November 18, 2015 — At least 100,000 Texas women have attempted to terminate a pregnancy without medical assistance, according to a study released on Tuesday by the Texas Policy Evaluation Project, the Austin Chronicle reports (Tuma, Austin Chronicle, 11/17).
Texas in 2013 passed an omnibus antiabortion-rights law (HB 2) that prohibits abortion after 20 weeks' gestation, restricts the use of medication abortion, requires abortion clinics to meet the building standards of ambulatory surgical centers and mandates that abortion providers have admitting privileges at nearby hospitals (Women's Health Policy Report, 10/6). Last week, the Supreme Court announced it will hear a challenge to the law's admitting privileges requirement and building code regulations (Women's Health Policy Report, 11/13).
According to Planned Parenthood of Greater Texas and Whole Woman's Health, the number of abortion care facilities in Texas has dropped from 42 to 19 since HB 2 took effect (Herskovitz, Reuters, 11/17). Other TxPEP research recently found that the wait time for an abortion care appointment in some Texas metropolitan areas increased to about 20 days following HB 2's passage (Women's Health Policy Report, 10/6).
According to the Chronicle, TxPEP released the findings as part of a five-year analysis on how Texas antiabortion policies have affected women's health care. TxPEP involves researchers from Ibis Reproductive Health, the University of Alabama-Birmingham, the University of California-San Francisco and the University of Texas' Population Research Center (Austin Chronicle, 11/17).
For the most recent study, the researchers surveyed 779 Texas women between the ages of 18 and 49. The interviews were conducted in 2014 and 2015 (Somashekhar, "To Your Health," Washington Post, 11/17). The research provides the first insight into the rate of self-induced abortion among the general population, the Texas Observer reports (Garcia-Ditta, Texas Observer, 11/17).
The study found that at least 100,000 Texas women between ages 18 and 49 have tried to self-induce an abortion. However, the researchers noted that because abortion stigma can deter women from reporting on abortion surveys, the final total could include as many as 240,000 women (Austin Chronicle, 11/17). Overall, according to researchers' estimates, the rate of self-induced abortion among Texas women in that age group is between 1.7% and 4.1%.
Daniel Grossman, a professor of obstetrics and gynecology at the University of California-San Francisco, said clinic closures following HB 2 might result in an increase in self-induced abortions (Texas Observer, 11/17).
According to "To Your Health," researchers suggested another reason for the statistic could be relative ease of access to misoprostol, the FDA-approved medication used to induce abortion. Misoprostol is available only by prescription in the U.S., but it can be obtained without a prescription in Mexico ("To Your Health," Washington Post, 11/7). The Texas law's stringent provisions also apply to medication abortions.
Reasons for Attempted Self-Induced Abortion
An accompanying TxPEP brief noted that the four main reasons women gave for deciding to try to self-induce an abortion included: access barriers related to travel and affordability, closure of a local clinic, recommendation from a friend or relative to self-induce abortion, and stigma associated with abortion.
However, the researchers noted that low-income status appeared to be the primary reason women tried to self-induce an abortion. "No single one of these reasons was sufficient for a woman to consider self-induction ... while women in our study were diverse in many ways, a common thread was that poverty layered upon one or more additional obstacles left them feeling that they had no other option," the researchers wrote ("To Your Health," Washington Post, 11/17).
Methods Women Use
According to the researchers, the use of misoprostol was the most common method for self-induced abortion ("To Your Health," Washington Post, 11/17). Women also reported using herbs and homeopathic methods, as well as "getting hit or punched in the abdomen, using alcohol or illicit drugs, or taking hormonal pills," according to the study (Austin Chronicle, 11/17).
Grossman noted that while misoprostol is safe when used appropriately, it can pose risks if taken incorrectly ("To Your Health," Washington Post, 11/17). Grossman added that all of the women who reported using misoprostol on their own said they would have rather obtained abortion care in a clinical setting.
Meanwhile, Amy Hagstrom Miller, founder and CEO of Whole Woman's Health and a plaintiff in the HB 2 lawsuit, said, "I think misoprostol is a tremendous resource to us for harm reduction, or where abortion is out of reach (such as Ireland or Mexico). But in the United States, (abortion is) legal and women should be able to make a choice to go to a clinic, or make a choice, if they're interested, in another approach, and not be forced to" (Texas Observer, 11/17).
Higher Likelihood Among Latinas
The study also found that Latinas living near the Texas-Mexico border and women who faced difficulty accessing basic reproductive health care were more likely to report trying to self-induce an abortion (Austin Chronicle, 11/17).
According to the Observer, only one clinic has remained open in the Rio Grande Valley since HB 2's passage. Ana Rodriguez Defrates, Texas policy and advocacy director with the National Latina Institute for Reproductive Health, noted that about 40% of women in Texas are Latina. She added that Latinas are often disproportionately affected by statewide family planning cuts and antiabortion-rights measures.
She said, "When abortion is stigmatized, not covered by insurance and/or regulated out of existence, some women will take abortion into their own hands," adding, “No woman should feel like she has no choices" (Texas Observer, 11/17).