Self-induced abortion

A self-induced abortion is an abortion performed outside the recognized medical system. Although the term can include abortions induced through legal, over-the-counter medication, it also refers to efforts to terminate a pregnancy through more dangerous means. Such practices are illegal in most jurisdictions - even where abortion itself is legal - and may present a grave threat to the life of a woman. Self-induced abortions are usually performed when circumstances (legal constraints, cost, concerns about secrecy) prohibit women from seeking safer procedures. Presently they are more common in developing countries where abortion is illegal, but have occurred in developed countries as well.

Methods
There are a number of anecdotally recorded and disseminated methods of performing a self-induced abortion. These may include:
 * physical exertion designed to bring about a miscarriage
 * abdominal massage
 * receiving blows to the abdominal area
 * attempted removal of the fetus with a coat-hanger or similar device inserted into the uterus through the cervix
 * attempted piercing of the fetus with a knitting needle or similar device inserted into the uterus through the cervix
 * self-induced suction through the insertion of a rubber tube into the uterus via the cervix
 * ingesting abortifacients, high quantities of vitamin C, or other substances believed to induce miscarriage
 * douching with substances believed to induce miscarriage (beginning in the 1960s, many women used Coca Cola for this purpose, although its utility is at least dubious)

Many of the above named methods present significant dangers to the life or health of the woman. In particular, attempts to insert hazardous objects into the uterus can cause punctures leading to septicemia. Ingesting or douching with harmful substances can have poisonous results. Receiving blows to the abdomen, whether self inflicted or at the hands of another, can damage organs. Furthermore, the less dangerous methods - physical exertion, abdominal massage, and ingestion of relatively harmless substances thought to induce miscarriage - are less effective, and may result in the fetus developing birth defects. However, abdominal massage abortion is traditionally practised in Myanmar, Thailand, Malaysia, the Philippines, and Indonesia.

The cheap prescription blood pressure drug Misoprostol is often used as an abortifacient in self-induced abortion in Latin American countries where legal abortions are unavailable, and its use has also been observed in immigrant populations in New York. Although proponents of this method deem it to be safer than those using insertion of objects or chemicals into the uterus, they also note that failure to effect an abortion by this method can lead to the child being born with serious birth defects.Furthermore, the drug causes a drastic drop in blood pressure, and women may haemmorhage as a result of misusing the drug for the purpose of abortion.

Current medical procedures are significantly safer than traditional at-home methods. In 1979, Bernard Nathanson, MD, an "abortion expert and an obstetrician-gynecologist who once presided over the largest abortion clinic in the world," wrote in his book Aborting America:


 * "The practice of abortion was revolutionized at virtually the same moment that the laws were revolutionized, through the widespread introduction of suction curettage in 1970. ... Even without a suction machine, a simple combination of catheter and syringe can produce enough suction to carry out a safe early abortion. As for the self-induced abortion, by thrusting a coat hanger or other dangerous object into the womb, this will also be a thing of the past."

In the United States
The practice of self-induced abortion by various means has long been recorded in the United States. Turn-of-the-20th-century birth control advocate Margaret Sanger wrote in her autobiography of a 1912 incident in which she was summoned to treat a woman who had nearly died from such an attempt.

A study concluded in 1968 determined that over 1.2 million illegal abortions were performed every year in the United States, a portion of which were performed by women acting alone. The study suggested that the number of women dying as a result of self-induced abortions exceeded those resulting from abortions performed by another person. Due to estimated underreporting of illegal procedures, these numbers may not be accurate. A 1979 study noted that many women who required hospitalization following self-induced abortion attempts were admitted under the pretext of having had a spontaneous abortion.

Although Roe v. Wade, 410 U.S. 113 (1973), made abortion more readily available throughout the U.S., it remains a crime in most jurisdictions for a woman to attempt to perform an abortion on herself. In May of 2005, Gabriela Flores - a Mexican immigrant living in South Carolina - was charged under such a statute, which carried a maximum penalty of two years in prison. She had induced abortion by ingesting misoprostol, an ulcer medication with abortifacient potential. Mississippi classifies self-induced abortions as deaths which affect the public interest, requiring that physicians report them to the local medical examiner. By contrast, New Mexico's "Unborn Victims of Violence Act" exempts self-induced abortion from the criminal liability the act creates.