Reframing Abortion Harm Reduction

In settings where abortion is restricted by law or other barriers to access exist, women are increasingly choosing medication abortion--mifepristone and/or misoprostol—to terminate their own pregnancies with very low rates of complications. Increased use of medication abortion in legally restrictive settings has been shown to significantly decrease the incidence of unsafe abortion—the consequences of which can include acute and chronic complications and even death. Around the world, women’s health and rights advocates are combatting mortality and morbidity from unsafe abortion by providing women with information about medications for abortion under the umbrella of a ‘harm reduction’ framework.  Abortion harm reduction interventions now take place on every continent, in clinic settings, through hotlines, on websites, and through grassroots information campaigns.

In restrictive legal contexts, well-informed self-induced abortion may not only reduce the harms associated with unsafe abortion by reducing the incidence of abortions that pose risks to women’s health and lives, but may, indeed, empower women to feel more agency and autonomy thorough out the abortion process.  By providing such care, “harm reduction” interventions may, in fact, have changed women’s own perceptions of what constitutes ‘quality abortion care’.  It is time for a new public health framework for abortion, in both restrictive and liberal environments, that does not focus solely on reducing harm, but that integrates women’s desire for agency and autonomy into the definition of quality abortion care.