How to Get an Abortion if You’re Under 18

Though it may seem like there are lots of obstacles in place, you’ve got options and resources to help you get a safe, discreet abortion.

Sep 8 2021, 2:33pm

It fundamentally sucks not to be able to make your own choices without the bumper rails of adult supervision narrowing down your options. When you’re under 18, life is all about living under (and working around) the rules of parents or older family members, religious leaders, teachers, coaches, and even politicians—people who believe that their advanced age gives them license to control you. 

Those rules and restrictions should come from a place of care, concern, and love, but there might be important moments when your needs don’t match up with those rules. One of the most callous, wrongheaded ways adults try to control teenagers is in the field of reproductive rights, where politicians stake a claim on your body by blocking your access to birth control and abortions. In many states, that comes in the form of choking out access to abortion clinics—Kentucky, Mississippi, Missouri, North Dakota, South Dakota and West Virginia each have one clinic within state lines—requiring clinicians to perform “mandatory counseling” or ultrasounds prior to an abortion, or the shockingly restrictive Texas law SB8, which bans abortions after six weeks

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These restrictions impact all people who gestate—but if you’re under the age of 18 and trying to get an abortion, it might seem like there are insurmountable obstacles in your way, particularly if your family or community is anti-choice. Luckily, there are plenty of people fighting to help you retain control of your body, no matter your family situation, race, economic background, immigration status, or location. 

The people who want to control your body need you to think you’re evil for getting an abortion; they need you to think you’re alone; they need you to think you’re endangering yourself and permanently altering who you are as a person. They’re completely wrong. Abortions (medical and surgical) are among the safest medical procedures available, and they’re so common that one in four women in the United States gets an abortion before the age of 45. The powers that be want you to believe otherwise in order to preserve the patriarchy—not your health or safety. You are not a bad person for wanting an abortion and you are not a bad person for getting one, whether you do that by self-managing a medicinal abortion at home or receiving treatment from a provider for your medicinal or surgical abortion.

VICE spoke with experts who help minors navigate their abortions about ways you can get one safely if you want one—even if there may be legal hurdles, even if you can’t pay, and even if there are certain adults in your life who can’t find out. You’ve got safe and reliable options, and you’re not alone.

How to Self-Manage an Abortion at Home

How do medicinal abortions work? 

If you are less than 11 weeks pregnant—that means within 77 days of the first day of your missed period, to be as precise as possible—then a medicinal abortion is going to be your most discreet and accessible option. 

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A medicinal abortion involves taking one or two medications: two doses of a drug called misoprostol (which is 80 to 85 percent effective, and easier to obtain) or one dose of misoprostol in combination with one dose of another drug called mifepristone (which is between 95 and 98 percent effective, but harder to get a hold of). This readable, illustrated walkthrough from Jewish Currents is a great source for more step-by-step information on what to expect when you self-manage an abortion using misoprostol alone, but here’s a little overview of the big-picture questions. 

According to Elisa Wells, a public health expert who founded a campaign called Plan C that is dedicated to increasing access to abortion pills, ordering both mifepristone and misoprostol online from one of the sources the campaign has verified as credible, like TelAbortion or OnlineAbortionPillRx, is safe and easier than ever. 

“Self-managing an abortion at home is really not that different than going to a clinic, getting pills, and then taking them at home, because the clinic sends you home with the pills, and you essentially self-manage the abortion at home anyway,” Wells told VICE.

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Can I get the pills I need online, or do I have to talk to a doctor? 

The rise of telehealth means you might not need to physically go to a clinic to get a prescription for abortion pills, and, according to Wells, there are also certain organizations that allow everyone everywhere in the U.S. access to abortion pills—no prescription or consultation necessary. 

You should only use providers listed on Plan C’s database in order to find a safe, legitimate source for abortion pills, since the group verifies every source it lists on its website in order to ensure that you are getting authentic, safe, and effective abortion pills. Sourcing pills elsewhere, especially from someone who isn’t a licensed clinician, carries both medical and legal risks—that the pills contain too little misoprostol and or mifepristone to work, that they contain other potentially dangerous substances, or that the provider could compromise your information and leave you legally vulnerable.

Wells said that Plan C’s database sorts its sources according to whether or not consultation with a medical professional is necessary to obtain the pills. “When you search by state, the first option is always clinician-supported care, but the second option that comes up is mailed pills without clinician support,” Wells said. “Those are largely online pharmacies that ship you the pills with no prescription needed or no consultation, but also no information.” Luckily, that information is still available on Plan C’s website, or at hotlines like the Ally Chatbot, where doctors, doulas and counselors can talk you through the medical abortion process via WhatsApp, or the M+A Hotline (that’s miscarriage and abortion), where you can call and text pro-choice doctors to ensure that your abortion is proceding normally as it’s happening.

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Wells also highly recommended one source to young people in all 50 states seeking misoprostol and mifepristone: AidAccess is a physician-supported telehealth service, does not limit care based on age, and operates out of Amsterdam with an international human rights orientation. (The only downside is that shipping can take between 10 days and four weeks, which means you should contact AidAccess as soon as you know you’re pregnant in order to ensure they arrive within the 11-week window.) 

How much do abortion pills cost? 

The cost is going to vary depending on where you live and which providers you have access to—on Plan C’s website, after you search for providers by state, you will be able to see how much pills will cost you (a quick search shows most pills are available for somewhere between $105 and $500, either in a kit with both medications or just misoprostol alone), plus an estimated shipping time to help you make an informed decision about potential cost and speed of delivery tradeoffs. Plan C also provides information about how you can pay for the abortion pills—via credit card, PayPal, or other secure platforms like Wise (formerly TransferWise) if billing is a concern for you.

How long will an at-home abortion take?

A self-managed medicinal abortion will take one to three days to complete, according to Planned Parenthood. If you are taking both mifepristone and misoprostol, you will swallow a single dose of mifepristone. Then, 24 to 48 hours later, you’ll place four tablets of misoprostol under your tongue for 30 minutes until they start to dissolve (after 30 minutes, swallow whatever is left of the pills). If you are taking misoprostol alone, you will place four tablets under your tongue, allow them to dissolve for 30 minutes, swallow, then dissolve four more tablets under your tongue for 30 minutes. 

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After you take your dose or doses of misoprostol, the cramping and bleeding should begin one to four hours later, with some cramping, spotting, and a tired feeling persisting for the next few days. 

Will an at-home abortion hurt? 

“Everybody's experience is a little bit different. It really depends on who you are, your pain tolerance and how far along in the pregnancy you are,” Wells said. “Most people describe having a medication abortion as being similar to a really heavy period, with a lot of cramping and blood—that’s to be expected, because it means that the pills are working.” 

She suggested using a heating pad to alleviate cramps, and timing your procedure so that you don’t have to be on your feet and can relax, veg out, and have a friend or loved one over to help distract you.

What are some basic ways I can keep myself safe during and after an at-home abortion? 

During the procedure itself, avoid taking aspirin to alleviate pain from cramps—it can increase bleeding, so reach for Tylenol or ibuprofen instead. When it comes to managing bleeding, use sanitary pads, not tampons, during the abortion itself in order to avoid infection and keep track of how much you are bleeding. 

Symptoms like fever, chills, and nausea are normal during a medicinal abortion, but if they persist for more than 24 hours after you take your final dose of misoprostol, contact your doctor because you may have contracted an infection—this is uncommon, but it does happen. 

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While bleeding is part of a medicinal abortion, there are abnormal patterns that mean you must contact a doctor: Bleeding that soaks through more than two maxi pads in an hour for more than two hours in a row, passing blood clots larger than a lemon for more than two hours in a row, or a total lack of bleeding within 24 hours of taking your dose of misoprostol all mean a medical professional’s help is necessary. These complications are rare, but worth keeping an eye out for in order to keep yourself safe. 

If you’re worried about people finding out you were inducing an abortion and so think you’d feel reluctant to get in touch with a doctor about complications, don’t worry: Know that, from a doctor’s perspective, a miscarriage and a medicinal abortion from pills you take orally are identical, which means your doctor will only know you had an abortion if you tell them.

Two weeks after your abortion, confirm via a pregnancy test that you are no longer pregnant—otherwise, you may need to seek out a surgical procedure and clinical advice. If you are no longer pregnant, Planned Parenthood’s website states that you can resume sexual activity, use of tampons, and birth control as soon as you feel ready to do so. You should, however, avoid “hard work” or “heavy exercise” for around a week after your abortion. 

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Will abortion pills damage my reproductive system in the long term? 

No. The overwhelming medical consensus is that having an abortion does not impact your ability to get pregnant in the future and will not increase your chances of complications in a future pregnancy.

Will I get in trouble if someone finds out I had a self-managed abortion? 

Organizations like Plan C are careful to stress that people have been prosecuted for performing a self-managed abortion in recent history, which means that it does carry legal risk—but that legal risk is ultimately extremely low. “Any attempt to criminalize or control self-managed abortion is illegitimate and unconstitutional,” said Farah Diaz-Tello, senior counsel at the reproductive justice organization If/When/How told VICE in 2019. “The charges usually end up getting dropped because the law doesn’t apply.”

In Texas, this still holds true despite the new ban. Rosann Mariapurram, the executive director of Texas-based reproductive rights nonprofit Jane’s Due Process, noted that trying to get an abortion can be particularly fraught for her most vulnerable clients in Texas, like young people in the foster care system, in immigration detention facilities, undocumented minors, or minors from “mixed status” families, where some members are U.S. citizens and others are not. Still, while these complications present obstacles, Mariapurram said it’s critical to stress that under the new SB8 law, you cannot be sued for getting an abortion. “The bounty language is not about the pregnant person,” she said. “The lawsuit piece is about the groups like us, the abortion clinics, the doctors. They're trying to stop us from existing so that we won’t provide help to the people they’ve completely abandoned.”

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“Over the past 20 years, there have been at least 24 cases where people have been prosecuted for self-managing their abortions (charges have varied from concealing a birth to homicide),” according to a Plan C FAQ on abortion pills. “During that same time, research suggests that a hundred thousand (or likely more) people have self-managed their abortions.” If you do have concerns about legal issues, (ie, a parent or another adult finds out that you self-managed an abortion and threatens to call the police) Wells recommended the reproductive justice organization If/When/How’s Repro Legal Hotline, which offers free, confidential legal advice about self-managing an abortion. 

How to Get an Abortion If It’s Legal and Accessible in Your State

How do I find an abortion clinic near me? 

There are plenty of databases online with information about where and how to obtain an abortion in your area. Abortion Finder and ineedana both offer information about clinics and practitioners and allow you to input your age to ensure that you connect with a clinic that will work with you to get you the abortion care you want—whether that’s in the form of a medicinal abortion or, if you’ve been pregnant for more than 11 weeks, a surgical procedure.

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What do I do if I don’t want to tell my parents about my abortion? 

This is where things get tricky. In order to obtain an abortion in a clinic, 37 states require parental notification and/or parental consent according to Tamara Marzouk, director of abortion access at Advocates for Youth, an organization dedicated to promoting sexual health and reproductive rights for young people. “In those states, the only alternative is an onerous legal process called judicial bypass, where the young person has to go before a judge who decides if they are allowed to get an abortion,” Marzouk told VICE. She pointed to the Judicial Bypass Wiki from If/When/How as a resource for minors looking to check the laws in every state and a “JB helpline” to assist you if you need to navigate through the bypass system.

It’s important to note that the judicial review process will add time to the experience of getting an abortion. Mariapurram told VICE that Jane’s Due Process connects teenage clients to lawyers free of charge in order to navigate the judicial bypass process—but that things get tricky when teens have to travel in order to see a judge, obtain the bypass, then connect to a clinic that performs abortions—plus the legally required sonogram or ultrasound that anyone who wants an abortion must undergo according to state law. 

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“From when a teen calls us and starts this process to when they get their abortion, it's usually two to three weeks,” Mariappuram said. “The majority of our teens don't find out they're pregnant until they miss their first period—around four, five, or six weeks. The new law basically pushes this approach completely out of reach for most of our clients, because if they find out they're pregnant, it's five or six weeks, they can't get a bypass and the abortion care within the time before the law now stops them.”

According to Marzouk, the push to involve parents in your decision flies in the face of what actual medical professionals want and believe in. “All major medical associations, including the American Medical Association and the Society for Adolescent Health and Medicine, oppose forced parental involvement laws,” she said. “These laws are brought forward by anti-abortion extremists and are not motivated by concern for young people's health.” 

How much does a clinic-supported abortion cost? 

According to a 2018 estimate from The Cut, a surgical abortion in the first trimester will likely cost between $500 and $3,000 without insurance (Planned Parenthood capped the cost off at “up to $1,500” in a 2020 report). A medicinal abortion performed in a clinical setting would likely cost around $500 ($504 on average, according to the Guttmacher Institute)—but could creep up to $1,600 without insurance. Some abortion providers, like Planned Parenthood, will work also with you on coming up with an income-based, sliding-scale price for the procedure.

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If you don’t have the money to pay for an abortion with or without insurance, don’t worry—there are abortion funds explicitly set up to help you access the care you need for free or reduced cost. For more information on your local funds and what they cover, visit National Network of Abortion Funds.

Should I use health insurance to pay for an abortion? 

Not if you want to keep your guardians from finding out. If you use a parent’s insurance to cover anything related to your reproductive health, from birth control to pregnancy testing to a pre-procedure ultrasound, be aware that they will receive an “explanation of benefits” after the fact—which means that their insurance company will let them know that you received medical treatment and what the nature of that treatment was. (It’s also worth noting that thanks to the Hyde Amendment, which bans federal funds from covering almost all abortion care, your parent’s insurance might not even cover an abortion procedure anyway.)

What to Do if You Have to Go to Another State to Get a Clinical Abortion

How do I set up an appointment at a clinic in a state I don’t live in? 

According to Mariapurram, the process is pretty similar to an in-state clinic—consult the Judicial Bypass Wiki to see if you’re traveling to a state with parental involvement laws and connect with organizations like Jane’s Due Process for help booking an appointment. For young people specifically based in Texas, she recommends Need Abortion, a service from the Know Your Rights Campaign, for information on clinics and abortion funds in neighboring states like New Mexico, Oklahoma, Colorado, Louisiana, and Florida. 

If you’re outside of Texas, but in a state with extremely limited access to clinics or medical practitioners who perform abortions, Marzouk said you can research your options at ineedana by entering your age and a zip code for the area where you’ll be seeking treatment. 

If you’re leaving the state, it’s crucial to plan ahead. “Create a plan with support people regarding funds, transportation, and lodging,” she said, which means tagging in a close friend or loved one whom you deeply trust to help you deal with the logistics. 

If that sounds stressful or inaccessible to you, remember that it’s not the only option. Wells of Plan C said the “abortion road trip” is far more of a last resort than it used to be because abortion pills are so readily accessible and safe to use at home. “Abortion road trips are sort of a thing of the past,” she said. “There's a lot of talk now in Texas, about, ‘Oh, people are gonna have to drive 500 miles to get services,’ but we do have access to the modern technology of abortion pills directly through the mail, anywhere in the United States.” 

Before you worry about how far the next clinic is from where you live, read up on your other options about what’s most feasible, safe, and discreet for you. If you have more questions, contact any of the organizations mentioned here. Resources dedicated to reproductive justice exist specifically to help you get a safe abortion, no matter where you are—or how old you are. 

Tagged:

abortion, reproductive rights, abortion pills, surgical abortion, sb8, self-managed abortion, abortion funds, medicinal abortion

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