Safe Abortion Using Pills - National Network of Abortion Funds

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If you or someone you know is being investigated, detained, arrested, or concerned they might be questioned by law enforcement or other government agents for having an abortion or a pregnancy loss, contact the Repro Legal Helpline.

Legal Help

For financial support with posting bail and securing defense counsel, contact the Repro Legal Defense Fund.

Repro Legal Defense Fund

For more information about abortion with pills, check out Self-Managed Abortion; Safe and Supported.

Everyone who wants or needs an abortion should be supported in deciding the abortion method that works best for them – whether that is care with a provider (in-person or telehealth) or by self-managing their own abortion.

At NNAF, we affirm the autonomy of all people to self-determine their reproductive lives, including whether to end or continue a pregnancy without fear of discrimination, harassment, violence, or criminalization.

Self-managed abortion (SMA) is when a person manages their own abortion; SMA may include the use of pills, herbs or other methods.

SMAs happen outside of a medical setting, without the involvement of a medical provider acting within their legal scope of practice.
SMAs happen in the setting decided on by the pregnant person, sometimes with the help of a caregiver, friend, or family member.

There are many reasons one might prefer to end their own pregnancy, and many people experience co-existing dynamics as they weigh their decisions. A person might want to exercise more control over the experience, the location, and the timing of their abortion for highly personal reasons. They might be grappling with immense financial and logistical barriers, or struggling to find an available appointment as the number of abortion providers and states with abortion protections shrinks across the US.

No one should face criminal charges or incarceration for making their own pregnancy decisions, including abortion.

There are several states that explicitly prohibit self-managing an abortion. But even in states where there are no laws against abortion, prosecutors have used and misused a wide variety of laws to punish people for self-managing– including laws that were never intended to be used against the pregnant person for their own pregnancy outcome.

Visit the Repro Legal Helpline to find more information about the laws and potential legal risk in your state.

Medication abortion or abortion with pills
Medication abortion, or abortion with pills, is ending a pregnancy by using pills. People effectively use the medication misoprostol to end pregnancies, either by itself, or in combination with another medication, mifepristone.
- Some people use medication abortion after a visit with a provider who prescribes these pills. Others self-source their pills as part of managing their own abortion.
- In the U.S., people who get medication abortion from a health care provider will receive the two-medication regimen– meaning misoprostol and mifepristone; today over half of all abortions in the U.S. are with medication abortion.
- Research shows that both types of medication abortion are safe and effective options for ending a pregnancy.
- Misoprostol causes dilation and cramping, which empties the contents of the uterus, mifepristone blocks progesterone, the hormone that maintains pregnancy; misoprostol can be used in combination with mifepristone or alone.
- Some states are working on making medication abortion available at public universities, and others are trying to expand the range of healthcare providers that can prescribe medication abortion. You can check out your state’s policies on medication abortion here.
Self-managed abortion with pills
Self-managed abortion with pills is when a person manages their own abortion, with abortion pills. People effectively use 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.
- Misoprostol causes dilation and cramping, which empties the contents of the uterus, mifepristone blocks progesterone, the hormone that maintains pregnancy; misoprostol can be used in combination with mifepristone or alone.
Telehealth abortion services
Telehealth abortion is when a person seeking an abortion consults with a medical provider through phone or online communications and then receives the abortion medication (abortion pills) from the provider, usually through the mail.
- While they allow many people to experience their abortion in a setting of their choosing, we do not consider telehealth abortion services with a health care provider to be self-managed abortions. Rather, they are abortions that are prescribed by and supported by a medical professional in your state, acting within their legal scope of practice of your state.
- Accessing telehealth abortion services doesn’t have the same legal risks for a patient that someone might face if they self-manage their abortion.
- Access to and availability of telehealth abortion services depends on where a person is physically located when seeking medication abortion. Many states currently allow telehealth abortion services, while others do not.

Learn more

NNAF does not monitor or endorse the accuracy of any information contained at these links. Listing these resources does not imply endorsement of any content. The information contained at these links represents the views of the organizations linked, not NNAF.

Ways to protect the privacy of online research and communications about abortion
If/When/How: Lawyering for Reproductive Justice: information on legal risks and criminalization related to pregnancy, abortion, or pregnancy outcomes
If/When/How Repro Legal Defense Fund: provides financial support for posting bail and securing defense counsel when a person has been targeted by law enforcement for ending their own pregnancy
Self-Managed Abortion; Safe and Supported (SASS): provides detailed information and support around self-managed abortion (Available in English & Spanish).
M+A Hotline: provides volunteer clinician support for miscarriage or abortion (Available in English and Spanish; can be reached by phone call or text).
Reprocare Healthline: provides information and peer-based emotional support for planning or having an abortion with pills. (Available in English and Spanish; can be reached by phone call or text).
Euki App: provides sexual and reproductive health information and tools to track what’s going on with your body in one place, using a private and secure platform. The app is especially for people in the United States, but much of the information is relevant to people all over the world.
The SAFE Study: includes data on the effectiveness and safety of self-managed medication abortion with accompaniment support (Available in English and Spanish).
Abortion on Our Own Terms: A resource with information about self-managed abortion with pills as well as politically-imposed barriers to self-managed abortion with pills

Legal Help

For more information about abortion with pills, check out Self-Managed Abortion; Safe and Supported.

What are abortion pills?

Over two decades, scientific and medical advances have revolutionized how people can get an abortion, and the experience of their abortion process using abortion pills. Abortion pills, the medications mifepristone and misoprostol, have been included on the World Health Organization’s (WHO) List of Essential Medicines since 2005.

Abortion with pills is well documented to be a safe and effective option for ending a pregnancy, with complications occurring in less than one-percent of abortions. In 2022, the WHO affirmed that self-management with pills is safe, effective, and potentially empowering for those seeking abortion based on a variety of personal circumstances and preferences.

The misoprostol pill causes contractions of the uterus, and the uterus pushes out the pregnancy. The pill mifepristone blocks the hormone progesterone, which is required to sustain a pregnancy. Without this hormone, the uterine lining is disrupted and the pregnancy stops growing. When taken correctly, the experience and risks involved with using these medicines to end a pregnancy are similar to those of a miscarriage.

In the U.S., healthcare providers prescribe a combination of mifepristone and misoprostol for abortion. While the U.S. Food and Drug Administration only has approved the use of mifepristone and misoprostol in combination, taking only misoprostol can also be safe and effective when taken correctly, according to medical guidelines.¹

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¹World Health Organization, Abortion care guideline (2022), https://www.who.int/publications/i/item/9789240039483(see pages 98-99).
Is it legal to use abortion pills or end a pregnacy without a healthcare provider?

While some have obtained and used abortion pills or other means to end their own pregnancies without facing any legal repercussions, others have faced arrest, investigation, or criminal prosecution by law enforcement for doing so. In some cases, those who self-managed were reported by people they confided in, including family, friends, neighbors, and hospital staff.

Despite the fact that only five states have laws that explicitly make self-managing an abortion a crime, there are several other laws that exist in every state that have been used to arrest and jail those accused of ending their own pregnancies. Since 2000, at least twenty-one people — and possibly even more — have been arrested or prosecuted for ending their own pregnancy or for helping someone else end their pregnancy.

Arrests and prosecutions of people who seek to safely self-manage their abortions are likely to disproportionately impact the same people who are most affected by restrictions on abortion and other forms of criminalization: Black people, Indigenous people, people of color, poor people, immigrants, LGBTQ and Intersex people, disabled people, young people, and others who are disproportionately profiled by law enforcement and medical institutions, as well as those subjected to the steepest barriers to safe, affordable, and accessible reproductive healthcare free of discrimination, harassment, and violence.

Visit the Repro Legal Helpline to find more information about the laws and potential legal risk in your state.

Legal Help

For financial support with posting bail and securing defense counsel, contact the Repro Legal Defense Fund.

Repro Legal Defense Fund

For more information on criminalization of pregnancy outcomes, visit If/When/How: Lawyering for Reproductive Justice.