Abortion in the Archive

By Alex McKinley


Special Issues: Attempting to comprehensively feature information about healing is challenging. All matters of health are important and shaped by societal factors (such as racism, sexism, colonialism, ableism, etc.); and some more than others. The Archive of Healing™ will occasionally feature essays, available in the main menu as such, that discuss these matters relevant to healing and wellness which deserve particular attention.


One of the Archive of Healing’s central goals is to democratize the knowledge and practice of healing. Because the realm of reproductive health is so stigmatized and often inaccessible, one crucial step toward health justice is sharing the long-clandestine knowledge of abortion and birth control. Also, we hope to contextualize the presence of reproductive care methods in the Archive of Healing™. To those ends, we have outlined some common methods of controlling one’s own reproduction in order to:

  1. avoid misinformation and harmful methods of reproductive care
  2. elaborate on abortion and contraception methods within the Archive, and
  3. present individuals with as many options as possible to suit individual needs. 

Because many individuals and communities face multiple structural barriers to accessing abortion services, we focus on how low-income, BIPOC, queer, and otherwise marginalized individuals can access safe abortions.

The following information is mostly based on laws and organizations within the U.S. International users are encouraged to share their knowledge and practice of reproductive care in their communities by commenting on search results or submitting new approaches (as those features become available).

 

The Archive of Healing™ does not endorse or advocate for individuals to utilize any of the following healthcare practices. The following information is intended for educational purposes only.

 

 


Emergency Contraception

Within five days after sex, emergency contraception (also known as “Plan B” or “the morning after pill”) will prevent a potential pregnancy by delaying the release of an egg from the uterus, preventing the fertilization or implantation of an egg. Emergency contraception is most effective within seventy-two hours of sex and will work up to 120 hours (five days) after sex. Emergency contraception is different from the “abortion pill” and therefore will not induce an abortion. Instead, emergency contraceptive pills are the most accessible method of preventing a pregnancy immediately after unprotected sex. Most emergency contraception ranges from $35 to $60 at most drugstores or online and does not require a prescription. However, if you obtain a prescription, health insurance (including Medicaid) may cover the cost of Plan B. Also, local health clinics and Planned Parenthoods often offer emergency contraception for free and on a sliding scale.

Some research suggests that over-the-counter emergency contraception, like Plan B One Step, is less effective for individuals who weigh roughly 165 pounds and above. Taking two over-the-counter pills will increase the efficiency of emergency contraception for these individuals. Doubling the dose should not cause serious side effects, but this method has not been researched thoroughly. Officially, the prescription-only emergency contraceptive Ella will be more effective. With health insurance, the cost of Ella will likely be covered. Otherwise, Ella ranges from $50-$90, but community health clinics and local Planned Parenthoods may offer Ella for free and on a sliding scale.

To find a local health center, please follow the link to Planned Parenthood.

 


Menstrual Extraction

    Menstrual extraction (A.K.A “menstrual regulation” or “aspiration”) is traditionally used to lighten and shorten an individual’s period, or to induce an early stage abortion.1 By using a thin tube inserted into the cervix to gently suction out the contents of one’s uterus, menstrual extraction can entirely remove a fertilized egg up to six weeks after fertilization. Although this procedure has slowly declined in popularity since Roe v. Wade, feminist groups around the U.S. and the world continue to train themselves to perform menstrual extraction on each other safely. Modern research on menstrual extraction is lacking, but in several countries including Bangladesh and Vietnam, “menstrual regulation” remains a common, safe, and accessible abortion method. Menstrual extraction is a difficult procedure to perform on one’s self and should only be performed by well-trained individuals, so reaching out to local doulas, feminist circles, or health clinics trained in menstrual extraction are safer options.

To find a local health center, please follow the link to Planned Parenthood or National Abortion Federation.

 


In-Clinic Abortion

For resources for having an in-clinic abortion as a minor (younger than 18 years old), and having an abortion in prison, visit Legal, Practical, Spiritual, and Emotional Support.

As of March 2020, abortion services are legal in every state in the U.S. and every state has at least one abortion clinic. However, in-clinic abortions can be entirely inaccessible without community support. The average in-clinic early medical abortion (with pills) in the U.S. costs $504, without factoring in the prices of transportation, childcare, and other related costs. Moreover, the number of clinics that perform abortions is shrinking quickly, so individuals in many states may need to travel great distances to reach a clinic that provides abortions. 

For those who face barriers to in-clinic abortion, some local and national abortion funds offer support to those who need abortions by paying for all or part of medical costs and related expenses, or by providing services such as childcare, transportation, translation, and other needs. Many abortion funds also provide safe places to stay if individuals need to travel to access an abortion.

The National Network of Abortion Funds website recommends that those who need abortions should first make an appointment at the nearest abortion clinic (even if you need to reschedule later), determine how much of the costs you can pay for, and then reach out to every local and national abortion fund that applies to you depending on your state and chosen clinic. Using multiple abortion funds will cover more of the cost and other needs than using just one.

To find a clinic that performs abortion services near you, please follow either of these links: 

U.S. and international abortion providers: National Abortion Federation 

U.S. only: Planned Parenthood 

To find an abortion fund that suits your needs, please follow the link to “Find a Fund” here: National Network of Abortion Funds 

When searching for a clinic that provides abortions, please BEWARE of fake abortion clinics (also called “crisis pregnancy centers”) that are operated by individuals and organizations opposed to abortion. These disinformation centers do NOT perform abortions, and instead attempt to coerce and manipulate individuals out of having an abortion. 

To avoid fake clinics in your area, visit: Expose Fake Clinics

 


Self-Managed Medical Abortion (DIY)

Modern self-managed abortion (SMA) means acquiring and using abortion pills without the direction of a health practitioner. SMA does not refer to dangerous “back-alley” methods of abortion popular before abortion was legalized in the U.S.

For individuals who are under twelve weeks pregnant and cannot access or do not want an in-clinic abortion, SMA is the most accessible method of safe abortion. In-clinic medication abortions use two types of pills: mifepristone and misoprostol. SMA uses the same abortion pills that clinics do, although many individuals use only misoprostol instead of the combination because misoprostol pills are much cheaper than combination packs. Using misoprostol pills alone is 85% effective on average and using mifepristone in combination with misoprostol is 96 to 98% effective.

Individuals who desire a misoprostol-only abortion purchase twelve misoprostol pills (brand name Cytotec), which are around $1.09 each, and can be purchased online, through a pet pharmacy, or from pharmacies in countries with over-the-counter misoprostol, like Mexico. Misoprostol and mifepristone combined packs are only found online, and often cost around $200.2

    Individuals who use SMA often require a trusted companion or partner for support throughout the process and in case of any emergency. SMA should not be used by individuals who have an IUD, who live more than 2 hours away from their nearest hospital, or who have serious illnesses that are worsened by blood loss.

According to WHO Safe Abortion Protocol, SMA with misoprostol requires the following steps:

  1. Place 4 misoprostol pills (200 mcg each) under the tongue and allow to dissolve for 30 minutes. Swallow the pills AFTER 30 minutes.
  2. WAIT 3 HOURS, then place 4 misoprostol pills (200 mcg each) under the tongue and allow to dissolve for 30 minutes. Swallow the pills AFTER 30 minutes.
  3. WAIT 3 HOURS, then place 4 misoprostol pills (200 mcg each) under the tongue and allow to dissolve for 30 minutes. Swallow the pills AFTER 30 minutes.

To order pills online, visit: Women on Web

DO NOT purchase pills from these websites: Fake Abortion Pills Online 

As with in-clinic abortions, side effects include cramping, menstrual bleeding, nausea, vomiting, and diarrhea. Individuals can choose to take anti-nausea medicine before SMA to avoid vomiting up the pills. Anyone who decides to use SMA must also watch for (rare) potential side effects that could indicate hemorrhaging or other complications. These include:

  • Heavy bleeding for more than 2 hours that soaks 2 pads per hour
  • A fever of 102 degrees and over
  • Severe pain that lasts for more than a few hours
  • Abnormal vaginal discharge with a strong odor

For additional information on SMA, mifepristone and misoprostol abortion, and aftercare, please visit the following links:

Self Managed Abortion, Safe and Supported (SASS)

Reproaction

Women on Waves 

Women Help Women 

Plan C

HowtoUseAbortionPill

UCSF Self-Managed Abortion

***IMPORTANT***

Managing one’s own abortion is illegal, and individuals who are discovered to have used SMA can be prosecuted under various laws, including practicing medicine without a license. For more marginalized individuals or those living in communities that are over-policed, the risk of being prosecuted for SMA is higher than for others. Those who decide to use SMA should consider carefully the consequences of telling healthcare providers and others that they have taken abortion pills since those other people could inform law enforcement. If individuals who use SMA experience side effects such as hemorrhaging that must be addressed by a healthcare provider, individuals do not have to disclose that they used abortion pills. An individual can instead say they are having a miscarriage, which is indistinguishable from a medical abortion. 

For more information on the legal considerations of using SMA in the U.S. please visit:

SASS, particularly the section, “What are the symptoms of complications?” 

For additional resources and legal support related to SMA, please visit Legal, Practical, Spiritual, and Emotional Support.

 


Herbal Abortion and Contraception

If you need an abortion outside a clinic or medical setting and for a low price, please visit Self-Managed Medical Abortion (DIY).

First, our warnings:

  1. Inserting any herbs into the vagina can cause life-threatening infections.
  2. Using essential oils of any abortifacient herbs is DEADLY. Several women have died while attempting herbal abortion with essential oils.
  3. Herb dosages are very subjective to each individual and therefore difficult to control. Abortifacient herbs are often toxic and will cause liver and kidney damage or other serious side effects if used incorrectly or in the wrong dosages. Natural does not mean safe.
  4. Herbal abortion is unpredictable and, by the most generous of estimates, probably unsuccessful upwards of 60% of the time.3 If unsuccessful, the individual who has attempted herbal abortion must have an in-clinic abortion or risk life-threatening complications.
  5. Abortifacient herbs may aggravate existing medical issues or interact dangerously with other drugs in a person’s system.
  6. Any complications from herbal abortion must be treated at a reproductive health clinic immediately. If an individual does not have access to an abortion clinic, attempting an abortion with herbs can be fatal.

Many communities have relied and still rely on herbs for abortions (or simply “birth control,” as many peoples have not distinguished between the two).4 However, because ancient women’s secrets and knowledges were not valued or allowed to be recorded, the most effective and safe naturopathic abortion methods may be lost forever. The herbs we consider abortifacients today are often the herbs that male writers knew about. While for many health conditions, herbs are safer than biomedical strategies, modern abortifacient herbs are nearly all poisonous (especially pennyroyal) in the amounts that one would need to take to induce a miscarriage of an implanted egg. 

Moreover, some “abortifacient” herbs prevent the nourishment of an embryo, while others cause miscarriage contractions. To complete an abortion, the embryo must be expelled. Using just one abortifacient herb without understanding its properties could simply create dead tissue in an individual's uterus, which will cause an infection if not removed.

The best online resource for information on herbal abortions is Sister Zeus. Unlike many online herbal abortion resources that are misleading and limited in their scope, Sister Zeus is thorough, knowledgeable, and responsible with the information she provides on herbal abortion with tea infusions. While she lists some herb dosages, she acknowledges that this information is highly subjective, and she encourages individuals to only attempt an herbal abortion at the careful guidance of an herbalist, midwife, or other healthcare specialist. However, the Archive of Healing™ encourages users to first visit our section on Self-Managed Medical Abortion (DIY).

Herbal abortion information is included on this page to help individuals make informed decisions and better understand the health risks of various methods. We are not recommending herbal abortions for pregnant people. Herbal abortion can be extremely dangerous, and anyone interested in herbal abortion is encouraged to thoroughly research this topic and its side effects, and to fully understand other abortion options before attempting any herbal abortion method.

 

A note on herbal contraception:

According to Sister Zeus, “abortifacient” herbs are most effective when used before the implantation of an egg (within seventy-two hours of sex), as a form of emergency contraception. In this form, they may also be considered “emmenagogues,” or herbs which bring on one’s period, in the Archive. Using herbs to induce one’s period is generally safer than herbal abortion as this process requires smaller doses of herbs. However, this method still cannot be considered reliable birth control.

Please visit Emergency Contraception or Menstrual Extraction if you are looking for birth control options after unprotected sex. 

Herbal contraceptive methods (spermicides, fertility reducers, and emmenagogues) within the Archive can also not be considered reliable birth control and will not protect against sexually transmitted diseases.

For information on effective contraceptive methods, follow the link to Planned Parenthood.

If you need contraceptives but cannot access them, visit Women on Web to apply for free contraceptives.

 

For more information on herbal abortion and contraception, we recommend:

Riddle, John M. Eve’s Herbs: A History of Contraception and Abortion in the West. Cambridge, 

Massachusetts: Harvard University Press, 1997.

Sage-Femme Collective. Natural Liberty: Rediscovering Self-Induced Abortion Methods. Las 

Vegas, Nevada: Sage-femme, 2008. 

Chalker, Rebecca and Carol Downer. A Woman’s Book of Choices: Abortion, Menstrual 

Extraction, RU-486. New York: Four Walls Eight Windows, 1992.

 


Legal, Practical, Spiritual, and Emotional Support

Legal Support:

These resources can serve any individuals experiencing reproductive oppression. This includes minors (under eighteen years old) in the U.S. who need an abortion, individuals involved in a pregnancy-related criminal case, individuals who need legal support regarding self-managed abortion, and individuals who are pregnant and in prison.

Practical Support:

  • National Network of Abortion Funds: Lists all abortion funds in the U.S. that will pay for your abortion and related expenses, and provide related needs
  • National Abortion Federation: Federation of abortion providers in the U.S., Mexico, Columbia, and Canada
  • Planned Parenthood: Federation of reproductive health clinics in the U.S. and abroad
  • Full Spectrum Doulas: Abortion doulas based in Seattle who provide in-person and telephone support to individuals throughout the process of having an abortion, in both medical and non-medical settings

Spiritual Support:

Emotional Support:

  • All-Options Talkline: a judgement-free talk-line for people at any stage of pregnancy, and for every outcome of pregnancy (1-888-493-0092)
  • Exhale: a judgement-free talk-line for after an abortion (866-4-Exhale) 

 

References:

  1. Chalker, Rebecca and Carol Downer. A Woman’s Book of Choices: Abortion, Menstrual Extraction, RU-486. New York: Four Walls Eight Windows, 1992.
  2. Marty, Robin. Handbook for a Post-Roe America. New York: Seven Stories Press, 2019.
  3. Sage-Femme Collective. Natural Liberty: Rediscovering Self-Induced Abortion Methods. Las Vegas, Nevada: Sage-femme, 2008. 
  4. Riddle, John M. Eve’s Herbs: A History of Contraception and Abortion in the West. Cambridge, Massachusetts: Harvard University Press, 1997.
  5. Sage-Femme Collective. Natural Liberty: Rediscovering Self-Induced Abortion Methods. Las Vegas, Nevada: Sage-femme, 2008. 

 

Some research on SMA and its safety:

Grossman D, Baum SE, D Andjelic, C Tatum, G Torres, L Fuentes, et al. “A harm-reduction 

model of abortion counseling about misoprostol use in Peru with telephone and in-person 

follow-up: A cohort study.” PLoS One 13, no. 1 (2018)

Erdman, Joanna N., Kinga Jelinska, and Susan Yanow. “Understandings of Self-Managed 

Abortion as Health Inequity, Harm Reduction and Social Change.” Reproductive Health 

Matters 26, no. 54 (2018): 13-19.

Purcell, C., S. Cameron, J. Lawton, A. Glasier, and J. Harden. “Self-Management of First 

Trimester Medical Termination of Pregnancy: A Qualitative Study of Women’s 

Experiences.” BJOG - AN INTERNATIONAL JOURNAL OF OBSTETRICS AND 

GYNAECOLOGY 124, no. 13 (Dec 2017): 2001–2008.

Aiken, Abigail R A, Irena Digol, James Trussell, and Rebecca Gomperts. “Self reported 

outcomes and adverse events after medical abortion through online telemedicine: 

population based study in the Republic of Ireland and Northern Ireland.” BMJ (2017).

 

***

 

Alex McKinley studies Gender Studies as a third-year undergraduate at UCLA. She formerly was at Smith College in The Study of Women.