Pregnancy termination outside the formal healthcare system before Dobbs: Consideration and attempts among abortion seekers in Mississippi.

Research on abortion outside formal healthcare has focused primarily on self-sourced medication abortion (mifepristone and misoprostol or misoprostol alone). Less is known about how abortion seekers understand other pregnancy-ending practices, including non-evidence-based methods such as herbs, vitamins, alcohol, or physical stress. We examine how abortion seekers in pre-Dobbs Mississippi learned about, evaluated, attempted, or rejected these methods before obtaining clinic-based abortion care. Between December 2021 and August 2022, we conducted semi-structured telephone interviews with 24 abortion seekers recruited through Mississippi's only outpatient abortion clinic and analyzed transcripts using inductive thematic analysis. Interest in pregnancy termination outside formal healthcare was shaped by cost, travel, scheduling demands, and privacy and disclosure concerns. Respondents' language did not map neatly onto distinctions between evidence-based self-sourced medication abortion and non-evidence-based methods; instead, they described "at-home abortion," home remedies, or efforts to induce a period or miscarriage. They relied primarily on informal information sources, including online searches, friends, and personal or professional networks. Concerns about safety, effectiveness, bodily harm, and future fertility led some to reject or stop attempts to end pregnancies on their own. Six respondents attempted pregnancy termination before presenting for clinic-based care using non-evidence-based methods; none succeeded. These findings show how structural barriers, limited reliable information, and uncertainty shaped abortion-seeking before Dobbs, even when clinic-based care remained legally available. These accounts illuminate informational gaps and risk perceptions that may be especially consequential after Dobbs, as access to clinic-based care becomes more restricted.