Locating Autonomous Abortion Accompanied by Feminist Activists in the Spectrum of Self‐Managed Medication Abortion

Abstract

Diverse models of self-managed medication abortion exist-ranging from some interaction with medical personnel to completely autonomous abortion. In this commentary, we propose a new classification of self-managed medication abortion and describe the different modalities. We highlight autonomous abortion accompanied by feminist activists, called "acompañantes," as a communityand rights-based strategy that can be a safe alternative to clinical abortion services in clandestine as well as legal settings. To improve access, abortion needs to be decriminalized and governments must acknowledge and facilitate the diversity of safe abortion options so women may choose where, when, how, and with whom to abort.

Client-reported quality of facility-managed medication abortion compared with pharmacy-sourced self-managed abortion in Bangladesh

“…Self-managed medication abortion (SMA), where an individual terminates their pregnancy with medications without formal clinical management, has been shown to be safe and effective, has been incorporated into global care standards, and has the potential to expand abortion access and improve health outcomes 1–4. SMA exists on a continuum from minimal or no interaction with health systems, as in accompaniment models, hotlines, and independent drug shops, to some or more health system interaction, as in direct pharmacy-based care 5 6. SMA facilitated through pharmacy-sourced abortion medications occurs primarily in low- and middle-income countries (LMIC) where a person obtains medications and information directly from pharmacies or retail drug shops without a prescription, from staff who may or may not have adequate medication abortion training 7 8.…”