The XX Factor

When Abortion Restrictions Increase, Women Start Googling How to Do It at Home

“how to do a coat hanger abortion”


It would be nearly impossible to calculate how many U.S. women have given themselves home abortions. Even legal, clinic-based abortions are shrouded in stigma and shame—one 2014 study found that about 1 in 3 people who’ve had an abortion or whose partner has had an abortion told no one about it; the rest only told an average of 1.2 people.

But in Sunday’s New York Times, Seth Stephens-Davidowitz used Google search data to track U.S. interest in self-induced abortions over time, mapping spikes in searches for “how to self-abort” and “how to have a miscarriage” to times and places that saw increased legal restrictions on abortion. His results paint a compelling, if unscientific, picture of the dire consequences of the so-called TRAP laws—that’s “targeted regulation of abortion providers”—on the Supreme Court’s current agenda.

The states whose residents searched least for home abortion methods were states that have enacted few restrictions on abortions. Accordingly, eight of the 10 states with the highest rates of Google searches about self-induced abortions are noted as “hostile” or “very hostile” to abortion, as measured by state restrictions on the procedure by the Guttmacher Institute. Mississippi, whose one remaining abortion clinic has been fighting the state’s admitting privileges law for years, had the highest search rate for self-induced abortions in 2015.

Stephens-Davidowitz reports that such nationwide search rates spiked 40 percent in 2011, when states around the country ratified a combined total of 92 new abortion restrictions, marking the dawn of this most recent phase of anti-choice political activism in the U.S. At the same time, birth and abortion rates indicated that women might be self-inducing abortions in states where it’s hardest to get one at a clinic:

In 2011, the last year with complete state-level abortion data, women living in states with few abortion clinics had many fewer legal abortions. Compare the 10 states with the most abortion clinics per capita (a list that includes New York and California) to the 10 states with the fewest abortion clinics per capita (a list that includes Mississippi and Oklahoma). Women living in states with the fewest abortion clinics had 54 percent fewer legal abortions—a difference of 11 abortions for every 1,000 women between the ages of 15 and 44. Women living in states with the fewest abortion clinics also had more live births. However, the difference was not enough to make up for the lower number of abortions. There were six more live births for every 1,000 women of childbearing age.

Women in states with few abortion clinics may have been miscarrying at higher rates and getting pregnant at lower rates than women in other areas of the country, but considering that these states also condemn sex education and contraceptives, it’s likely that home abortions were responsible for some of the gap in births. In Texas, where rising wait times for an abortion at one of the state’s few remaining clinics have contributed to more second-trimester abortions since the passage of HB2, one 2015 study found that between 1.7 and 4.1 percent of the state’s women aged 18 to 49 have attempted to self-terminate a pregnancy using herbs, teas, vitamins, caffeine, alcohol, drugs, abdominal trauma, or a medical abortion pill (misoprostol) obtained on the black market or from a Mexican pharmacy. The searches Stephens-Davidowitz analyzed reveal other specific, disturbing methods:

There were more than 700,000 Google searches looking into self-induced abortions in 2015. The 700,000 searches included about 160,000 asking how to get abortion pills through unofficial channels—searches like “buy abortion pills online” and “free abortion pills.” There were tens of thousands of searches looking into abortion by herbs like parsley or by vitamin C. There were some 4,000 searches looking for directions on coat hanger abortions, including about 1,300 for the exact phrase “how to do a coat hanger abortion.” There were also a few hundred looking into abortion through bleaching one’s uterus and punching one’s stomach.

Case studies from around the world indicate that abortion rates do not decline when the procedure is restricted or banned. (Abortion rates do fall off as fewer people experience unintended pregnancies, usually because of increased access to sex education and contraception.) Stephens-Davidowitz’s analysis supports the argument that anti-choice laws don’t prevent abortion—they just make it less safe.

Wealthy women will always find a way to terminate their pregnancies; even without the protections of Roe v. Wade, women with money can travel to another state or country for the procedure. When poverty intersects with abortion restrictions and the clinic closures they trigger, barriers to abortion build up: Poor women have a harder time saving up for an abortion, traveling to a clinic, taking time off from work for the procedure, and jumping through the waiting-period hoops a growing number of states require.

So it’s no surprise that the states with the highest search rates for self-induced abortion methods are also some of the poorest in the nation. The 2015 Texas survey reported that Latina women living near the Mexican border and women who were too poor to afford reproductive health care were significantly more likely to report having self-induced an abortion or having a friend who’d done so. Stephens-Davidowitz saw home-abortion searches surge in 2008, along with the country’s financial meltdown and recession, as more women faced economic insecurity. As TRAP laws are challenged in the Supreme Court and introduced in state legislatures, abortion rights aren’t all that’s at stake—the health and safety of the country’s poor women hang in the balance.