“Becoming the woman she wishes you to be”: A qualitative study exploring the experiences of medication abortion acompañantes in three regions in Mexico

Locating Autonomous Abortion Accompanied by Feminist Activists in the Spectrum of Self‐Managed Medication Abortion

“…Women also choose autonomous MA even where first trimester abortion is legal, such as in Mexico City (Veldhuis et al. 2022).…”

“…They offer holistic accompaniment, which is horizontal and trusting, includes the provision of evidence-based information on safe MA, guidance on seeking care, respect for the autonomy of women who abort, prevention of criminalization, emotional and even economic support throughout the self-managed process, by means of flexible and personalized practices. It also aims to reduce stigma (Drovetta 2015;Casas and Vivaldi 2014;Moseson, Bullard, et al 2020;Veldhuis et al 2022). The few studies published on the phenomenon describe the use of telephone hotlines as well as a diversity of other (in-person) acompañante models, such as those implemented by well-known grass-roots feminist organizations such as the Socorristas en Red in Argentina, and Las Libres in México (Drovetta 2015;Singer 2019;Zurbriggen et al 2018).…”

“…It places bodily autonomy above concerns about the legality of abortion: "realizing abortion rights," instead of waiting for their implementation by the state (Singer 2019), not as a "less unsafe" last resort, but as a safe and even preferred option (Jelinska and Yanow 2018). In contrast to harm-reduction models that function within formal health systems, the acompañante model is not limited to the provision of information but includes support for the acquirement (and even supply) of reliable medication if needed (Erdman et al 2018;Jelinska and Yanow 2018;Veldhuis et al 2022). The holistic accompaniment offers benefits beyond harm-reduction (Gerdts and Hudaya 2016) as it may serve as an example of the interpersonal quality of care and safety in a broad sense, which is often lacking in provider-led models of health care (Altshuler and Whaley 2018;Darney et al 2018;Sedgh et al 2016).…”

“…Although acompañante models may seem similar to services such as safe abortion hotlines operated by NGO-trained counselors or online telehealth services (Baum et al 2020), it is fundamentally different in the sense that there is no provider involved; the acompañante model consists of the horizontal exchange of information and support between acompañante and woman seeking information in which the woman becomes her own "provider" (Erdman et al 2018;Jelinska and Yanow 2018;Veldhuis et al 2022). The diversity of existing acompañante models reflects the variety of settings and women accompanied, each with different needs that are attended to by the acompañantes, who are grassroots activists.…”

“…The acompañante model predominates in Latin America, where self-managed MA originates but has spread to other continents. We argue that it represents a community-and rights-based strategy that may be preferred to clinical services by women even in contexts where abortion is legal (Assis and Larrea 2020;Chemlal and Russo 2019;Veldhuis et al 2022), and therefore should be considered by clinicians and policymakers worldwide as a viable alternative to in-clinic abortion services. This commentary is informed by ongoing research in Mexico but is applicable to self-managed MA in other countries as well.…”