Researchers connect medical mistrust with self-induced abortions
Some dangerous methods like relying on herbs or physical trauma were reported as ways in which women ended pregnancies.
A new study shows medical mistrust is associated with having abortions without the help or advice of medical providers.
The study appeared in Contraception, a monthly peer-reviewed journal. Advancing New Standards in Reproductive Health, based at the University of California San Francisco, compiled the data. Dr. Lauren Ralph was one of the authors behind the study.
“We find that people who report prior experiences of medical mistreatment and mistrust are more likely to say that they ever considered self-managing an abortion in a prior pregnancy,” Ralph said. “So it means that those who have experienced that certainly are more likely to have considered self-managed abortion.”
When I spoke with her about what self-managed could mean, she explained that it could be the typical mifepristone-misoprostol regimen. Still, it could also mean they rely on herbs and physical methods like intentional punching of the stomach of a pregnant woman or throwing themselves downstairs.
“There's vitamin C. There's mugwort. There's a lot of herbal or traditional compounds that people talk about,” Ralph said. “We had a couple of people write in Pennyroyal. So it’s a wide-ranging.”
I’ve interviewed women who have used hangers to self-induce abortions before Roe v. Wade. Ralph said that wasn’t commonly reported, and only three percent of the people in the study said they had inserted something into themselves to cause an abortion.
“It's not that it's gone away entirely, but it is the least commonly reported method people use,” Ralph said.
It is worth noting that the respondents were talking about lifetime experiences, so their abortions may not have happened in the last 20 years.
A lot of this has to do with the mistrust. According to her study, 38.8 percent of respondents reported finding it moderately challenging to trust providers, and 22.2 percent had experienced ridicule or humiliation in a previous healthcare encounter.
Those who had experienced ridicule or humiliation by healthcare providers had increased odds of considering self-managed abortion compared to those without such experiences. Participants who believed others perceived them as Black or Arab/Middle Eastern, were poor in their youth, or identified as Lesbian, Gay, Bisexual, Transgender, Queer, and other had higher proportions of considering self-managed abortions.
Ralph said it was essential to foster trust in all healthcare settings.
“It's not just people who are seeking reproductive healthcare, but what experience that you might have had in your primary healthcare setting or other healthcare settings certainly might contribute to you feeling less likely to want to interact with the healthcare provider now that you're facing the decision around a pregnancy,” Ralph said. “ So I think it's across all medical specialties. It's improving trust between healthcare providers and patients.”