Thursday, August 01, 2024

An Uptick in Self-Managed Abortions in the US after Supreme Court overturned Roe v. Wade in 2022. Really!

Most likely this story is exaggerated as usual! It may qualify as junk journalism.

What is also not addressed is the use of abortion pills and how they were obtained.

As usual ideological blindness prevented to highlight one really shocking finding of this study: About 40% of self-managed abortions are done by women under age 20. According to this study that number went down in recent years.

The use of the word "uptick" is already very revealing! It appears this "uptick" might be well within the margin of error or due to the method of selection of survey participants. The participants were politically correct and ideologically  "assigned female sex at birth"! Other participant categories "non-Hispanic Black" and "non-Hispanic White".

So called "self-managed abortions" are no justification for legalizing abortion without any restrictions! Unborn human life has rights too for as long as we do not have a substitute for the uterus.

"A growing number of American women say they have tried to terminate their own pregnancies since the U.S. Supreme Court overturned Roe v. Wade in 2022—turning to self-administered medications or resorting to risky practices like drinking alcohol, ingesting herbs, or hitting themselves, reports the AP. 

A closer look: Researchers surveyed ~7,000 reproductive-age women before and after the Court’s decision and found that the number who reported trying to administer their own abortions rose from 2.4% to 3.3%, per the study published yesterday in JAMA Network Open."

From the key points and abstract:
"Key Points
Question  Did the prevalence of self-managed abortion increase following the Supreme Court’s June 2022 decision overturning federal protections on abortion?

Findings  In this cross-sectional survey study, with surveys administered to different cohorts in December 2021 and January 2022 (n = 7016) and June and July 2023 (n = 7148), the proportion of the US female population of reproductive age reporting having ever self-managed an abortion increased from 2.4% to 3.3%. The projected lifetime experience with self-managed abortion, adjusted for underreporting of abortion, was 10.1%.

Meaning  These findings suggest an increased prevalence of self-managed abortion in the US; self-managed abortion should continue to be monitored carefully as barriers to facility-based care broaden.

Abstract
Importance
With decreasing access to facility-based abortion in the US, an increase in self-managed abortion (SMA) using various methods is anticipated. To date, no studies have examined changes in SMA in the shifting policy landscape.
Objective
To estimate changes in SMA prevalence among the general US population from before to after the Supreme Court’s June 2022 decision overturning federal abortion protections.
Design, Setting, and Participants
Serial cross-sectional surveys were administered throughout the US from December 10, 2021, to January 11, 2022, and June 14 to July 7, 2023. Participants included online panel members assigned female sex at birth, ages 18 to 49 years (or ages 15-17 years if a household member), who were English- or Spanish-speaking.

Exposure  Year of the survey (2021-2022 vs 2023).

Main Outcome and Measures
Participants were asked whether they had “ever taken or done something on their own, without medical assistance, to try to end a pregnancy” and, if so, details of their experience. Changes in the weighted SMA prevalence between survey years were examined, factors associated with SMA experience were identified, and projected lifetime SMA prevalence was calculated using discrete-time event history models, accounting for abortion underreporting.

Results  Median age of the participants was 32.5 (IQR, 25-41) years in 2021-2022 (n = 7016) and 32.0 (IQR, 24-40) in 2023 (n = 7148). Across both years, approximately 14% were non-Hispanic Black, 21% were Hispanic, and 54% were non-Hispanic White. The weighted adjusted proportion that ever attempted SMA was 2.4% (95% CI, 1.9%-3.0%) in 2021-2022 and 3.4% (95% CI, 2.8%-4.0%) in 2023—an increase of 1.0% (95% CI, 0.2%-1.7%; P = .03). Projected lifetime SMA prevalence accounting for abortion underreporting was 10.7% (95% CI, 8.6%-12.8%). In adjusted analyses, SMA experience was higher among non-Hispanic Black (4.3%; 95% CI, 2.8%-5.8%) vs other racial and ethnic (2.7%; 95% CI, 2.2%-3.1%) groups (P = .04) and sexual and gender minority (5.0%; 95% CI, 3.4%-6.6%) vs heterosexual or cisgender (2.5%; 95% CI, 2.0%-2.9%) participants (P < .001).
Approximately 4 in 10 (45.3% in 2021 and 39.0% in 2023) SMA attempts occurred before age 20 years. The methods used included herbs (29.8% [2021-2022] vs 25.9% [2023]), physical methods (28.6% [2021-2022] vs 29.7% [2023]), or alcohol or other substances (17.9% [2021-2022] vs 18.6% [2023]). Few participants (7.1% [2021-2022] vs 4.7% [2023]) sought emergency care for a complication.

Conclusions and Relevance
In this serial nationally representative survey study, increased SMA was observed following the loss of federal abortion protections. The findings revealed increased SMA use among marginalized groups, most often with ineffective methods. These findings suggest the need to expand access to alternative models of safe and effective abortion care and ensure those seeking health care post-SMA do not face legal risks."

Global Health NOW: An Uptick in Self-Managed Abortions; Dispatches from Sudan’s ‘Humanitarian Desert’; and Inequities in Diabetes-Related Amputations

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