Abortion self induction among low income women in San Francisco, Boston, and New York: A quantitative and qualitative study
Awarded 2007
Large Research Grants
Daniel Grossman, MD
Ibis Reproductive Health

Reproductive health service providers, community-based organizations and women’s health and rights advocates in the US have become increasingly aware of the use of misoprostol to self-induce abortion outside of the clinic setting. Abortion self-induction has been reported predominantly among immigrant women, particularly those from Latin America and the Caribbean, but anecdotal reports suggest that US-born Latinas and other marginalized communities are also using misoprostol. While little research exists about this, in several recent cases serious legal charges were brought against women who self-induced their abortions. It is critical that physicians and advocates understand the factors contributing to self-medication with misoprostol in order to provide better care for this vulnerable population and to refocus attention on the growing barriers to abortion access. We propose to conduct a mixed-methods study to better understand the phenomenon of abortion self-induction in three US cities with large immigrant populations: San Francisco, Boston and New York. For the first part of the study we will administer a survey to 500 women in general reproductive health and abortion clinics in these cities (total n=1,500) in which we will measure the prevalence of attempted self-induction and the agents used, and assess knowledge about self-induction and about abortion laws and services. Logistic regression will be used to determine which background, demographic, knowledge and attitude factors correlate with misoprostol use. We will also perform in-depth interviews with 15 women reporting previous self-induction in each city (total n=45) to explore qualitatively their experiences with misoprostol, the reasons why they chose initially not to use legal abortion clinics and insights about how their reproductive health needs might be better met. The results will be used to develop policy and practice recommendations for improving women’s reproductive health services, with a focus on access to safe abortion care for low-income and immigrant women.