A number of women—often those who are poor or otherwise disadvantaged—have been prosecuted in the United States for self-inducing abortion under a variety of state statutes, ranging from fetal homicide to failure to report an abortion to the coroner. Recently, the issue has gained greater attention because of several well-publicized cases in which women were prosecuted and imprisoned for self-inducing an abortion or being suspected of doing so.

The criminalization of self-induced abortion, as well as of pregnant and miscarrying women, does not advance women’s health or address the underlying societal and public health issues, according to a new analysis in the Guttmacher Policy Review. Rather than taking a punitive approach, policymakers should focus on expanding access to social and health services, including family planning services and safe abortion care.

"While it’s unclear whether there is an increase in women self-inducing abortion, there is no doubt that the issue has received more attention," says Andrea Rowan, author of the new analysis. "What this heightened scrutiny has revealed is that laws around pregnancy and abortion—and how they are applied by overzealous prosecutors—often lack compassion and are ultimately self-defeating from a public health perspective."

Rowan details a number of cases of women in the United States facing prosecution for ending or attempting to end their own pregnancies, often by clandestinely procuring and ingesting abortion-inducing medications. Reproductive health advocates worry that self-induced abortion, and the safety concerns associated with it, will become a more common phenomenon as the surge in state abortion restrictions limits access to legal abortion care under proper medical supervision for growing numbers of U.S. women.

"The impact of restrictions on abortion services falls hardest upon low-income women," says Rowan. "Some women want to terminate their pregnancies but live in hostile geographic areas and have limited resources and support. They are left with no practical options other than to self-induce, which in turn may put them at risk of prosecution. This situation is all too familiar in some countries where abortion is highly restricted."

Rowan goes on to discuss how the growing climate of suspicion surrounding pregnant women’s choices and actions has also had an impact on those struggling with substance abuse while pregnant. In dozens of cases, women have been prosecuted for substance abuse during pregnancy, including after these women had sought medical help for their addiction. Rowan argues that laws penalizing women for substance abuse during pregnancy may prevent women from seeking addiction treatment and prenatal care.

Rowan concludes that low-income women, in particular, are exposed to the many legal barriers to safe abortion care, as well as to other medical and social supports for pregnancy, miscarriage and substance abuse treatment. Rather than pursuing policies that leave women vulnerable to prosecution and imprisonment, the analysis calls for better access to contraceptive services and safe abortion care, as well as for addiction treatment, mental health services and strong social support systems that provide assistance to low-income women of reproductive age.

Full article: "Prosecuting Women for Self-Inducing Abortion: Counterproductive and Lacking Compassion," by Andrea Rowan