Medicalization as a Social Good? Lay Perceptions about Self-Managed Abortion, Legality, and Criminality

Interest in ending a pregnancy outside the formal healthcare sector, also known as self-managed abortion (SMA), is expected to increase in the wake of the overturning of Roe v Wade. However, there is little social scientific research on public perceptions of SMA, particularly regarding opinions around legality and criminalization. We seek to fill this gap in this paper by drawing on 54 in-depth interviews with a mixed-gender sample (men, women, nonbinary) recruited from eight U.S. states with the most restrictive abortion laws. Our analysis finds that most participants believed that SMA should not be illegal or criminalized largely due to two overarching justifications: (1) due to a belief that people should have a right to their own bodily autonomy even in the case of potential self-harm and (2) the belief that criminalizing SMA would be against public health goals. Further, many are concerned that making SMA illegal will lead to unfair or even cruel punishment. However, an underlying thread connecting both support and opposition to SMA legality and criminalization is the assumption that SMA is inherently harmful or dangerous, indicating a lack of lay awareness about the safety and efficacy of SMA using medication abortion pills. These findings indicate the power of medicalization and a valuing of medicalization as a social good, as many believe that behaviors occurring within the healthcare system are inherently safer, more justified, and more moral.