform a self-managed abortion is with
pills—usually some variation of the same ones administered at doctors’offces.
Unfortunately, safe and affordable medical care isn't accessible everywhere or to
everyone. Since the 2010 midrerm elections, we've seen anti-choice legislation
spread across the country at unprecedented speed. From mandatory waiting periods
o laws regulating the width of hallways in abortion clinics, targeted restrctions
on abortion providers (known as TRAP laws) have shut down hundseds of clinics.
Now, conservative states are taking advantage of recent hard-right appointments.
o the Supreme Court by introducing laws that either ban abortion outright or
restrict it to the first si to eight weeks of pregnancy—before many people even
know they're pregnant.

Exeryone deserves to control their own reproduction. This guide to self-managing
your abortion using misoprostol,a medication which causes uterine contractions,

is intended as a community resource in the service of reproductive justice

UNDERSTANDING THE RISKS

According to a 2018 statement from Physicians for Reproductive Health, “self-
administered medication abortion is as safe, effective and acceptable to patients
and providers as healtheare facility-based medication administration.” Numerous
medical groups, including the World Health Organization, have endorsed self-
managed abortion using misoprostol in situations where abortion care through
a medical provider is unavailable. That said, self-managed abortion using
misoprostol takes longer than a clnic abortion, which typically uses a combination
of medications, and the side effects (including nausea, diarrhea, and abdominal
pain) are usually more pronounced.

Additionally, self-managing an abortion could put a person at legal risk. Though
advocates only know of 20 people in the United States who have been arrested
for self-managing an abortion since 1973, and fewer than ten states explicitly
ban the pracice, there are laws on the books in many states that can be used to.
punish a person managing their own abortion, such as those criminalizing harm
0 a fetus, or governing the disposal of medical byproducts. And people who are
disproportionately targeted by law enforcement (people of color, trans people,
homeless people, and undocumented people, for example) are at greater risk of
legal punishment. For a few legal resources, check out the “More Information”
section at the end of this article.

MAKE SURE THIS METHOD IS RIGHT FOR YOU

First, check how pregnant you are. This method s intended only for first-trimester
pregnancies (up to 10 weeks from your last menstrual period). Keep in mind
that contrary to popular belief, pregnancy is et counted from the “moment of
conception,”but from the first day of your last period.

According to Women on Web and Safe2Choose, you should not use this method
if:

» You have a disease called porphyria
» You have a bleeding disorder
» You are taking anticoagulants

» You know you'e allergic to misoprostol

1¢ extremely rare to get pregnant if you have an TUD, but if that's the case, you,
should have it removed before having an abortion.

GET YOURSELF SOME PILLS

When doctors perform medical abortions using pills, they use two drugs:
mifepristone and misoprostol. Mifeprisotone is harder to obtain in_ person
(although some websites now sell i as part of a combination pack of pills), so the
instructions here are for misoprostol only, which still has an 85% success rate at
ending a pregnancy when taken alone.

[Update 9/1/21: Sinee this article was published in early 2020, it has become
easier for people in the United States to find both mifepristone and misoprostol
online. The website Plan C pills (plancpills.org) has information on the ways
Americans have been able to abtain packs containing both pill,in order to safely
and effectively manage their own abortions. Both options e safe and effective—
mifepristone and misoprostol together have an efficacy rate of over 95%, while
misoprostol alone works 85% of the time. Additionally over the past year, new
legal resources have been made available to people self-managing their abortion.
1f you have legal questions or need support, you can now contact 1fWhen/How's
Repro Legal Help Line at 844-868-2812 or through a secure form at htps://
wwweprolegalhelpline org/contact-the-helpline.]
You will need 12 tablets of misoprostol at 200 micrograms each. There are three
ways you can get them:

Inperson

In addition to helping people manage abortions at home, misoprostol is used to.
treat stomach ulrs in people with arthritis, s0 it's kept behind the counter at
most US pharmacies. In many Latin American couniries, s well as in some border
communities in the United States, you can get it over the counter under the brand.
name Cytotec. People who have purchased misoprostol without a prescription in
the United States have used the following strategies:

» Location is everything: People report having an easier time buying
misoprostol at local pharmacy than at a chain like CVS or Rite Aid.

» What amighty good man: People have found that pharmacists are less
likely to suspect men of using pill to induce sbortion, and are more
likely to give them pills.

» Excuses, excuses: People have successfully acaquired pill by telling the
pharmacist their grandparent with rheumatoid arthriis is visiting
and forgot their pills at home.

Through avet

Misoprostol i also used to treat stomach ulcers in dogs. Ifyou have a reationship.
with a local, friendly vet, you might be able to work it to your advantage!

Online

‘Though many online pharmacies require a prescription, with some searching, you
might be able to find either an internet vet supply store or a Canadian pharmacy
(for humans!) that sells misoprostol without a script.

1f these methods dorit work, you aren't out of luck. Many people have safely and
succesfully purchased abortion pills online at dedicated websites. A 2017 study
of abortion pills bought on the internet found that the pills from all 18 sites
studied contained the labeled active ingredients at more or less the written dose.
The website Plan C (plancpill.org) has the results of the study, s well 2 a report
cad for each site based on price, shipping time, and product quality:

PREPARE YOURSELF

Having a medical sbortion can be very physically unpleasant (think: bad flu), so
plan on being out of commission for a full day. You can eat and drink normally,
but alcohol or drugs are 2 no no—you want to be able to pay full attention to your
body. The chances of something going wrong are extremely low but just in case,
it’s good to be within an hour of a hospital (make that half an hour if you have
anemia)
Justlike building TKEA furniture, managing your abortion is easier and safer with
a friend. Make sure this friend is someone you trust to be discreet, to help protect
you from legal risk.

TAKE THE PILLS CORRECTLY

Many reputable websites, including Women on Web, Women on Waves,
‘Women Help Women, and the Intenational Women's Health Coalition, provide
instructions based on World Health Organization protocols on how to use
misoprostol for safe abortion before 10 weeks of pregnancy. This is 2 summary of
those instructions:

Put the first four tablets under your tongue and let them dissolve for 30 minutes.
You can swallow your saliva, but don't swallow the tablets until at least 30 minutes.
have passed. At that point, you can swallow what remains of the tablets.

After three hours, epeat with the next four tablets, making sure to dissolve them
for 30 minutes under your tongue instead of swallowing Three hours after that,
repeat with the final four tablets.

(In the unlikely case that you purchased a pill with the brand name Arthrotec or
Oxaprost, the misoprostol will be coating a painkille. If that's the case, spit out
the pills after 30 minutes.)

DON'T swallow all the pils together. Nausea is a common side effect, and you
dont want to puke them up.

DON'T put the pillin your vagina. Iftaken under the tongue as directed, doctor
worit be able to tellf you've induced an abortion or had a ‘natural” miscariage. If
you put the pills in your vagina,a doctor can find the residue.

HAVE AN ABORTION!

This part probably won't be fun! You'll know your abortion has begun when you
start to cramp and bleed, which can happen anywhere from 30 minutes to several
hours after you take the first pill. To avoid infection, use pads for the bleeding,
and not tampons or a cup. Some unpleasant sde effects of misoprostol can include
dizziness, nausea, vomiting, iarrhea, and headaches, as well a fever and chills. You
can take ibuprofen and anti-nausea medications as needed—they won't interact
‘poorly with misoprostol. Try to hydrate, and eat if you're up for i

A WHAT TO DO IF SOMETHING GOES WRONG A

Fewer than 3% of people self-managing an abortion with pills require medical
attention. Women on Waves, Safe2Choose, and Women Help Women recommend
immediately seeking medical care if a person has any of the following symptoms:

» Bleeding through two or more maxi pads per hour for more than two hours
(this means that the pads are completely soaked through, front to back and
side to sde). This occursin less than 19 of cases.

» A fever above 100°F for more than 24 hours, or a fever sbove 102°F for any
amount of time. This could be 2 sign of infection, and it’s usully treated with
antibiorics.

» Intense abdominal pain that lasts for more than a few hours.

The good newsis, ifyou've followed theinstructions, there’ no medical wayforadoctor
1o tell whether you've taken pills toinduce abortion o if you're having a miscarriage The
only way a doctor will know is if you or your friend share the information, which
youbsolutely do not have to do. The symptoms, complications, and treatment will
be exactly the same as f you were miscarrying.

AFTER YOUR ABORTION

Dot put anything in your vagina for five days after your abortion—that means
o tampons, sex toys, fingers, or penises. You should also avoid intense physical
activity. You can expect to bleed s though you're having your period for anywhere
between a few days to a few weeks afier you take the pill. After four weeks, take
a pregnancy test to make sure the abortion was complete (carlier than four weeks,
and you may geta false positiv).

Ifit comes back positive: There are a couple of things that could be happening here.
For one, you could still be pregnant (this is more likely if you didn't experience
cramping or significant bleeding when you took the pills).

1¢s aso possible there is remaining tissue in your uterus, or that your pregnancy
implanted outside of the uterus (this is known as an cctopic pregnancy). Doctors
have safe and established protocols for dealing with these issues (remember: you
dont have to tell them you self-induced abortion), but both can cause serious
complications if left alone.

1f it comes back negaive: Congratulations! You have given yourself an abortion.
You might not be in the mood to get busy right away; but if you are,use condoms
or another form of birth control—you can get pregnant immediately after an
abortion.

RESOURCES AND MORE INFORMATION

Legal:Ifyou have questions about your legal rights in your state, or if you'e arrested.
or questioned by the police, you can message 1§When/How' legal helpline on
Signal at 707-827-9528, or contact them via phone, email, or online form. You can
also contact National Advocates for Pregnant Women, which provides free legal
representation to people charged with crimes in relationship to their pregnancies

Speating with a doctor or counselor: 1f you liv in the United States, you can email
with a doctor while you are self-managing an abortion at Aid Access,or you can
chat with a trained counselor and advocate by emailing info@safe2choose.org.
You can also read more, or gt in touch with counselors,via Women Help Women.
1f abortion i illegal where you live, you can speak with a counselor at Women on
‘Web, who il help you access pills and answer questions about your abortion.
Each of these websites also includes instructions and QScA for self-administering
an abortion with pills

Aduocacy: Tf you want to get involved in the campaign to destigmatize and spread
avwareness of self-managed abortion in the United States, you can connect with
Reproaction, a eproductive justice direct action group.
For the latest version of this
article scan the QR code or go to:
hetps://jewisheurrents.org/how-
to-give-yourself-an-abortion/

DISCLAIMER

The decision to end a pregnancy is a personal one; this article does not
intend 1o influence or encourage any persons decision. 1 am neither a
lawyer nor a medical professional, and this guide should not be a substitute
for medical or legal advice. The information below has been compiled
from a variety of source, including the World Health Organization,
Women on Web, Women Help Women, Safe2Choose, the International
Women's Health Coaltion, and Robin Martys Handbook for a Post-
Roe America. Individuals who are considering self-managing abortion
should refer directly to these resources for medical or legal guidance.