Complications of Unsafe and Self-Managed Abortion - NEJM
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When abortion is legally restricted or otherwise inaccessible, girls, women, and those who care about them look outside formal medical care to end pregnancies. Worldwide, people increasingly choose misoprostol or a combination of mifepristone and misoprostol to end pregnancies on their own (referred to as self-managed abortion).

This review provides the information clinicians need to prepare for an increasingly restrictive legal climate for abortion. Ultimately, we conclude that appropriate care is centered on two clinical concepts. First, because medication-induced abortion and spontaneous abortion are clinically similar processes, care can usually be given without knowledge of whether the abortion is self-managed or spontaneous. Second, because medication-induced abortion is safe, many patients who seek care will require only confirmation that their abortion is complete or outpatient intervention for incomplete abortion.

In contrast, those using unsafe methods may need lifesaving critical care for sepsis, hemorrhage, pelvic-organ injury, or toxic exposures. The hallmark of skilled care in this new era will be judicious use of intervention in most cases and readiness for aggressive treatment when needed. Appropriate care also involves understanding that women’s legal safety — their risk of prosecution — may be the biggest threat to their well-being. Seven states criminalize self-managed abortion, and 24 others have laws that can be interpreted as doing so.

However, no state mandates that health care providers report suspected or confirmed self-managed abortion, including for minors. Indeed, reporting may violate patients’ privacy rights and result in penalties for those who report. When patients present with bleeding in pregnancy and caregivers involve the police, patients may face detention and prosecution, regardless of whether they induced the abortion.

Source: https://www.nejm.org/doi/full/10.1056/NEJMra1908412?query=featured_home
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Dr. V●●●●●●j D●●●i
Dr. V●●●●●●j D●●●i Legal Medicine
The law on abortion is not the same all over the world. Mifepristone can not be sold here on the mere asking by a lady who is not a doctor. The reporting to the police or not should depend upon the situation in each case. If the history, examination & investigations of the patient indicate that there is nothing suspicious of foul play, there is no need to report to the police. There is presumption of bonafides when an obstetrician works. Law definitely protects bonafides.... Read more
Mar 30, 2020Like
Dr. V●●●●●●j D●●●i
Dr. V●●●●●●j D●●●i Legal Medicine
Please don' t forget the definition of ' rape' when it is sexual intercourse with a minor, even if the abortion happens to be natural. Rape has to be reported to the police, even if the abortion is natural.
Mar 30, 2020Like