Expectations Versus Reality: Self-Sourced and Managed Abortion Experiences of Miscarriage + Abortion Hotline Callers [ID 1203]

INTRODUCTION: Independent reproductive health navigation, including self-sourcing/managing abortions (SMA), has become more common post- Dobbs . We know SMA is used for diverse reasons, including barriers, privacy, and preference, but little is known about how individuals’ expectations compare to their realities of SMA. By engaging with callers from the Miscarriage + Abortion (M+A) Hotline—a clinician-run service offering evidence-based reproductive health information—we aim to understand these discrepancies. METHODS: We interviewed M+A Hotline callers from June to December 2024 in-depth about their SMA experiences. We analyzed interview transcripts using inductive and deductive codes and completed thematic analysis on the inductive code “Expectations vs. Reality of SMA Experience.” RESULTS: Most participants contacted the M+A Hotline to resolve the dissonance between their SMA expectations and lived experiences. These concerns included the following: anticipating “period-like” manifestations, but undergoing more intense cramping/bleeding; having a later-than-predicted onset of bleeding, causing anxiety about medication success; feeling unprepared to visualize pregnancy tissue; and experiencing longer-than-expected physical/emotional effects. M+A Hotline clinicians normalized callers’ symptoms, provided resources to improve expectation-setting, offered space for emotional processing, and informed callers of signs to seek in-person care, which overwhelmingly left callers feeling “reassured” and “supported.” CONCLUSIONS/IMPLICATIONS: People who use SMA, despite having decreased initial health care contact, often seek clinician guidance and benefit from receiving accurate information and normalization of their experiences. Physicians in formal clinical settings will encounter this population and can inform their understanding of SMA expectations and embody the counseling modeled by the M+A Hotline to better mitigate anxieties around the realities of SMA use.