BELIEFS ABOUT TRUSTING WOMEN TO MAKE THEIR OWN ABORTION DECISIONS AND PUNISHMENT FOR SELF-MANAGED MEDICATION ABORTION IN A NATIONALLY REPRESENTATIVE SAMPLE

Objectives

Given the anticipated increase in self-managed medication abortion due to decreased access to facility-based abortion in the US after Dobbs v Jackson Women’s Health Organization, we examined lay attitudes regarding trusting pregnant people to make their own abortion decisions and whether trusting women is associated with beliefs about punishment for self-managed medication abortion.

Methods

We conducted a nationally representative cross-sectional survey of 7,148 people assigned female at birth (AFAB), aged 15–49 from May to July 2023, using a probability-based panel. Participants were asked to indicate whether they agree or disagree that “Most women are capable of making the best decision on abortion for themselves.” We calculated a mean Trust women score (1–5, 5=higher trust). We conducted multivariable regression to assess factors associated with trusting women and whether trusting women was associated with support for reporting people to Child Protective Services or the police, having them pay a fine, or jailing those who self-managed a medication abortion.

Results

The mean Trust Women score was 2.6 (SD= 1.24). Respondents were evenly split between trusting women (50.36% agreed/strongly agreed, 49.64% disagreed, strongly disagreed, or neither agreed nor disagreed). Identifying as a gender or sexual minority, as Democrat, as non-Hispanic Black, and supportive of legal access to in-clinic abortion were associated with higher odds in trusting women to make abortion decisions. Trusting women was associated with decreased support for all forms of punishment for self-managed medication abortion.

Conclusions

Beliefs about trusting women are polarized, with only half of AFAB people reporting trusting women to make their own abortion decisions; these attitudes are associated with beliefs about punishing those who self-manage a medication abortion.