Recent media coverage and case reports have highlighted women's attempts to end their pregnancies by self-inducing abortions in the United States. This study explored women's motivations for attempting self-induction of abortion. We surveyed women in clinic waiting rooms in Boston, San Francisco, New York, and a city in Texas to identify women who had attempted self-induction. We conducted 30 in-depth interviews and inductively analyzed the data. Median age at time of self-induction attempt was 19 years. Between 1979 and 2008, the women used a variety of methods, including medications, malta beverage, herbs, physical manipulation and, increasingly, misoprostol. Reasons to self-induce included a desire to avoid abortion clinics, obstacles to accessing clinical services, especially due to young age and financial barriers, and a preference for self-induction. The methods used were generally readily accessible but mostly ineffective and occasionally unsafe. Of the 23 with confirmed pregnancies, three reported a successful abortion not requiring clinical care. Only one reported medical complications in the United States. Most would not self-induce again and recommended clinic-based services. Efforts should be made to inform women about and improve access to clinic-based abortion services, particularly for medical abortion, which may appeal to women who are drawn to self-induction because it is natural, non-invasive and private.

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METHODS: Overall, 192

The authors used the random response technique (RRT) to measure frequency of induced abortion in Mexico, where its practice is illegal under most circumstances. They applied RRT to a national, multistage probabilistic sample of 1,792 women ages 15 to 55. The distribution of women who reported having had an induced abortion was analyzed by sociodemographic characteristics. Bivariate and multiple logistic regression analyses were performed to identify factors associated with having had an induced abortion. Overall prevalence of induced abortion was 16.3 percent. Three factors were associated with reported induced abortion: having grown up in the city (bivariate odd ratio [OR] 2.16, multiple logistic OR 2.24), having never given birth (bivariate OR 1.60, multiple logistic OR 2.06), and having had an unwanted pregnancy (bivariate OR 2.09, multiple logistic OR 2.81). RRT produced a better estimation of induced abortion compared with other methodologies. This technique works best with urban and educated women.

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