Options for Teens with No Options: A Self-Managed Second Trimester Abortion

Background Several states have deemed abortions as non-essential services, effectively calling for a halt to abortion care during the COVID-19 pandemic. In response, women may elect for self-managed abortions by obtaining abortion medications online. Case A 15-year-old female presented with abdominal cramping and vaginal discharge after taking Misoprostol obtained from an online retailer for a self-managed abortion in her second trimester during the COVID-19 pandemic. Exam showed products of conception protruding from the vagina. The patient was emergently evaluated for an incomplete and possible septic abortion and underwent a dilation and evacuation (D&E) procedure. Summary and Conclusion Providers caring for adolescents should recognize the availability of self-managed abortions, become familiar with the expected course, possible complications, and the unique challenges of accessing abortion care faced by adolescents.