Self-Induced Abortions Common Among Hispanic Communities, Studies Say

Many Hispanic women have used medications or homemade concoctions in an attempt to end their pregnancies themselves, despite the availability of safe, legal and inexpensive abortions, the New York Times reports.
According to the Times, researchers believe women who attempt to self-induce abortion do so because of a mistrust of the health system, fear of surgery, worries about immigration status, concerns about protesters at family planning clinics, cost and shame.
Two recent studies by reproductive health providers examined the use of medications and other substances to self-induce abortion. For one study, expected to be released in the spring, researchers from Gynuity Health Projects and Ibis Reproductive Health surveyed 1,200 primarily Hispanic women from Boston, New York and San Francisco.
A second study, conducted by Planned Parenthood, involved a series of focus groups with women from the Dominican Republic living in New York and Santo Domingo. According to the two surveys, women from these communities have employed numerous methods in attempts to induce abortion, including taking the drug misoprostol; mixing malted beverages with aspirin, salt or nutmeg; throwing themselves down stairs; being punched in the stomach; drinking tea mixtures; and creating other homemade concoctions.
According to the Times, many women from these communities take the prescription drug misoprostol — FDA approved to reduce gastric ulcers — to terminate their pregnancies. The drug, sold under the brand name Cytotec, also is approved to induce abortion when taken with mifepristone, or RU-486. Although some physicians use misoprostol to induce labor, it is not approved for that use, the Times reports.
A spokesperson for Pfizer, which manufactures Cytotec, said the company does not support the off-label use of the drug to induce abortion, adding that the drug’s label includes “FDA’s strongest warning against use in women who are pregnant.” The warning also notes that the drug “can cause abortion,” the Times reports. Many health care workers and community leaders have expressed concern about the effectiveness and side effects from the improper administration of misoprostol.
According to the Times, women surveyed reported a wide variety of methods for using the drug, including inserting pills into the vagina or letting them dissolve under the tongue.
Jessica Gonzalez-Rojas of the National Latina Institute for Reproductive Health, said, “We do worry because we don’t know where women are getting the instructions” about how to take misoprostol. She added that she believes “there is misinformation about how to take it, which is why it could be a hit or miss.”
According to a study conducted in 2000 surveying 610 women at three New York clinics in primarily Dominican neighborhoods, 5% of women said that they had taken misoprostol and 37% said they knew that the drug induced abortions. Mark Rosing, an obstetrician at St. Barnabas Hospital who led the study, said taking abortifacients “turns abortion into a natural process and makes it look like a miscarriage.” He added, “For people who don’t have access to abortion for social reasons, financial reasons or immigration reasons, it doesn’t seem like this horrible thing.”
Daniel Grossman, an obstetrician with Ibis Reproductive Health, said many women from these communities attempt self-induced abortions because they “prefer to have a more private experience with their abortion, which is certainly understandable.” Grossman added that friends and family members often recommend these alternative pregnancy termination methods, which some women feel are “easier” than seeking abortions in clinics and hospitals. Carolyn Westhoff, an obstetrician at New York-Presbyterian/Columbia University Medical Center, said, “This is not just a culture of self-inducted abortion,” adding, “This is a culture of going to the pharmacy and getting the medicine you need.”
According to the Planned Parenthood study, birth control is generally seen as the woman’s responsibility in many Hispanic cultures that value “machismo.” The study concluded that women from these communities “seemed to see inducing the termination of pregnancy, or abortions, as part of the reality of their lives” (Lee/Buckley, New York Times, 1/5).

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