Beyond the clinic: Motivations for seeking self-induced and alternative methods of abortion care in North America

Abstract

Objectives: Recent research finds that self-provided and non-clinical abortions are on the rise, largely due to abortion restrictions. This is a qualitative study with a geographically diverse sample to describe people’s motivations for using and providing alternative abortion outside the formal healthcare system in North America. Methods: Using community engagement and peer-to-peer sampling, we interviewed 23 people who had recently used and/or provided alternative abortion methods. We asked participants to describe specific influential and motivating factors related to seeking and providing alternative abortion care. We conducted a thematic analysis of the interview transcripts and developed a theoretical framework to organize and explain the results. Results: Participants were located across the United States and Canada. Most people who used alternative abortion methods reported a prior in-clinic abortion, and indicated that those experiences factored into their decisions to seek alternative abortion methods. The desire for privacy, control, and active participation in the process, were other key factors, as was gaining bodily knowledge. Community-based abortion providers described several constraints to accessing in-clinic abortions as reasons people sought their services, including financial, geographic, and logistic barriers. Conclusions: People use alternative abortion methods for a variety of reasons beyond a lack of access to clinical care, and community-based providers facilitate the provision of these methods. This research can help advocates understand the complex motivations driving the emerging trends of self-induced and community-based abortion care, and provide a critical perspective on these experiences. Ultimately, this study presents valuable information about why and how people use alternative abortion methods that can inform future access to safe abortion care in a variety of settings.