Self-Sourced Medication Abortion, Physician Authority, and the Contradictions of Abortion Care

J Health Polit Policy Law. 2023 Jan 23;10449932. doi: 10.1215/03616878-10449932. Online ahead of print.

Abstract

The growing acknowledgement of the phenomenon of individuals terminating their pregnancies by obtaining medications necessary for an abortion-what we refer to as "self- sourced and managed medication abortion" (SSMA)- has shed a light on the current contradictions in the world of abortion provision. In this paper, we offer a brief historical overview of the relationship of abortion provision and mainstream medicine, pointing to the various factors that have led to the marginalization of abortion care. We then turn to interviews with 40 physicians who provide abortions about their perspectives on SSMA, and we explore how this group responds to the contradictions presented by SSMA. In doing so, we interrogate the changing meaning of "physician authority" among this subset of physicians. We suggest that these interviewees represent an emergent sensibility among this generation of abortion physicians, a sensibility very tied to a commitment to social justice.

Keywords: Abortion; physician expertise; reproductive autonomy; self-induced abortion; self-managed abortion.