Since Roe v. Wade fell, nearly half of states in the U.S. have implemented near-total bans or severe restrictions on abortion care. Getting an abortion was never easy, even when Roe was the law of the land, but now it’s a logistical and financial nightmare — putting care out of reach for most people, especially poor people, folks of color and women who live in rural areas.
But there’s a quiet revolution happening in the homes of American women and pregnant people across the country. People are taking matters into their own hands and ending unwanted pregnancies at home outside of a formal health care setting. And unlike the dangers of pre-Roe back-alley abortions, managing your own care with abortion pills is extremely safe and effective for anyone less than 13 weeks pregnant, according to the World Health Organization.
“People can self-manage their abortions, they can do their own abortions, and it is safe. But we have to talk about it,” Renee Bracey Sherman, founder and executive director of abortion storytelling organization We Testify, told HuffPost. “People have to be able to see people who have been there and done it so that they know they can do it, too.”
People can self-manage their abortions ... and it is safe. But we have to talk about it.Renee Bracey Sherman, We Testify
More and more people are ending unwanted pregnancies at home with abortion pills — the combination of two FDA-approved drugs called mifepristone and misoprostol or misoprostol alone. Access to abortion pills has expanded rapidly since the pandemic because of the rise of online pharmacies in the U.S. and international websites that ship abortion pills to your home. Women who choose to self-manage abortions outside of a health care setting can access resources like the Miscarriage and Abortion Hotline for medical support or the Repro Legal Helpline for legal advice.
Despite the fact that self-managed abortion is only illegal in Nevada, the threat of criminalization for managing your own care is real. Dozens of women have been arrested, prosecuted and jailed for managing their own care — often because a rogue prosecutor in a deeply conservative area misapplies laws to further his own anti-choice agenda.
“Before Roe, we had activists and folks like The Janes or Pat Maginnis or midwives and doulas, Black abortion providers in communities who provided safe abortions. That was because they spread the information to everyone in their communities to say, ‘This is actually OK,’” Bracey Sherman said. “We see talking about self-managed abortion in that same legacy.”
“Nineteen-year-old me would have loved to have known that there were pills I could have gotten to do my abortion at home,” she added. “Those of us who have been through it are trying to impart our abortion wisdom on people who are trying to get abortions right now.”
HuffPost spoke with four We Testify storytellers who recently managed their abortions from the comfort of their own homes. These are their stories, edited and condensed, below.
"We had prepped everything beforehand, so I had my meals here. I had different soups, different snacks to eat, food with protein in them, and I made sure I had food that also had iron."
The College Student With Three Jobs Who Couldn’t Fly Home To Kentucky
Kaniya (she/her) self-managed her abortion in 2023 in Maryland. She was between four and five weeks pregnant and used the mifepristone/misoprostol abortion pill method.
I decided to self-manage when I was looking for appointments at different clinics in the DMV [District of Columbia, Maryland, Virginia area]. A lot of the appointments were a month out and there were a lot of barriers to clinic care. I just wanted to have something where I could do the process on my own time, something that was convenient for me, something that didn’t involve too many people and not going to a place where I might have to interact with protesters. That’s why I decided to self-manage.
When I first found out that I was pregnant, I was actually going through finals. It was right before I finished out the school year. I have three jobs, so I remember going to work still and trying to hide my pregnancy. I also take summer classes. It was just a lot to deal with while working and me not being able to find an appointment; it was a very stressful situation.
I knew I was going to self-manage in Maryland. That’s why I didn’t tell my family back in Kentucky until after the process because I knew that they would want me to come home. Going back to Kentucky was really not an option. There were a few times I thought it would be easier having my family surrounding and supporting me through this process. But then I would be in Kentucky ― and that’s a very different situation compared to being in Maryland. [Kentucky has a near-total abortion ban in effect, although self-managed abortion is not a crime in the state.] I knew I felt more comfortable doing it in my apartment and not having to fly back home.
The first day [after taking mifepristone] was just a regular day; I was even able to go to the grocery store and come back home and relax and watch TV. The next day when I took the miso, it was a completely different day. I wasn’t so relaxed. I remember right after I took them I was laying in bed and I was like, ‘Well, maybe, if I can fall asleep I won’t feel as much of the cramping and everything.’ But I couldn’t get to sleep without having to run to the bathroom. I would come back to my room and lay down and be like, ‘OK this might be the worst few hours of my life.’ But I was in bed, eating soup, and we had prepped everything beforehand, so I had my meals here. I had different soups, different snacks to eat, food with protein in them, and I made sure I had food that also had iron. I had Gatorade and water and hot tea and my heating pad, and I was just checking my temperature every hour to make sure everything was good with that.
After I expelled the pregnancy, I remember having to lie down right after because I was really lightheaded and nauseous. I had to eat something with protein right then and there.
I know everyone’s experiences are different, but for me, it was very emotional. Just knowing that it was all over and everything I had to go through. I didn’t have any regrets about the abortion, but the situation was so hard. I chose, for my own mental health, to try to make it as easy as possible with as little amount of people knowing. That was the best thing for me to do in the moment. For me, I wanted to handle it the way I wanted to handle it. I knew that it was my body and no one else could tell me how to handle it.
There are some people who have this misconception that self-managing isn’t safe. But this is a very safe thing that a lot of us do, and some people don’t understand that. A lot of times you’ve met someone who’s had an abortion, a lot of times you love someone who’s had an abortion ― you just might not be aware of their situation. Everyone’s situation is different. But at the end of the day, we are still people, and our decisions are our decisions to make. I just really love and support people that have gone through the same things that I have, because sometimes it’s not easy depending on your story. I just want people to know that.
"When my kids were asleep, I sat down on the couch and I remember looking out the window, and it was sunny outside. I just realized, ‘Wow, I was blessed to have this opportunity to discontinue a pregnancy that I didn’t want to continue.’"
The Mother Who Had To Take Care Of Her Kids
Angel (she/her) self-managed her abortion in 2023 in Texas. She was between four and six weeks pregnant and used the mifepristone/misoprostol abortion pill method.
When people ask about my experience self-managing, I always tell them it’s just convenient. You can do it at home, on your own time ― not between clinic hours or having to travel. Also the privacy of being able to do so in my own home and not having to deal with protesters outside of a clinic or anyone knowing or talking about it. It was very private. It was even better being at home, somewhere you’re comfortable.
I already travel a lot as it is, so I can’t really make time to go to a clinic. I’ve had other abortions; one in-clinic abortion and I’ve self-managed once before.
I think I just have a high pain tolerance so I never had any discomfort or pain. I was still able to continue to do everything ― running around with my kids, cooking dinner, taking the kids to school. I was able to still do my daily routine. It didn’t stop me from doing anything. I have heard people say that they cramp, they get period cramps. But I personally have never experienced any pain.
In a moment when my kids were asleep, I sat down on the couch and I remember looking out the window, and it was sunny outside. I just realized, ‘Wow, I was blessed to have this opportunity to discontinue a pregnancy that I didn’t want to continue.’ A lot of people don’t have this option or don’t have access to this, and even in the states where it is legal, a lot of people still can’t access it. I guess in that moment I was really just shocked that I was blessed to be in that position ― to make a decision for myself that I felt would better myself.
I wasn’t [worried about being criminalized] because I didn’t tell anyone that I was pregnant. [At the time Angel self-managed her abortion, Texas was enforcing a six-week bounty hunter abortion ban and an additional near-total abortion ban.] At the same time, after the law was passed, I lived with that fear for a while. Everyone already knows I do abortion storytelling and how I feel so strongly about it, so that’s another reason I was scared. It was a fear at first, but I just learned to keep things private, and no one knew but me and the person I was able to get the pills from in my community.
Me, personally, I’m just the type of person, like, I don’t care ― no one’s gonna tell me that I’m gonna go through with a pregnancy that I do not want. And I feel like that’s how everyone is at the end of the day, whether there’s a law in effect or not. A law is not gonna stop a person who really wants to end a pregnancy.
"I have no idea what it would look like if I had to actually leave my quarantine and go to a clinic to have my abortion. At that time, everything was so uncertain and so unsafe to be outside."
The New Yorker Stuck In Her Apartment During The Start Of COVID
Isabella (she/her) self-managed her abortion in 2020 in New York, just as the COVID pandemic hit the Northeast. She was between nine and 10 weeks pregnant and used the mifepristone/misoprostol abortion pill method.
When I self-managed my abortion, I actually already had the pills because I had ordered them in advance as a precaution. I knew a lot about how to take it at home, and I found out I was pregnant right when COVID first hit New York. So I was just avoiding most hospital or medical settings ― outside settings in general. It was right before spring break, and we didn’t have classes the week before and the week of spring break. And I couldn’t leave home because of COVID. So I was already going to be at home, and I had a lot of free time to do it.
I eventually had to go home, back to Brazil, for a lot of the pandemic. It was very interesting thinking how I could actually access abortion here [in New York] because in Brazil, it’s not reality. It’s illegal in Brazil.
Because of how stressful the whole situation was at the time — with COVID and people were still figuring out what was going to happen to visas and what was going to happen with school ― I was already so stressed out that I was having a lot of headaches. Taking the mifepristone did not help much because I felt like everything I was already feeling just became more pronounced.
The second day, the cramps were very strong, but I’m used to it because of my endometriosis. What was different is that usually, for me, when I have such strong cramps, they would come in intervals, they would be very acute pains and last for short time periods. Because of the misoprostol, I had very strong cramps for a couple of hours. I already knew a lot about which of my endometriosis medications I could or could not take for the cramps because I have some that are for very strong cramps but actually reduce bleeding and I have some that help with cramps but they’re an anticoagulant, so they’re gonna make you bleed more.
I was watching a TV series with my partner back then; I had a heating pad. It was a lot of pain, but it wasn’t something that I couldn’t manage. It never became an emergency or something that I couldn’t handle.
I did have post-complications because of my PCOS and endometriosis. I had to go in for a follow-up appointment when I was back in Brazil to remove the contents of the pregnancy surgically. Going into the surgery, I knew I couldn’t actually say everything ― I didn’t say, ‘Oh, I self-managed this abortion.’ I went to the doctor here in New York, we figured out that I still had to remove some of the content, but because of how quick things happened [during COVID], I went back to Brazil. I couldn’t say there, like, ‘Oh, I had an abortion and I need to finish it’ because the process as a whole is criminalized there. So I had to act like I had no idea, more like, ‘Oh, I’m having these cramps’ and they would just assume that it was a miscarriage from a pregnancy I didn’t know about.
In my case, I have no idea what it would look like if I had to actually leave my quarantine and go to a clinic to have my abortion. At that time, everything was so uncertain and so unsafe to be outside. It was so nice to be able to do it at home where, considering everything that was going on, I felt safe. It was really nice to be able to be home, watching [a TV] series and being in more control of what was happening.
"When I self-managed, I had access to the pills, so it wasn’t a strain financially. My care didn’t feel like it was in somebody else’s hands. I knew that I had control over what I wanted to happen and I had no stress about it at all."
The Texas Native Whose Past Abortions Financially Drained Her
Bex (she/they) self-managed their abortion in 2023 in Colorado. She was between four and five weeks pregnant and used the mifepristone/misoprostol abortion pill method.
I self-managed my abortion in the spring. It was the fourth abortion that I’ve had. I’ve had surgical abortions in clinics before. This time around, I decided to self-manage because I feel pretty uncomfortable in medical spaces in general. Normally when I’m at doctor’s offices I feel a little nervous and out of place, and that is how I felt in the clinics that I went to in the past. Even though they were really nice, I was just uncomfortable.
The weekend was coming up and I was like, ‘I don’t want this to be in the back of my head the whole weekend.’ So, I took a pregnancy test the day before my period [was supposed to start] and it was positive, so I ended up taking the pills four-and-some-change weeks pregnant, which I knew had the possibility of not working as well, since there are some opinions that it doesn’t work as well pre-five weeks. But I gave it a shot.
I was super prepared to be on the couch, and then it ended up being so anticlimactic because I was early. Things were able to go extremely smoothly because I had access to pills, had access to pregnancy tests, already had heat patches and pads at my house. Everything was already in place. I was super prepared, but then I ended up feeling fine. I was running errands. I worked one day. Just because my bleeding wasn’t heavy; I’m sure if I was farther along it would have been different. But, honestly, I continued my life as normal.
I did call the M+A [Miscarriage + Abortion] hotline when I was self-managing. I was trying to decide whether or not I needed to take a second dose of miso. Even though I know a lot about it, it was super nice to just talk to someone about, like, ‘Have I bled enough? Do I think I bled enough? Is there any harm in taking more miso? Not really.’ Stuff like that. It was nice to have someone to call.
Before, whenever I had surgical abortions, I lived in a rural area of Texas, and the wait times were really long to access clinical abortions. Each time, I had to wait two or three weeks for an appointment, and I lived about two hours from the clinic. So I had to go there twice because there were mandatory waiting periods. I was in college, so it was a huge strain on me, logistically and financially. I knew that experiencing unwanted pregnancy was stressful for me, in the past, and I think a lot of it was having to access it when it was really hard. I didn’t have the money, I ended up having to take out a loan for my surgical abortions. Things like that made it just a huge strain and felt like a big life event.
When I self-managed, I had access to the pills, so it wasn’t a strain financially. My care didn’t feel like it was in somebody else’s hands. I knew that I had control over what I wanted to happen and I had no stress about it at all. I told my partner about it, and they were like, ‘Sounds good.’ That was it. There was no stress about when my appointment is or how far out in advance these clinics are booked up or anything like that. I didn’t realize what the source of my stress was prior because each time, I knew that I didn’t want to continue the pregnancy, but this time it was completely stress-free, and that really surprised me.
I want people to know that there is a way to access abortion in the first trimester that’s safe and effective without them having to move their life around and travel across the country and find child care and ask off from work — all of these crazy logistical barriers that people are having to face in order to access care. I wish that they knew that this was an option. I think if a lot of people knew it was an option, then they would consider it.
If you or anyone you know needs assistance self-managing a miscarriage or abortion, please call the Miscarriage + Abortion Hotline at (833) 246-2632 for confidential medical support or the Repro Legal Helpline at (844) 868-2812 for confidential legal information and advice.
CORRECTION: An earlier version of this article misstated that self-managed abortion was illegal in South Carolina, but the recent six-week abortion ban implemented in the state actually repealed the statute that criminalized self-managed abortions.