Verma Nisha, Grossman Daniel
Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA USA.
Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco (UCSF), 1330 Broadway, Suite 1100, Oakland, CA 94612 USA.
Curr Obstet Gynecol Rep. 2023;12(2):70-75. doi: 10.1007/s13669-023-00354-x. Epub 2023 Mar 7.
This review aims to provide up-to-date information about self-managed abortion in the USA.
Evidence indicates that there is growing demand for self-managed abortion in the USA as obstacles to facility-based care increase, especially since the Supreme Court overturned . Self-managed abortion with medications is safe and effective.
Based on a nationally representative survey, the lifetime prevalence of self-managed abortion in the USA in 2017 was estimated to be 7%. People experiencing barriers to abortion care, including people of color, people with lower incomes, people in states that have restrictive abortion laws, and those living farther from facilities providing abortion care are more likely to attempt self-managed abortion. While people may use a range of methods to self-manage abortion, there is growing use of safe and effective medications, including mifepristone used together with misoprostol and misoprostol used alone; use of traumatic and dangerous methods is rare. While many people attempt to self-manage their abortion because of barriers to facility-based care, others have a preference for self-care because it is convenient, accessible, and private. While the medical risks of self-managed abortion may be few, the legal risks may be significant. Sixty-one people have been criminally investigated or arrested between 2000 and 2020 for allegedly self-managing their abortion or helping someone else do so. Clinicians play an important role in providing evidence-based information and care to patients considering or attempting self-managed abortion, as well as minimizing legal risks.
本综述旨在提供有关美国自行管理堕胎的最新信息。
有证据表明,随着基于医疗机构的护理障碍增加,美国对自行管理堕胎的需求不断增长,尤其是自最高法院推翻相关裁决以来。使用药物自行管理堕胎是安全有效的。
根据一项具有全国代表性的调查,2017年美国自行管理堕胎的终生患病率估计为7%。在堕胎护理方面面临障碍的人群,包括有色人种、低收入人群、所在州有严格堕胎法律的人群以及居住在距离提供堕胎护理的机构较远地区的人群,更有可能尝试自行管理堕胎。虽然人们可能会使用多种方法自行管理堕胎,但安全有效的药物的使用越来越多,包括米非司酮与米索前列醇联合使用以及单独使用米索前列醇;使用创伤性和危险方法的情况很少见。虽然许多人因基于医疗机构的护理障碍而尝试自行管理堕胎,但其他人则更倾向于自我护理,因为它方便、可及且私密。虽然自行管理堕胎的医疗风险可能较小,但法律风险可能很大。在2000年至2020年期间,有61人因涉嫌自行管理堕胎或帮助他人自行管理堕胎而受到刑事调查或逮捕。临床医生在为考虑或尝试自行管理堕胎的患者提供基于证据的信息和护理以及将法律风险降至最低方面发挥着重要作用。