Obstet Gynecol. 2024 Dec 1;144(6):e152-e159. doi: 10.1097/AOG.0000000000005755.
Self-managed abortion (SMA) refers to actions people take to end a pregnancy outside the formal health care system. There are a variety of reasons people choose to self-manage their abortions, and these reasons may vary based on regional contexts. For some people, medically delivered abortion care is no longer, or has never been, available in their community. Available options might be inaccessible or unacceptable, or the person might have a preference for self-managed care as a primary choice. The majority of SMAs are completed safely with misoprostol, either alone or with mifepristone. Rare medical complications should be managed as they would be in any case of spontaneous pregnancy loss. For many people, the greatest risk of harm related to SMA comes from the threat of criminalization. Many U.S. states have at least one law in place that could be misused to prosecute people attempting or assisting with SMA. Criminalization makes people less safe and harms the confidential patient-practitioner relationship. Obstetrician-gynecologists and other health care professionals should provide all people with compassionate, nonjudgmental medical care, including those presenting before, during, or after self-managing an abortion.
自行终止妊娠（SMA）是指人们在正规医疗体系之外采取的终止妊娠的行为。人们选择自行终止妊娠的原因多种多样，这些原因可能因地区情况而异。对于一些人来说，他们所在的社区不再提供或从未提供过医疗方式的堕胎服务。可选择的服务可能无法获得或无法接受，或者人们可能更倾向于将自行管理的护理作为首选。大多数 SMA 都可以通过米非司酮或米索前列醇单独或联合使用安全完成。罕见的医疗并发症应按任何自然流产的情况进行处理。对于许多人来说，与 SMA 相关的最大危害风险来自于被定罪的威胁。美国许多州都至少有一项法律可能被滥用来起诉试图或协助 SMA 的人。定罪会使人们更不安全，并损害保密的医患关系。妇产科医生和其他医疗保健专业人员应为所有寻求帮助的人提供富有同情心、不评判的医疗服务，包括那些在自行堕胎前、堕胎期间或堕胎后寻求帮助的人。
