Abortion pill use has risen since Roe

Jumps seen as court case begins

on the eve of oral arguments in a Supreme Court case that could affect future access to abortion pills, new research shows the fast-growing use of medication abortion nationally and the many ways women have obtained access to the method since Roe v. wade was overturned in June 2022.

a study, published monday in the medical journal Jama, found that the number of abortions using pills obtained outside the formal health system soared in the six months after the national right to abortion was overturned. another report, published last week by the guttmacher institute, a research organization that supports abortion rights, found medication abortions now account for nearly two-thirds of all abortions provided by the country’s formal health system, which includes clinics and telemedicine abortion services.

the Jama study evaluated data from overseas telemedicine organizations, online vendors, and networks of community volunteers that generally obtain pills from outside the United States. before Roe was overturned, these avenues provided abortion pills to about 1,400 women per month, but in the six months afterward, the average jumped to 5,900 per month, the study reported.

overall, the study found that while abortions in the formal health care system declined by about 32,000 from July through December 2022, much of that decline was offset by about 26,000 medication abortions from pills provided by sources outside the formal health system.

“we see what we see elsewhere in the world, in the US — that when antiabortion laws go into effect, oftentimes outside of the formal health care setting is where people look, and the locus of care gets shifted,” said Dr. abigail aiken, who is an associate professor at the University of texas austin and the lead author of the Jama study.

the coauthors were a statistics professor at the university; the founder of aid access, a Europe-based organization that helped pioneer telemedicine abortion in the United States; and a leader of plan C, an organization that provides consumers with information about medication abortion.

the telemedicine organizations in the study evaluated prospective patients using written medical questionnaires, issued prescriptions from doctors who were typically in Europe, and had pills shipped from pharmacies in india, generally charging about $100. Community networks typically asked for some information about the pregnancy and either delivered or mailed pills with detailed instructions, often for free.

the guttmacher report, focusing on the formal health care system, included data from clinics and telemedicine abortion services within the United States that provided abortion to patients who lived in or traveled to states with legal abortion between January and December 2023. it found that pills accounted for 63 percent of those abortions, up from 53 percent in 2020. the total number of abortions in the report was more than 1 million for the first time in more than a decade.

in the case that will be argued before the Supreme Court on tuesday, the plaintiffs, who oppose abortion, are suing the Food and Drug administration, seeking to block or drastically limit the availability of mifepristone, the first pill in the twodrug medication abortion regimen.