Introducing a New Resource—Self-Managed Abortion: The Global Legal Landscape

Medications like misoprostol and mifepristone offer people a safe, private, and effective way to self-manage their abortion outside a clinical setting during the first 12 weeks of pregnancy. And recently, the World Health Organization recognized self-managed abortion as a critical way to promote autonomy, privacy, and decision-making in sexual and reproductive health. Yet, legal and policy barriers that prevent people from accessing self-managed care persist in countries around the world. 

In a new online tool, Self-Managed Abortion: The Global Legal Landscape, the Center for Reproductive Rights is mapping and analyzing the laws and policies that impact whether and how people can self-manage their abortions in 35 countries and four U.S. states. This resource offers users a better understanding of the barriers blocking access to self-managed abortion, as well as a roadmap for shaping laws and practices that support reproductive autonomy and expand access to self-managed abortion care. 

Although supportive policies for self-managed care exist, the analysis shows that even in places with supportive abortion laws, numerous barriers undermine people’s ability to legally self-manage abortion. 

To learn more about the legal and policy barriers to self-managed abortion and how they impact access globally, explore the new resource here.

With the resource, you can click through the analysis country-by-country, by region, or by metric. A companion to the Center’s World Abortion Laws Map, this new resource offers a deeper dive into the laws that shape access to safe self-managed abortion care.

What does the new resource cover?

The interactive data visualizations highlight key legal and policy barriers that restrict access to self-managed abortion, even in countries where abortion is broadly legal. The visualizations focus on seven critical areas, including: 

• Legality of Abortion: What is the legal status of abortion until 12 weeks gestation? 
• Provider Involvement Requirements: Are there unnecessary supervision requirements that make it harder to privately manage an abortion? 
• Registration of Medication Abortion by the Government: Are abortion pills registered by the country’s pharmaceutical regulatory body and officially approved for abortion? 
• Availability of Medication Abortion Without Prescription: To what extent are people able to access abortion pills over the counter? 
• Timeframe for Use of Medication Abortion: Are there policies that limit the use of medication abortion before 12 weeks of pregnancy? 
• Location-based Restrictions: Are there laws preventing pregnant people from self-administering medication abortion without a pre- or post-abortion in-person visit? 
• Available via Telemedicine: Are individuals able to access abortion services via telemedicine or other telehealth services? 

By analyzing laws and policies according to these metrics, this analysis reveals how countries support or restrict self-management of abortion. The jurisdictions in the analysis were selected to ensure a geographically diverse sample, covering both liberal and restrictive abortion laws, with a focus on regions where the Center is working. 

What is self-managed abortion?

Self-managed abortion (SMA) refers to abortions undertaken without clinical supervision. Using medications like mifepristone and misoprostol, it is a safe and private method for ending pregnancy outside of a clinical setting.

While according to the World Health Organization (WHO), abortion can be safely self-managed during the first 12 weeks of pregnancy, legal restrictions in many regions make it difficult to access these medications or seek care through telemedicine.

Why might people choose to self-manage their abortion?

People may choose to self-manage their abortions in contexts where abortion access is limited due to factors such as limited access to health services, legal restrictions, and procedural barriers. Self-managing abortion care may also provide some individuals with a greater sense of control and agency in ending their pregnancies. Moreover, some people—especially those from historically underserved groups—may feel more comfortable self-managing their abortions due to concerns about the formal healthcare system, such as fear of mistreatment by staff.

For many, self-managed abortion through medications like mifepristone and misoprostol is the most accessible, affordable, and private method for accessing care. It returns reproductive freedom back to individuals and gives us the freedom to decide if, when, and where to access abortion care. But despite the safety and effectiveness, many individuals face legal risks, stigma, and barriers when seeking to manage their own abortion with medication.

Is self-managed abortion safe?

Yes, self-managed abortion using approved methods, such as medication abortion (mifepristone and misoprostol), is considered safe by the World Health Organization (WHO). Abortion pills have been found to be safer than common medicines such as penicillin, Tylenol and Viagra.

Is self-managed abortion legal?

The reality of legal enforcement for restrictions on self-managed abortion varies widely. In particularly restrictive contexts, this may include strict enforcement of laws criminalizing abortion or intimidation campaigns that allow authorities to harass pregnant people and providers under the guise of the law. Even in contexts where medication abortion itself is legal, specific laws, policies and guidelines may require the involvement of a healthcare professional for the abortion to be lawful.

Because legal risks vary so greatly, the Center’s Self-Managed Abortion resource is critical for understanding the particular laws and policies in each country’s context.

How can the new resource support advocacy?

Self-Managed Abortion: The Global Legal Landscape is designed to support advocates, policymakers, and individuals working to promote reproductive autonomy. By understanding the global legal landscape, people can better advocate for legal reforms that support self-managed abortion and expand access to telemedicine services.

Explore the new online resource here:

>> Self-Managed Abortion: The Global Legal Landscape

These print-ready reports complement the new resource tool:

• Legal and Policy Barriers to Self-Managed Abortion: A Comparative Analysis of the Laws of 35 Countries and 4 U.S. States (2024) identifies best practices and makes recommendations for strengthening laws and policies.
• SMA: Legal Analysis by Country provides detailed information about and citations for the specific laws and policies of each country related to each metric assessed.