Self-Managed Abortion (SMA)
The National Network of Abortion Funds (NNAF) believes everyone should be able to choose the abortion method that works best for them.
This could mean receiving care from a provider, either in-person or through telehealth, or self-managing their abortion.
NNAF affirms the autonomy of all people to determine their own reproductive lives without fear of discrimination, harassment, violence, or criminalization. We also recognize that the communities most impacted by barriers to abortion access (Black people, Indigenous people, and people of color; queer, transgender, and non-binary people; people affected by financial hardship; and undocumented people) are also those most at risk of criminalization for self-managing abortions.
NNAF is committed to normalizing and decriminalizing self-managed abortion. Our stance on self-managed abortion is grounded in racial, economic, and reproductive justice.
This page provides information and context about self-managed abortion but is not legal advice.
Self-managed abortion (SMA) is when a person ends their pregnancy outside the formal medical system. Many people use the phrase “at-home abortion,” but that is not exactly right. Even when someone gets abortion pills from a healthcare provider, they’re still having the abortion at home. An abortion is “self-managed” when someone does not get pills or medical care from a doctor or other healthcare provider licensed in the U.S.
Most people go to clinics to get abortion care, including abortion pills. But not everyone can or wants to go to a clinic. So, some people choose to manage their own abortion. Although many people self-manage their abortions using pills, people have and continue to use other methods too.
Self-managed abortion means the pregnant person decides when, where, and how their abortion happens.
Learn more about self-managed abortion with Abortion On Our Own Terms. This website provides accurate information about SMA, including facts about barriers to abortion care, resources, and how to take action.
Self-managed abortion with pills is when a person manages their abortion using abortion pills. Many people have effectively used the medication misoprostol to end pregnancies, either by itself or in combination with another medication, mifepristone.
Research shows that both types of medication abortion are medically safe and effective options for ending a pregnancy when used correctly. Mifepristone blocks progesterone, the hormone that maintains pregnancy, while misoprostol causes cramping, which empties the contents of the uterus.
Some people in the U.S. have faced investigation, arrest, and prosecution for self-managing with pills or for supporting someone else with SMA.
Read Is Self-managed Abortion Legal? later on this page to learn more.
The phrases “abortion with pills” and “medication abortion” are used interchangeably. Both terms can be used whether or not a medical provider is involved.
Use of the terms “medication abortion” or “abortion with pills” does not necessarily mean an abortion is self-managed.
Over half of abortions in the U.S. are currently done using pills.
A person might end their pregnancy for many reasons. They might want to decide when, where, and how their abortion happens. They might be facing financial, logistical, or structural barriers that prevent them from getting the abortions they need and want.
In many communities and in states that restrict abortion, those barriers have become even more challenging to overcome. Many clinics have closed, and those that remain are overburdened.
Even if someone can find an appointment, they often must pay for and arrange to travel long distances and take time away from work, school, or other responsibilities. These barriers are heightened for people in structurally oppressed and under-resourced communities, who already face existing and expanding inequities in our healthcare and economic systems.
Is Self-Managed Abortion Legal?
Laws regarding self-managed abortion (SMA) can be complex, uncertain, and vary depending on where someone lives and their specific circumstances. Nevada is the only state where it is a crime to self-manage your abortion, and then only after 24 weeks of pregnancy. But what the law says and what the reality is can be very different. Prosecutors have misused a wide variety of laws to punish people for managing their own abortions, including many laws that were never intended to apply to a pregnant person or a pregnancy outcome.
According to research by If/When/How, at least 61 people across 26 states were criminalized for self-managing their abortions between 2000 and 2020.
Help for People Seeking to Learn More About SMA
Self-managed abortion is only a crime in Nevada, but there can still be legal risks to self-managing in other states.
Contact If/When/How’s Repro Legal Helpline if you have questions about legal rights, risks, and options related to self-managed abortion.
Help for Abortion Funds
The abortion access and support landscape is complex and constantly changing, particularly when it comes to SMA. If you are an abortion fund, we can help you find a values-aligned lawyer to support you.
Are you a member fund with NNAF? Submit a technical assistance request.
Self-Managed Abortion: Additional Resources
Many movement partners have hotlines and offer resources related to SMA. Visit the sites on the right for more information on navigating your SMA.
Are you a movement partner? You can find support on this list, too.
*NNAF does not monitor or endorse the accuracy of any information found at these links. The information at these links represents the views of the organizations linked, not NNAF.
This confidential helpline is staffed by attorneys who can help people understand their legal rights and how to navigate them.
This fund provides legal and financial support to people who have been investigated or arrested for ending their pregnancy or helping someone else to do so.
This program offers technical assistance to movement partners, including abortion funds, about state abortion regulations (including those relevant to self-managed abortion), child welfare, and abortion reporting requirements. This program can also help movement partners learn how to safely exercise their First Amendment rights.
This organization provides information and peer-based emotional support in English and Spanish to people before, during, or after using abortion pills.
This is a national campaign to make safe, effective self-managed abortion accessible to all people without stigma or legal risk. Abortion On Our Own Terms provides accurate and detailed information about SMA.
This organization supports people considering their pregnancy options, including parenting, abortion, or adoption.
Clinicians with the M+A Hotline offer support and advice in both English and Spanish to people managing miscarriage or abortion with pills.
This website offers detailed information in English and Spanish about self-managed abortion and abortion with pills.
This resource helps you identify where and how to get abortion pills based on where you live.