A guide to abortion for survivors of domestic violence

If you’re experiencing domestic violence, the following resources may be able to help:

• National Domestic Violence Hotline
• National Sexual Assault Hotline
• Find a domestic violence shelter near you
• Free and Confidential LGBTQ Domestic Violence Hotline
• Pro-Choice Therapists
• Survivor Crisis Fund
• If/When/How legal fund and free, confidential services

‍

Many survivors of domestic violence, or DV, are denied the freedom to make their own reproductive choices, and pregnancy may be used as a tool of coercion against them. If you or someone you know is in a DV situation and in need of an abortion, there are discreet, safe, and affordable care options, like Hey Jane, that can ensure you get the care you need.

‍

Domestic violence can happen to anyone and is not a reflection of the survivor. Every person’s reasons for staying in a relationship are personal and complex. Hey Jane is here to help, never to judge. Continue reading to learn more about the ways that domestic violence may impact reproductive choices, what discreet birth control options are out there, ways to protect your safety during an abortion, and more. 

‍

How domestic violence impacts reproductive choices

Reproductive freedom has a direct and measurable impact on the safety of people who experience domestic violence. Reproductive coercion and non-consensual pregnancies are two ways someone can control their partners physical, emotional, and financial abilities to seek help or leave a DV situation.

‍

What is reproductive coercion? 

Reproductive coercion is a form of abuse in which one partner tries to control or interfere with the reproductive system of another, putting them at risk for unwanted and non-consensual pregnancies. Reproductive coercion can take many forms, including but not limited to:

• Refusing to use a condom or other methods of birth control
• Sabotaging a partner’s birth control (throwing away pills, tampering with condoms, etc.)
• Stealthing, or removing a condom during sex
• Removing a partner’s IUD, ring, contraceptive patch, etc. 
• Controlling finances to prevent a partner from obtaining birth control 
• Forcing a partner to have an abortion
• Preventing a partner from having an abortion
• Forcing a partner into a continuous state of pregnancy to prevent them from leaving

Reproductive coercion is not uncommon in abusive relationships. One in four callers to the National Domestic Violence Hotline have experienced reproductive coercion. 

‍

What are non-consensual pregnancies?

Non-consenual pregnancies are the result of sexual abuse (typically in the context of a broadly abusive relationship). People who become pregnant non-consensually are often prevented from having an abortion by their partner. Getting a partner pregnant can be used as a deliberate tool to keep a survivor trapped in an abusive relationship—when a person has children with their abuser, leaving that relationship becomes even more complicated. The survivor may feel an obligation to their abuser as the co-parent of their child. When planning to leave an abusive relationship, the survivor has to consider the safety of their children, access to child care, and the possibility that their abuser may have legal rights to visitation and/or custody of their children. 

‍

Some states with full abortion bans include an exception for rape and incest. However, this can often present more of a challenge to survivors than a solution. The burden falls on survivors to prove that their pregnancy is a result of rape or incest, forcing them to engage with a complex legal system, divulge personal details of a traumatic experience to strangers, and face public scrutiny with no guarantee that the process will result in abortion access. 

‍

How to stay safe during an abortion while in a domestic violence situation

People experiencing domestic violence may encounter unsafe situations while trying to seek an abortion, making it crucial to plan carefully and discreetly. Creating a safety plan (which is a set of actions that can help lower your risk of being hurt by your partne) can help you feel prepared before treatment. Part of that safety plan may be choosing a care option that meets your needs, such as an in-person procedure or taking medication to end the pregnancy.

‍

If early in pregnancy, abortion pills may be an option for treatment. These FDA-approved pills (mifepristone and misoprostol) are taken over a couple of days and usually don’t require any in-person visits if using a telehealth clinic like Hey Jane. The pills can be mailed directly to you, a post office, or a friend’s house in discreet, unmarked packaging and you can access clinical support discreetly on your phone, tablet, or computer. The effects of using the abortion pills look the same as a miscarriage, and partners usually cannot identify that you have taken the pills.

‍

Hey Jane providers can work with you to establish an abortion safety plan to minimize risk. Here are some factors you should consider when planning for your abortion.

Where to ship your abortion medication

When you have a telehealth abortion, the abortion medication will be shipped to an address you provide, but this doesn’t have to be your home. You can ship your medication to a friend or family member, PO box, Fed-Ex pick-up location, secure workplace, or anywhere that you can safely and discreetly collect the package. Abortion pills and everything else you need for treatment come in a plain white envelope when you order from Hey Jane. There is no branding or identifying information about our clinic on the outside of the package to retain your privacy.

‍

When and where to take your medication

Heavy bleeding typically doesn’t last longer than 24 hours. If possible, plan to take your abortion medication at a trusted friend or loved one’s home. If you live with your partner or your partner has tabs on your location and it’s not typical to go 24 hours without seeing them, you may consider having an explanation for this absence in place. You can say the friend or family member is going through a personal event (the death of a loved one, breakup, job loss, etc.) and need your support. Ensure that the friend or family is aware of the explanation and can corroborate it. 

If a friend or family’s home isn’t an option, consider taking your medication in a hotel room. Abortion funds don’t just help you pay for the procedure—they also help you pay for the logistics, like lodging and transportation.

‍

How to take your pills and what to expect

Medication abortion involves taking two pills (mifepristone and misoprostol). Your Hey Jane package comes with an in-depth treatment guide that includes illustrations on how to take the medications. We will also send you a digital version of the treatment guide on Spruce, the secure messaging app where you’ll communicate with our team, if you prefer to not have a hard copy lying around. 

‍

Mifepristone is taken first by swallowing with water. Misoprostol is taken up to 48 hours after taking the first medication depending on what method is used. You can take misoprostol vaginally, buccally (between the gums and cheeks), or sublingually (under the tongue) by letting it absorb for 30 minutes. While taking misoprostol vaginally causes the least nausea, it may also leave some detectable residue. Taking misoprostol buccally (between the gums and cheeks) may be a more discreet option, especially because the medication has no taste.

‍

Heavy bleeding and cramps typically start 4-6 hours after taking the second medication. Once the bleeding starts, it typically lasts for around 6 hours. Heavy bleeding usually does not last longer than 24 hours, then bleeding becomes lighter. It’s normal to experience light bleeding for days or weeks after the abortion. 

‍

For more details on taking abortion pills, read our full guide here.

‍

How to explain irregular bleeding

Your abortion will likely cause a period of heavy bleeding (typically around 6 hours) followed by a period of spotting that can last days to weeks after taking the medication. If you expect that your partner might notice irregular bleeding, you should consider having a plan in place to address it. It’s important to note that there is no way to distinguish between a miscarriage and a medication abortion—it is extremely plausible to become pregnant and miscarry before you were aware of the pregnancy. Other common causes of spotting or irregular bleeding include:

‍

• Hormonal imbalances 
• Stress
• Changes to your diet and exercise
• Infection
• Medications like blood thinners and aspirin 
• Weight gain or weight loss

‍

Paying for your abortion

Many people in abusive relationships may not be financially independent or have control over their funds. Additionally, survivors of DV may want to avoid using insurance for abortion medication to prevent a partner from receiving a summary of benefits in the mail. Hey Jane works with a trusted network of abortion funds who can bring the cost of your abortion down to as low as $0. Hey Jane also accepts payments from CashApp as a discreet option. 

‍

Discreet birth control options

Some birth control methods are more discreet than others, and therefore easier to conceal from a partner who wants to prevent you from taking birth control. Consider the following options if you want to conceal that you are on birth control.

‍

The birth control shot

The birth control shot, brand name Depo-Provera, is the most discreet form of birth control. Unlike the implant, Depo-Provera is a shot of medication that you can’t feel under the skin. The medication is injected every three months, and is over 94% effective with typical use. Depo-Provera is typically administered by your provider in a doctor’s office. If your partner has access to your location and you want to minimize visits to a doctor’s office, a self-injectable version of the medication called Depo-subQ Provera 104 is available by prescription via a clinic like Hey Jane (your provider will teach you how to give yourself the shot so you can continue to inject the medication on your own in a safe location). You can also get Depo injections at most pharmacies where there are a number of errands you can claim to be doing in order to conceal the true reason for your location.

‍

IUDs

An IUD (intrauterine device) is placed inside the uterus by a health care provider. The device itself cannot be felt by a partner during penetration. However, it is possible a partner may feel the retrieval string that extends from the IUD. Cervical mucus that coats the string (which is made of extremely thin plastic, like a fishing line), will make the string difficult to detect. It is more likely a partner may feel the string during penetration with their fingers than with a penis. You can ask your health care provider to trim the string as short as possible to avoid detection.

‍

Another way a partner may detect an IUD is through changes to your menstrual cycle. For some people, IUDs may cause irregular bleeding or stop your periods altogether. 

‍

Emergency contraception

Emergency contraception is a pill that can be taken up to 3-5 days following unprotected sex to prevent pregnancy. Consider keeping some emergency contraception pills in a safe location, like a trusted friend’s home or workplace, for emergencies. Your health care provider can give you emergency contraception in a plain envelope, as opposed to packaging that signals what’s inside. You can also purchase emergency contraception through online providers like Hey Jane or over-the-counter at a local drug store. 

‍

Who is impacted by domestic violence?

Domestic violence knows no bounds when it comes to age, race and ethnicity, socioeconomic status, and more–an estimated 10 million people in the US will experience some form of DV each year. However, domestic violence is severely underreported. Many survivors hesitate to report intimate partner violence for fear of escalation from law enforcement, discrimination, immigration status, the list goes on.

‍

Domestic violence is highly prevalent among all populations, but members of the LGBTQIA+ community may be at even higher risk. Approximately 44% of lesbian and 61% of bisexual women have experienced rape and physical violence from a partner compared to 35% of straight women. Similarly, 26% of gay men and 37% of bisexual men have experienced rape and physical violence from an intimate partner compared to 29% of straight men. An estimated 31-50% of trans people are expected to experience violence from an intimate partner in their lifetime. 

‍

Based on police-reported incidents of domestic violence, Black and Hispanic women are 2-3 times more likely than white women to experience domestic violence. An estimated 56% of American Indigenous and Alaskan Native women have experienced sexual violence and/or physical violence from an intimate partner. 

‍

Despite experiencing higher rates of domestic violence, queer people and people of color are less likely to call for help due to the threat of state-sanctioned violence and discrimination. 

‍

Survivors of DV need abortion access

Reproductive choice is critical for those who have experienced reproductive coercion. Becoming pregnant, through coercion or not, drastically increases a person’s risk of experiencing violence from an intimate partner—the prevalence of homicide is 16% higher among pregnant and postpartum people than people who are not pregnant. Research has found that people who became pregnant within an abusive relationship who were unable to have an abortion were more likely to experience continued violence from a partner. People who became pregnant within an abusive relationship who were able to have an abortion experienced a reduction in physical violence. 

‍

Not every person who becomes pregnant as a result of reproductive coercion or sexual violence may choose to have an abortion, but the choice is critical to empower survivors of domestic violence. Hey Jane is here to help you through the process of obtaining a safe and effective abortion, no matter your circumstances.