harm reduction, medication abortion, nursing ethics, reproductive rights, self-managed abortion, social justice



  1. Manns-James, Laura PhD, CNM, WHNP-BC, CNE, FACNM
  2. Pfeifer, Kelly MD
  3. Gillmor-Kahn, Mickey MSN, CNM


ABSTRACT: The 2022 Supreme Court decision leaving the regulation of abortion to the states is sure to result in a complex regulatory environment for patients and nurses. In states where abortion is illegal, patients may self-manage abortions using medications they obtain through the mail or by other means. Nurses may care for these patients in multiple settings and may wonder about their own legal and ethical obligations. This article reviews patient privacy as it relates to self-managed abortion, ethical reporting requirements for nurses, and best practices for treating complications of self-managed abortion using a harm reduction framework, with a focus on protecting patients' rights. Recommendations for ethical patient care are also provided.