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This is a guide for sex workers from sex workers on how to navigate abortion. We teamed up with the baddies at SWOPLA who run the Sex Workers’ Abortion Navigation Services (SWANS) to create this guide that offers a supportive, sex worker–informed perspective on accessing abortion.

[Not a sex worker but want to know more about what sex work is? Click here]

Abortion is a deeply personal decision—one that can bring up a lot of emotions, questions, and considerations. For sex workers, the reality of navigating abortion care can be even more complex because of ongoing stigma and the criminalization of sex work in many parts of the U.S. We recognize that every experience is unique; our goal is to provide you with the knowledge and resources you need to make the decisions that are best for you.

What does abortion access look like right now?

There are three types of abortions; in-clinic abortion, medication abortion and self managed abortion. All are proven safe, but how easy they are to get really depends on where you live. Some states make it easier to access in-clinic abortions or abortion pills, while others have banned abortion entirely (however, pills by mail is always an option no matter where you live!). Ultimately, you know what’s best for your life—whether that means going somewhere in person or getting pills mailed to you.

What do I need to consider if I’m traveling for an abortion?

Most people have the right to travel between states—unless they are on probation, on parole or under some form of state surveillance. Read more about deciding to travel for an abortion.

If you travel for an abortion—especially if you live in a highly restricted state—or for work, there are additional considerations for sex workers. While there aren’t any federal laws criminalizing sex work itself, there are federal policies that indirectly target sex workers:

• Laws such as the Mann Act and the Travel Act can target sex workers, even when traveling across state lines for unrelated reasons (e.g., seeking medical care).
• Sex workers who are non-U.S. citizens, undocumented, of immigration status, and/or more likely to be racially profiled may face extra risks when crossing state lines. You never have to tell TSA, border agents, or cops why you are traveling. Check out this informative post: “Know Your Rights”.
• The Trafficking Victims Protection Act (TVPA) was designed to protect trafficking victims, but its broad language allows law enforcement to conflate trafficking with consensual sex work. This can lead to raids and arrests of sex workers, criminalizing them, increasing their vulnerability to abuse, and limiting their access to essential services and resources.
• Be mindful of what you share on social media or through text/email about your plans, and consider taking extra steps to secure your devices and data.

How can I make sure my information is kept private and confidential during an abortion appointment?

Abortion providers, like all medical professionals, are required by HIPAA (the Health Insurance Portability and Accountability Act) to keep your information private. No one can join your appointment unless you explicitly agree to it. If you have health insurance and someone else is the policy holder (e.g., spouse, parent, guardian), they may see certain billing information. However, if you choose to self-pay, pay out-of-pocket, or receive funding from an abortion fund, your records will remain private.

Do I need to tell the doctor I’m a sex worker?

Nope. You are never legally required to disclose your employment status to a healthcare provider.

If you do disclose, watch out for possible red flags. Examples include the provider conflating sex work with sex trafficking; blaming your work for unrelated health issues; pressuring you to leave your profession; assuming that you use/abuse alcohol or substances; and/or asking inappropriate, intrusive questions about your sexual history. If you experience any kind of discrimination, you have the right to file a grievance with the healthcare facility or a complaint with your state medical board.

At the clinic, they may question you about your job. If you don’t want to disclose your sex work, you don’t have to! You can make up another profession, say you do gig work, or whatever else feels right to you. Remember, you are allowed and encouraged to set boundaries during your appointment—apply the same skills you use with your clients to keep the appointment focused on your health and not on personal details that don't matter for your healthcare.

How can I make sure my information is private when booking a place to stay?

If you're worried about sharing your ID or other identifying information when booking lodging, consider these tips. First, check Vrbo for places that offer lockboxes or coded entry so you can stay contactless—a feature that's especially helpful if someone else is booking the Vrbo for you. Additionally, consider using an alias, as some hotels don't require ID at check-in.

Programs like SWANS can help you find confidential booking!

What things should I prepare for before and after my abortion?

Plan for time off

If you are a full-service or in-person worker, you may need a few days or more to rest before returning to your routine. If you work mostly online, try to set up some posts ahead of time using social media scheduling tools while you recover.

Financial planning

Do you have a client that might be more open to virtual options, such as digital content, phone sex, or sexting? Consider other platforms or services you can offer that may be more comfortable while you care for yourself. 

Talking to clients

You NEVER have to disclose why you aren’t able to take clients in person or aren’t available on certain days. You should never feel pressured to share the abortion with a client.Let your regulars know in advance that you'll be on vacation and have content ready to share! This is especially helpful if you do a variety of sex work. If you're traveling out of state, consider reaching out to that generous client to book you before you leave.

Need an extra boost after missed wages? Chat with SWANS to see how we can help!

Take care of yourself and monitor your symptoms

It’s common to experience cramping and bleeding for a couple of weeks. Use pads to monitor bleeding (you can have bleeding and spotting for up to 2-6 weeks). Heating pads or a warm compress can help ease the pain of cramps. You may feel relief, sadness, anxiety, joy, or a mixture of emotions. All feelings are valid, and professional or peer-based support can help. Many sex workers build strong communities, so don’t hesitate to reach out to trusted friends or sex workers–led organizations (SWOPLA has support group offerings - reach out to services.swopla@proton.me)

Returning to work

Some doctors recommend avoiding putting anything in the vagina—tampons, penetrative toys, or sexual activities—for at least one week to prevent infection. However, there is no evidence of this increasing your risk of infection. You know your body best so do what feels most comfortable for you.

If you choose to return to in-person work sooner, some sex workers use makeup sponges or specially designed products like Beppy sponges to prevent bleeding. You can have sex with a sponge—there’s no string visible, the client won’t feel it, and it can be softer and more comfortable. If you do have heavier bleeding again, switch back to pads because it’s a better way to monitor. If you’re filling up 4 overnight pads in 2 hours, it could be a sign that you’re hemorrhaging and you may need to go to the hospital.

It’s common to ovulate again within 1-4 weeks after an abortion, so the chances of getting pregnant again are possible, even if you’re still bleeding. Some people may lactate after their abortion. It's more common if an abortion happens after 14-16 weeks but it can also happen earlier in pregnancy. Abortion providers who are providing abortions in the 2nd trimester often give medication to help prevent this, but not always (you can definitely ask them about it!).

I don’t have anyone to talk to about this..

As a sex worker, sharing your decision to have an abortion can feel especially vulnerable. Focus on what feels right for you—whether it’s asking for support or simply telling loved ones. Choose someone you trust and set boundaries around what you’re comfortable sharing about your work and decisions. It’s okay if their reaction isn’t what you expected or hoped for. Prioritize your safety and emotional well-being. Reach out to your local SWOP chapter for support groups (Can’t find one? Ask us!).

SWANS is creating community support for sex workers who have had abortions—reach out to us!

What if I’m worried about needing an abortion in the future?

If you aren’t pregnant now but want to be prepared if you ever are, there is advanced provision of abortion pills. Which means you can order pills before you’re pregnant, so you have them in case you are pregnant in the future.

Wanting more 1-on-1 support?

I Need An A and SWANS want you to feel supported and cared for! While stigma and legal obstacles may make the journey complicated, it’s important to remember you are not alone. There are organizations, hotlines, and fellow sex workers who understand your circumstances and are ready to help! Whether you choose a self-managed abortion, an in-clinic procedure, or something in between, you deserve compassionate, respectful care—without having to compromise your safety or privacy.

Contact SWANS. They provide not only financial aid and trauma-informed peer support for those seeking an abortion, but also flights, hotels, meals, missed wages, and assistance booking and scheduling appointments and travel. This service is FOR sex workers, BY sex workers. You do not have to live in California to receive aid.

• Repro Legal Helpline: get legal questions answered
• M+A Hotline: get medical questions answered
• Reprocare: peer support hotline for people using pills
• SWOP-LA & SWANS: financial, travel, and peer support for sex workers
• All-Options: pregnancy counseling and emotional support
• Digital Defense Fund: online tools to keep you safe

Everybody deserves safe & accessible abortion care! #sexworkiswork