Self-Managed Abortions Soar Post-Dobbs

Requests for abortion pills increased 33 percent in the 30 most restrictive states after the decision to overturn Roe v. Wade came down.

Melissa Grant, chief operating officer of Carafem, holds up pills used for abortion on July 1, 2022. The FDA has approved a regimen of one mifepristone pill and four misoprostol pills through 10 weeks of pregnancy. (Amanda Andrade-Rhoades / For The Washington Post via Getty Images)

New research is showing the impact of Supreme Court decision in June overturning constitutional abortion rights and allowing abortion bans to take effect in many states.

Reported abortion in states with restricted access dropped 32 percent between April and August 2022, according to recent study from the Society of Family Planning—while reported abortion in states with protected access increased by 11 percent.

Reported abortions dropped 6 percent overall, with over 10,000 fewer reported abortions reported in July and August.

However, another recent study shows requests for self-managed abortion through Austria-based telemedicine abortion provider Aid Access increased 33 percent in the 30 most restrictive states from before the leaked Supreme Court opinion on May 2 and after the decision came down on June 24.

Before the Supreme Court’s abortion decision leaked on May 2, requests averaged around 83 a day. After the leak, that number jumped to 137. Since the court decision on June 24, the daily average has increased to nearly 214. Over July and August, that’s 13,268 requests. Most are filled.

Together these studies indicate that many people living in restrictive states are accessing abortion by traveling to states where abortion is legal or self-managing their abortions by ordering abortion pills online from outside of the country.

“Abortion pills are safe, effective, and awesome,” said Erin Matson, executive director of Reproaction. “No matter what happens to laws, abortion pills aren’t going anywhere—and information about how they work belongs to everyone.”

Dutch physician Rebecca Gomperts founded Aid Access in 2018 to provide telemedicine abortion to people in all 50 states. At the time, telemedicine abortion was not available from U.S.-based providers because of restrictive policies of the U.S. Food and Drug Administration (FDA)—restrictions that have since been lifted. In the 30 states that still ban telemedicine abortion, Aid Access provides this service from outside of the United States for a sliding scale fee up to $105.

Rebecca Gomperts lands a ship in Valencia, Spain, as part of Women on Waves, which brought reproductive health services to women in countries with restrictive abortion laws. Gomperts founded Aid Access in in 2018, which ships abortion pills from abroad. (Courtesy of Vessel press kit)

“We know that self-managed abortion is highly safe and effective, and a method of choice for people who prefer or need the privacy and comfort of their own home for their abortions,” said Matson. “This data backs that up even more, and strengthens our resolve to fight against barriers to accessing self-managed abortion with pills—including unnecessary medical restrictions, abortion stigma, and the risk of criminalization.”

Twelve states now have total bans on abortion in effect; one has a six week ban in effect and two more have 15-week bans. Another 15 states have highly restricted access to abortion, including bans on telemedicine abortion. Despite these restrictions, many people are nevertheless finding ways to safely self-manage their abortions outside of the formal U.S. medical system. Guttmacher Institute estimates that over half of states will eventually ban abortion.

While the largest increase in requests to Aid Access came from states with restricted access to abortion, every state had increased requests for abortion pills during the post-leak and post-decision periods.

  • In states with total abortion bans, 31.4 percent of respondents cited “current abortion restrictions” as a reason for their request pre-decision, versus 62.4 percent after the decision.
  • In states with no current restrictions, 12.5 percent of respondents cited “possible future legal restrictions” versus 35.5 percent post-decision in states with no current restrictions on abortion. 

“The increases indicate that while abortion bans create access barriers that lead to more people self-managing their abortions, self-managed abortion is also a method of choice for some,” said lead researcher Dr. Abigail R.A. Aiken, assistant professor at the University of Texas Austin’s LBJ School of Public Affairs.

“The increase in the visibility created by the Dobbs decision means that more people are aware of self-managed abortion as an option,” said Aiken. “However, interest in self-managed abortion is not new. It has existed for centuries, and now self-managed abortion with pills is backed up by studies proving its safety and effectiveness.” 

In a study released last winter, Aiken found a spike in requests for self-managed abortion through Aid Access after Texas banned abortion at six weeks in September of 2021. During the first week after the ban, the average daily requests in Texas increased by 1,180 percent over baseline—from 10.8 to 137.7 per day. 

One of Aiken’s studies released last winter found that 96.4 percent of those who used abortion medications purchased from Aid Access reported successfully ending their pregnancy without surgical intervention.

“It’s so encouraging to see this research validate what we’ve known would happen. When given the option, people want the ability to manage their abortion on their own terms,” said Kimberly Inez McGuire, executive director of URGE: Unite for Reproductive & Gender Equity. “As we continue to navigate the national crisis of abortion bans, more people are seeking to self-manage their abortion with pills. They know where and how to get the medication, and they’re choosing it because it provides control over their reproductive lives.”

Many advocates are offering resources to assist people self-managing abortion. The organization Plan C has a comprehensive guide to finding abortion pills on their website at Detailed instructions for how to take abortion pills are available in 27 languages at

The Miscarriage and Abortion Hotline has clinicians available to help people with questions about how to self-manage an abortion and SASS (Self-Managed Abortion; Safe and Supported) has a secure online chat portal to speak with skilled counselors.

“At a time where anti-abortion lawmakers are banning and restricting access to abortion at every turn, we are grateful for the providers and organizations who are doing everything they can to give the greatest number of people access to abortion medication,” said Andrea Miller, president of the National Institute for Reproductive Health. “Everyone should be able to access abortion on their own terms and in their own community, full stop. Especially as abortion bans disproportionately harm already marginalized communities, we need all hands on deck in this incredibly difficult moment.”

But advocates expressed concern about the risk of criminalization for people self-managing abortion.

“While self-managed abortion has revolutionary potential, we cannot ignore the criminalization people may face when using this option,” said Inez McGuire. “We cannot ignore the barriers to access—not everyone has resources to buy pills, or a safe place to end their pregnancy. We cannot ignore the need for clinics in our communities AND pills in our hands. That’s why, as a leader with the Abortion On Our Own Terms campaign, I’m committed to raising awareness, destigmatizing, and decriminalizing self-managed abortion, for a truly liberated future.”

The Repro Legal Helpline provides free and confidential legal advice that can help people better understand the laws and legal risk they may face. 

“Anyone who decides to end a pregnancy should be able to choose to self-manage an abortion somewhere we feel safe—with the control in our hands, surrounded by the people we love and with the support we want,” said Renee Bracey Sherman, founder and executive director of We Testify. “The ability to decide if, when and how to start or grow our families is a basic human right. Self-managed abortion is a safe and necessary option that must remain accessible without shame or judgment.”

Up next:

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Carrie N. Baker, J.D., Ph.D., is the Sylvia Dlugasch Bauman professor of American Studies and the chair of the Program for the Study of Women and Gender at Smith College. She is a contributing editor at Ms. magazine. You can contact Dr. Baker at or follow her on Twitter @CarrieNBaker.