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How Not to Have an Abortion

Natural Liberty: Rediscovering Self-Induced Abortion Methods by Sage-Femme!
(Sage-Femme Collective)

When I was phone banking for the No on 4 campaign, we followed a script that I can still more or less recite from memory: “Prop 4 requires parental notification before a teen terminates a pregnancy, which looks good on paper, but actually puts young women in danger. Scared, pregnant teens who can’t talk to their parents may take matters into their own hands – they might seek a back-alley abortion, self-induce, or even consider suicide!” We were told to sound cheerful when we introduced ourselves, but then tone it down while we were talking about sixteen-year-olds maiming themselves. This was serious stuff.

I could recognize the gravity of the situation, but I found that I could never take it quite as seriously as I was supposed to. The idea of giving yourself an abortion was just a total mystery to me. I’d grown up relatively sheltered, and despite spending my adolescence in Orange County, had miraculously gotten to college unimpregnated (thanks, in part, to a boyfriend in a school district with more comprehensive sex ed). When I warned women that their daughters might be self-inducing or going to back alleys, the words were utter abstractions. Sure, I knew that somewhere, women were doing this, but it was impossible to picture.

Not anymore. Natural Liberty, an extensive catalog of self-induced abortion methods published by the Sage-Femme Collective, has cleared that right up. The first half of the book is an overview of the abortion process; it goes over common reasons why a woman might self-induce, what a woman can expect if she’s attempting it, pre- and post-abortion care, and signs of infection and other complications. The second half is an encyclopedia of various methods of self-induced abortion, including medical abortions, a basic surgical technique, herbal abortifacients, massage, homeopathy, yoga, acupuncture, and psychic methods. Each entry in the guide contains the chemicals that act on a woman’s body, the historical use, preparation and dosage, and a chart listing the effectiveness (four stars: highly effective; one star: don’t hold your breath), hormonal and physiological effects, and reported deaths.

Now, let’s be clear: despite the title, this book is NOT intended as an actual guide to terminating your pregnancy. With one or two exceptions – the guide recommends contacting womenonweb.org to obtain a prescription if you don’t have access to a clinic – the authors make it clear that they’re not advocating this stuff, and almost none of these methods seem really viable anyway. Every single herb has a reputed effectiveness of only one or two stars, and over half of them have caused deaths; tansy, for instance, must be simmered in water and sipped throughout the day for up to 5 days, and has been known to cause nausea, vomiting, inflammation of the stomach lining, dilated pupils, weakened and/or rapid pulse, convulsions, and coma. Yoga and acupuncture are less dangerous (and about as reliable), but acupuncture requires the assistance of a trained professional, and the yoga positions that may or may not cause miscarriage are advanced postures – not something a novice could glance at and then bust out in her living room. Any method requires pre- and post-abortion trips to a clinic to check for abnormalities, age the fetus, and confirm termination, which begs the question of why, if you have such extensive access to a reproductive health center, you’re not having the procedure done professionally. In the entire guide, the only two techniques with an effectiveness of 4 stars are menstrual extraction, in which a tube is inserted into the uterus and the contents are removed via a vacuum seal, and medical abortion. And both of those methods have killed women.

So if the overwhelming message throughout the book is don’t try this at home!, why publish it at all? The easy explanation is that, by emphasizing the risks, Sage-Femme! is protecting itself from lawsuits. Sure, that’s probably part of it. But providing access to this information makes a deeper statement about our right to bodily autonomy, especially since American cultures have a deep-seated need to keep women in the dark about what’s going on in our guts. In her memoir Recollections of My Life as a Woman, Diane di Prima describes having a nitrous oxide mask slammed onto her face as her first child is crowning, despite her demands to remain conscious during labor; her experience echos that of countless other women who have had body-altering substances forced on them without their knowledge or consent. (I myself once had to fight off twilight anesthesia when a doctor was resetting a broken finger bone.) Anti-choice rhetoric, bolstered by tactics like crisis pregnancy centers and mandatory ultrasounds, emphasize the myth that women who terminate their pregnancies are too naive to know what the word “fetus” actually means. Moralizers love to crow that if we become pregnant, it was our choice to have sex and our responsibility to accept the consequences; funny how that ownership of our bodies disappears the second we seek to understand or alter them. Even if the methods in this book are too dangerous to try, understanding how pregnancy and abortion work helps make women full participants in our reproductive health, not passive recipients of aid.

Knowledge of self-inducing techniques also raises some interesting questions about the nature of prohibitory laws. If, according to anti-choicers, eating a common plant (onion and rosemary are among the abortifacients listed in the guide) or moving in a certain way should be a crime after you’ve had sex, how can an abortion ban ever be enforced without going to ridiculous Ceauşescu-era extremes? How does this reality affect attitudes towards, say, marijuana cultivation and use? Even if you subscribe to the notion that there’s never a good reason to terminate a pregnancy, how far can you take the strict parent mentality before you must admit that prevention, not punishment, is vastly easier to implement?

The book isn’t without its problems. The language is rather dry, which is understandable since it’s essentially a medical text, but doesn’t make for the type of book you’d cuddle up with before bed. Some of the methods, especially psychic abortion, will seem exasperatingly kooky to those who don’t subscribe to alternative medicine, and the authors’ claim that legal abortion reduces crime rates (because unwanted children are more likely to grow up to be criminals) is not only dubious, but racist when you consider the racial breakdown of the US prison population.

With that said, though, I’m glad Sage-Femme! is furthering this discussion. At the very least, next time I’m warning people about the dangers of restricting access to clinical and medical abortion, I’ll have a clearer idea of what exactly I’m talking about.

And I’m sure this goes without saying, but just in case you didn’t hear me the first time – please, please, please, don’t try this at home.


35 thoughts on How Not to Have an Abortion

  1. The “abortion reduces crime” claim probably originated with the book Freakonomics, in which they correlate the advent of abortions with the reduction of crime 20ish years later, when those first aborted poor kids would have grown up. I read the book and there were no race-related implications made by its authors. You might find more information at their blog.

  2. prolifers don’t want to prevent pregnancy. nor do they want to support pregnant women or care for babies or children. if they did, they would support sex ed, birth control, and shower poor pregnant women and single mothers with gifts. they don’t.

    gluttony is a sin, as well. you don’t see these same people protesting treatment for diabetes brought on by obesity, now do you?

    prolifers just want to punish women for enjoying sex. not just having sex, but enjoying it. they seek to make babies the punishment for sex. just read their websites: if women never had sex outside of marriage, they would never need abortions or contract stds. this is ridiculous and easily disproven, but reveals their fear of empowered women demanding an orgasm.

    that’s right baby, i have a clitoris, i know how to use it, and i’m not afraid to do so.

  3. I don’t understand what’s so wrong with natural methods of doing things. Maybe someone wouldn’t want to go through a medical abortion, which can be a horrifying procedure. Don’t get me wrong, I am 110% for safe, legal abortions, but part of having a CHOICE means that we can choose (under the care of someone who knows what they’re doing) to take our bodies into our own hands and seek more natural methods. I mean, how do you think women stopped pregnancies before the medical abortion?

    Besides a smart, informed woman using one of these herbal remedies is a lot different than a scared teenager ODing on something she googled, and definitely VERY different from a backalley abortion.

    As someone whose partner is a midwife (safe femme is midwife in French, btw) and as someone who has had friends successfully treat unwanted pregnancies (in the very early stages) with an herbal remedy, I find this post quite offensive.

  4. *meant to say “sage femme is midwife in french” not “safe femme” though that’s a great little slip.

  5. Historically, the most commmon approaches to abortion were poisons. Very toxic, very fatal poisons. Fatality rates would often be 50% and always resulted in severe illnesses for the woman. A basic example is how much cyanide would it take to cause an abortion, and how much cyanide would kill a woman? This was the choice many women faced.

  6. I would be very interested to know what they said about the effectiveness of homeopathic abortificants.

  7. This is a great thing. The information should be out there. Women’s reproductive options should not be exercised only at the pleasure of legislators, parents, and doctors.

    One would hope that women who live in locales with access to safe abortion from trained doctors would go that route (perhaps after trying a particularly low-risk home-remedy) but a 15 year old girl in the middle of Montana who has access to the Amazon bookstore, but not a Planned Parenthood within a couple of hundred miles and/or reasonable, supportive parents, should not be doomed to forced birth.

    I see major parallels here to self-management of hormones for transgender persons. Yes, it might be safer and better if I had a doctor managing my hormone replacement (particularly if I had a doctor who actually had some training relating to cross-sex hormones… which exceedingly few do), but there are so many barriers, both institutional and financial to legitimate medical treatment that it’s just not an option for everyone. (I followed the WPATH standards, but was unemployed and broke by the time I could see the endocrinologist, so internet hormones is it!*)

    Women seeking abortions actually have it worse in a way, because they’re susceptible to concern-trolling from anti-choice nuts, whereas those devoted to making things hard on trans folks can’t even be bothered to muster up fake concern for the lot of us freaks.

    * It’s also better for my overall health that my HRT not appear on my doctors’ charts, because my insurance will cut me off like a brown-and-green wart if they catch wind of my transness.

  8. And Alex, at the risk of tipping off a ginormous flamewar,that WOULD be a good test case for the bullshit-o-meter.

  9. i have known women to self-induce… the only reason it seems uncommon is because of the silence surrounding it.

    all abortion methods carry a risk. for those who want to have complete control of the process, using reputable resources about herbs and other methods you can do yourself may make the most sense. it is scary to do it yourself, but plenty of women have sound reasons for not going to a clinic: their guardian would never let them, they don’t have the money, there isn’t a nearby clinic, they must keep the abortion completely private, etc.

    as long as a woman is fully informed of the risks she is taking, and has a back-up plan in case things go wrong, i see no reason to advise women not to use home methods.

  10. While I’m not saying that there isn’t are not safe herbs etc. An abortion provided in a proper clinic is one of the safest medical procedures you can have. Experimenting with herbs is dangerous. A herb powerful enough to cause an abortion is sure to have very serious side effects.

  11. Pinko,

    So long as it has a one-star “don’t hold your breath” rating, it absolutely belongs there, because people believe that shit, for whatever reason.

  12. not to join a medical doctors/naturopathy flamewar, but the fact of the matter is (a) even a spontaneous abortion, i.e. miscarriage, can be dangerous to future fertility and life itself, so inducing an abortion, even with a “natural” substance (remember, arsenic is natural) could have horrendous consequences, and (b) you could have an allergic reaction to the herb, or it could interact with an underlying condition you are unaware of, and that reaction could kill you.

    either way, attempting an abortion while not under a doctor’s care is dangerous, unnecessarily so. (it should be unnecessary, anyway.)

    in answer to my transgendered sister, i’ve done what you did, in a way. as a porphyria patient, it was easier to educate myself on porphyria than to find a doctor who knew anything about it. so, i told my doctor to prescribe me bc pills, figured out exactly how much sugar to eat (4x the recommended daily amount), etc. to treat myself. probably not as effective or smart as doing it under an experienced doctor’s care, but what can you do?

  13. “Maybe someone wouldn’t want to go through a medical abortion, which can be a horrifying procedure.”

    If you’re talking about medical (RU-486) vs. surgical…well, the drug induces a miscarriage in much the same way any of the stuff in this book would. Miscarriages tend to be varying degrees of unpleasant, no matter what caused them. There’s no way to just magic an embryo or fetus out of a uterus, fallopian tube, or abdominal cavity. And as for surgical, you frequently need D&Cs to clear out the products of conception that remain after a miscarriage to prevent infection anyway.

  14. “I don’t understand what’s so wrong with natural methods of doing things. Maybe someone wouldn’t want to go through a medical abortion, which can be a horrifying procedure.”

    Wait, what is the practical difference between a ‘natural’ abortion and a ‘medical’ one? Natural: Take herbs (which may have icky side effects and risks) to end the pregnancy and cause intense uterine contractions which result in the ejection of the products of conception. Medical: Take drugs (which may have icky side effects and risks) to end the pregnancy and cause intense uterine contractions which result in the ejection of the products of conception.

    I’m not placing a greater moral value on one or the other, and I understand that some women have to rely on herbs, but it bothers me to see ‘natural’ held up on a pedestal. An induced miscarriage is typically uncomfortable, be it induced by magical marshmallow overdose or drugs from Ye Olde Doctor.

    Very few things of any significant size come out of the typical uterus without some pretty goddamned gnarly contractions.

    And in case my political position isn’t clear, yay for information, but bigger yay for access to safe, legal, affordable abortion.

  15. I strongly suspect that most of the herbs mentioned are either too slight in effect to be really worth it, or else the effective dose would be dangerously close to the toxic dose. Pennyroyal (Mentha pulegium) comes to mind as an example of the second sort. It contains pulegone, which causes uterine contractions. But the amount useful as an abortifacient is close to the lethal dose, and people have died because of it. Why then would a woman use such a dangerous substance (I mean the plant, the oil is extremely toxic)? I would guess that a desperate woman would use desperate measures, especially if the chances of dying in childbirth were higher than the chances of dying from pennyroyal poisoning. Something similar could likely be said about other herbs.

  16. akeeyu, I think the practical difference here is between a ‘natural’ abortion induced by, effectively, the herbal version of drugs, vs. surgical procedures performed in a clinic, such as dialation-and-extration. Abortifaciaent drugs would fall in the middle ground here. They, like natural methods, allow a woman privacy and control over the timing, but would still require assistance from the medical establishment.

  17. Historically, the most commmon approaches to abortion were poisons. Very toxic, very fatal poisons.

    I wonder if this is why all the old Mystery novels from the 20’s and 30’s always have a detective saying “Poison is a WOMAN’S weapon” all the time.

    I bet it is!

  18. I think this is actually a good thing. They’re providing methods in case Roe vs. Wade is repealed. (Btw, does anyone know of the group “I bet I can find 1,000 women against abortion on Facebook? I’d like to help someone set up a countergroup. I can’t do it myself, ’cause I have a lot of friends who are pro-forced-birth. Why is it so easy to get women to hate themselves.)

  19. Anyone else remember reading Cunt? The author has two surgical abortions and finds them gross, and then has a “natural” abortion by, iirc, getting a massage and then thinking the fetus out of her, which fell out of her body in a little ball o’ fetus. It was a wallbanger moment for me.

    The thing is, while I see plenty of problems with the medical field as-is, I am not sure “natural” medicine is the way, the truth, and the life. Homeopathic medicine is by its very definition untested. Sure, there may be some people who swear up and down that their methods work, but one should be skeptical of these things because there are plenty of reasons people believe medicine might work- they don’t want to feel like suckers, they want to believe it worked, they want prove a skeptic wrong, they would have gotten better regardless of medicine consumed, etc, etc.

    Abortion is one of the safest procedures out there. Taking poisons to have a miscarriage is of debatable safeness. Now, I am not going to stop anyone from their home remedies. Cure your cancer with cinnamon, end AIDS with salt, and poke as many holes in yourself as you want, but realize that I am still going to tell you they are unsafe and unproven.

  20. I would guess that a desperate woman would use desperate measures, especially if the chances of dying in childbirth were higher than the chances of dying from pennyroyal poisoning. Something similar could likely be said about other herbs.

    Well, there’s rational and then there’s rationalized; it’s normal to rate similar risks by disparate standards, especially when you’re looking at likely death vs. likely death. Who wouldn’t try to think their way out of that situation?

    There’s also the massive stigma attached to out-of-wedlock pregnancies–and all sorts of other outlaw circumstances under which women got pregnant. A desperate woman would have been looking at other consequences, like poverty, unemployment, eviction, and violence. And it’s not unlikely that she would have had other children and family members to provide for.

    I’ve never had to poison myself in the hopes of inducing miscarriage, but the medicine-method might also have offered a sense of control. Even if you know it’s very dangerous, a dose is an action you take, with help from a close friend or someone in the know. Maybe a more bearable deadly risk than waiting. Women who had to undertake dangerous abortions in secret didn’t typically live in societies where childbearing was theirs; it was something done to you, something you suffered, and for these women a punishment for weakness.

  21. Abortion is medicine, tested and proven acceptably safe. Clinics, hospitals, & dr. offices provide good, above-board, necessary services and I am proud of the work I’ve done for abortion loan funds and for abortion clinics.

    Self-abortion/ inducing miscarriage is not medicine, but neither is it unequivocally out of reach for a woman who knows her body and trusts herself. I didn’t want another abortion (but knew it would be my Plan B), so I chose to inform myself with the anecdotal evidence out there. I designed a plan to self-abort a very very early pregnancy and recorded my actions and their effects.

    And what did I get but a magic bean (figuratively, ladies). It’s one of the most remarkable things I’ve done in my life, and makes me feel very grateful and powerful. While I would never recommend or advocate self-abortion to someone under my care, I would absolutely try it again if I needed to.

    I’ve struggled with how to frame my experience for others, some of whom are horrified or flatly disbelieving. This is How Not to Have an Abortion, but what do we do with this evidence that says, It’s How I Did and I’m Okay (Better, even).

  22. I am an acupuncturist and I have tried acupuncture to induce and abortion. In my experience it only works if the patient is prone to miscarriage already and it requires heavy needling which is painful.

    Also, when it has worked for me, the patient still needed to get a D&C to properly clean out the uterus to prevent infection.

  23. Who has complete control over their body at any time? It’s odd that rhetoric about choice can be so absolutist about control over your body in the wake of an unintended problem with it. “I didn’t mean to get pregnant, and I ended up that way, but I really really intend for method x to safely terminate the pregnancy, so I’m going to go with it and celebrate my control over my body in the event that I can think that I did.”

  24. Some of the methods, especially psychic abortion, will seem exasperatingly kooky to those who subscribe to reality.

    There. Fixed it for you.

    Homeopathic medicine is by its very definition untested.

    Actually, homeopathic medicine has been thoroughly tested. And it’s 100% pure, unadulterated bullshit. The amount of “medicine” in a homeopathic solution is equivalent to crushing up a grain of rice and mixing it into a volume of water the size of the solar system.

  25. Oh, I remember that part in Cunt, too! I liked it about as much as I liked her telling me what forms of birth control were okay (condoms) and which were anti-woman (everything else).

  26. So, I’ve actually lived somewhere women regularly used herbal methods to attempt abortion. This was in rural Paraguay, where there is a very elaborate and well developed herbal medicine tradition. Abortion is illegal, but any book of herbal medicine you can buy at a kiosk will give you a remedy for “delayed menstruation” and all the healers know these remedies as well.

    This shit is no walk in the park, and no one should be under the impression this a good alternative to legal medical or surgical abortion. It certainly can and does work. However, even when it does work, it is not that unusual for a woman to experience hemorrhaging due to “retained products of conception.” This is a potential complication of miscarriage, so that shouldn’t be surprising, and it’s why you are supposed to go back in after a medical abortion to get checked out. Often, it resolves itself. Sometimes, it doesn’t, and the consequences are serious.

    When it doesn’t work, the babies often are born premature and with severe birth defects from the poisons they were exposed to in utero. I know at least two women who had this happen to them. From not wanting a child at all to having to care for a special needs child in an environment where you have absolutely zero resources to help that child.

    One older woman in my village told me a story about a woman who kept taking the concoction and it didn’t work and it didn’t work so she kept taking more and more. She was quite ill for months. “And her menstruation just wouldn’t come,” the woman told me. Finally, it worked and she was seized with strong contractions. They helped her to the latrine and held her arms while she squatted and the fetus slid out into the latrine – maybe five or six months along.

    The problem isn’t that “herbs don’t work.” The plants do contain the chemical compounds attributed to them and those compounds have the effects attributed to them. It’s that the amounts in the plants vary a lot depending on everything from the soil conditions to how much it rained, and the teas and other preparations vary a lot too depending on how long you boil it, etc.

  27. “Oh, I remember that part in Cunt, too! I liked it about as much as I liked her telling me what forms of birth control were okay (condoms) and which were anti-woman (everything else).”

    Don’t forget her super-duper 100% approved pro-woman method… the rhythm method. >.>

  28. The position that purveyors of natural remedies hold is that they should be allowed to administer treatments that they know are ineffective for financial gain. Just so you know.

  29. Entomologista, I’ll say it again – if you want to participate in this discussion, you need to be more respectful.

  30. For what it’s worth, I agree with Entomologista. Ineffective-to-dangerous horseshit is not something that needs respect.

  31. a response to number 19 from “politicalguineapig” …why does standing up for those who cannot speak for themselves constitute a woman’s “hating herself?” besides, there are already several counter-groups to the “i bet i can find 1,000,000 women against abortion” group and not one of them has come close to “countering” it. but go ahead, try to do it… you’ll fail…

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