An estimated 100,000 to 240,000 women of reproductive age in Texas have attempted a self-induced abortion at some point in their lives, according to a new study.
Researchers from the Texas Policy Evaluation Project (TxPEP), who conducted the study at the University of Texas, surveyed 779 women ages 18 to 49 from across the state. Of these women, 1.7 percent reported ever having attempted to end a pregnancy on their own without medical assistance. When asked about their best friends, 4.7 percent of the participants said they were either sure or suspected the friend had tried a self-induced abortion.
The researchers applied these proportions to the almost 6 million women aged 18 to 49 living in Texas to arrive at an estimate that somewhere between 100,000 and 240,000 women of reproductive age in the state have attempted to end a pregnancy on their own without medical assistance.
The study also showed that Latinas near the U.S.-Mexico border and women who report barriers to accessing reproductive health care were significantly more likely to have tried self-induced abortion themselves or know someone who had attempted to end a pregnancy on their own.
The researchers say they expect that number to increase should Texas implement further legislative restrictions on access to abortion.
"As clinic-based care becomes harder to access in Texas, we can expect more women to feel that they have no other option and take matters into their own hands," Dr. Daniel Grossman, TxPEP co-investigator and professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of California, San Francisco, said in a statement.
The researchers found that the self-induction methods most often used by the women fell into two categories: ineffective home remedies such as herbs, tea and vitamins; and medications to induce abortion bought in bordering Mexico where a prescription isn't needed.
Alongside this data, the researchers published a research brief of interviews they conducted with 18 women living in Texas who reported attempting self-induced abortions within the past five years.
The women reported several reasons for attempting self-induced abortions, including the lack of money and resources to travel to a clinic or to pay for the procedure.
"I didn't have any money to go to San Antonio or Corpus [Christi]. I didn't even have any money to get across town. Like I was just dirt broke. I was poor," said one 24-year-old woman from the Lower Rio Grande Valley.
Other women cited a number of different reasons for trying a home abortion, including that their local clinic had closed, a close family member or friend recommended a self-induced abortion, and a desire to avoid the stigma or shame of going to an abortion clinic.
Ten of the 18 women interviewed took the medication obtained in Mexico. Most of them reported having a complete abortion. But since the process was not overseen by a physician, some wondered if their symptoms were normal.
"It was the worst cramping I've ever had and probably one of the worst pains I've gone through," a 24-year-old woman from Lower Rio Grande Valley said. "And there was also the fact that I'm doing it at home, we're not - though we have all of the information as to how much bleeding is too much bleeding, you know, or that, there's always that slight uncertainty of like I don't really know what I'm doing."
Six women reported using herbs, teas, caffeine, seeds and vitamin C in an attempt to end a pregnancy, but they were not effective.
One 20-year-old woman from Houston described how she felt after taking "basically three pills every hour" for more than a week, including caffeine, black cohosh, vitamin C and a "special root pill."
"After a while taking all the pills was very nauseating and I didn't want to do it anymore," she said. "So, it was just a lot to take in and I wasn't taking it well, but I kept doing it anyway."
The women who reported trying these methods all ultimately obtained a surgical abortion after it was evident their attempts hadn't worked.
While none of the women interviewed reported medical complications resulting from their attempts at home abortions, the researchers raised concerns that some women may put themselves at risk. They pointed to a 2014 survey that found some women said they tried potentially dangerous behaviors such as getting hit in the abdomen to end their pregnancy.
Little is known about whether women are seeking medical care for complications associated with attempts at home abortion, and the study authors suggest more research is needed.
The reports come from the TxPEP five-year project to document and analyze the impact of measures passed by Texas lawmakers affecting reproductive health.
A state law known as HB2, enacted in 2013, resulted in the closure of more than half of the 41 licensed facilities providing abortion care in Texas. The U.S. Supreme Court has agreed to decide whether to uphold the law -- which would result in the closure of even more abortion clinics.
Opponents of the law say if it is more widely implemented, the number of women who attempt self-induced abortions will likely increase.
"We are getting a sense of the very real impact these restrictions have on women, and it's deeply disturbing," Cecile Richards, president of Planned Parenthood Federation of America, said in a statement. "Most people thought we were well past the days of women taking matters into their own hands, but laws that make it impossible to get safe and legal abortion are taking us backwards."