While the studies don't address how women came up with their methods, the Internet seems, unsurprisingly, to play a key role, with two detailed guides to do-it-yourself abortions appearing online in recent years. The first, published by an amateur herbalist who goes by Sister Zeus, offers a "library of forbidden knowledge." Sister Zeus, whom I interviewed by e-mail but who declined to give her real name (presumably for legal reasons), says she has counseled more than 1,000 women about herbal "fertility control" over the past few years. In spite of her name, she is a cautious guide, encouraging readers to access mainstream abortions if they can. ("Sometimes clinics offer payment plans," she notes helpfully.) Those who aren't deterred are repeatedly encouraged to use herbs such as blue and black cohosh, pennyroyal, and dong quai with caution.
The other guide, Natural Liberty: Rediscovering Self-Induced Abortion Methods, covers methods beyond herbs, including menstrual extraction (the suction-based technique Downer taught), homeopathy, acupuncture, yoga, massage, hypothermia, and, intriguingly, psychic strategies. Published in print and online in 2008 by a feminist collective based in Las Vegas, the book reads like something out of the pre-Roe era. Fittingly, a book blurb from Carol Downer expresses concern that abortion might become illegal again: "Keep this book and your speculum in a safe place," she writes. "Whatever the political climate, you have the tools you need."
Whether those tools actually work is an open question. No one has reliable large-scale data on the effectiveness of nonmedical techniques. According to a database Sister Zeus has compiled, of the 149 women she has tracked who had confirmed their pregnancies with tests, 46 percent successfully terminated their pregnancies with herbs. The attempts tracked by the Reproductive Health Matters study were far less successful.
When self-inductions didn't work, women either had clinic abortions (sometimes after a delay that made for a more involved, more expensive ordeal) or they continued their pregnancies, in some cases risking birth defects. In Brazil, one of many countries where misoprostol self-abortions are common, there is widespread evidence of facial, nerve, and limb malformation in children born to the 5 percent to 10 percent of mothers whose efforts to abort with the drug fail.
"The point of having legal abortion is to make it safe and a decent, dignified experience," says Wendy Chavkin, a physician and professor of public health and gynecology at Columbia's Mailman School of Public Health. In countries where abortion is illegal, doing it yourself might be the best option. Here, says Chavkin, there's no need for women to face the health risks, such as hemorrhaging, on their own: "People should get legal, good care, not second rate care."
But at least some doctors think women should have more control over ending their own pregnancies soon after they're detected. "Very early abortion is not rocket science," says Beverly Winikoff, a physician and one of the co-authors of the Reproductive Health Matters study. "The earlier you're going to do this, the more the woman could do herself."Certainly, some women will try. For as with anything else, there will always be those who are inclined to take matters into their own hands.