Although the numbers are declining, 1.2 million abortions were performed in the United States in 2005, the last year statistics are available, making it a one of the most common procedures undergone by women. An estimated 40 percent of all women will have an induced abortion in their lifetime, according to the Guttmacher Institute.
The median cost for a first-trimester abortion is $430 and for a second trimester procedure, $1260, according to a study published in the February issue of the journal, Contraception.
As a group, women aged 24 to 34 are more likely to be uninsured and to have an abortion. Their out-of-pocket medical expenses can be as much as 10 percent of their annual income. Women pay more out of pocket than men and the gender disparity will worsen as health care reform further restricts access, according to researchers.
"We just want a fairer playing field," said Gonzalez-Roja. "We want women to [seek an abortion] in a clinic that is safe, accessible, affordable and culturally competent."
The use of misoprostol is often seen in the Hispanic community, where a self-induced abortion is known as, "bringing your period down."
Women call them "star pills" for their hexagonal shape and they are commonly used in Latin America where abortion is illegal, turning a shameful procedure into something that looks like a miscarriage.
American immigrants can obtain them for about $2 a pill from relatives overseas or in bodegas and pharmacies.
Finding the exact numbers of women who use the drug is "a challenge," according to Gonzalez-Roja. "The issue is very stigmatizing and is spoken in quiet and secrecy and we don't hear from women when it happens."
In a recently completed survey by Ibis Reproductive Health and Gynuity Health Projects of about 1,500 women in New York, Boston, San Francisco and along the Texas-Mexico border, about 4 percent of ever-pregnant women admitted using the drug or some other method to self-induce an abortion.
"Forever, women have used things to end an unwanted pregnancy, and misoprostol is a new solution to an old problem," said Dr. Daniel Grossman, a San Francisco obstetrician gynecologist and a researcher with Ibis Reproductive Health.
"They are using a lot of different kinds of methods, including throwing themselves down the stairs and being punched in the stomach," he said. "In Michigan a young woman told her boyfriend to beat her with a toy bat to try to induce an abortion."
Grossman said use of misoprostol is not common, and though women do face economic barriers, they also have misinformation about abortion procedures and services, often relying on friends and family for advice, rather than health professionals.
"The important issue here is to look at why women do this," said Grossman. "It really comes down to barriers women face accessing abortion care. Restrictions we put on abortion access, like parental consent and denying public funding, end up forcing some women to kind of take matters into their own hands."
Misoprostol, a prostaglandin inhibitor, is usually used as part of a two-part FDA-approved medical abortion with mifepristone or RU486.