One in six abortions are done with online prescription pills, data shows
The news
A growing share of abortions are now performed via telemedicine, with doctors prescribing mail-order abortion pills after online consultations. the first national census of telehealth abortions in the US medical system. At least one in six abortions, about 14,000 per month, was performed via telehealth from July through September, the most recent months for which data is available.
How it works
Pills are prescribed by virtual-only providers and by clinics that also offer in-person services. Patients complete an online questionnaire or meet with a doctor via video or text chat. This method began nationwide in 2020, when the Food and Drug Administration began allowing abortion providers to ship pills without a clinic visit during the pandemic.
Some of the prescriptions included in the new count were given to patients in states that ban abortion, a new development made possible by shield laws. These laws protect doctors in states where abortion is legal when they prescribe and send pills to patients in states where it is not. Shield laws were in effect in Colorado, Massachusetts, New York, Vermont and Washington during the period covered by the new data, and California has since passed one.
Why it matters
The growth of telemedicine abortion has made it easier and often cheaper for women to obtain abortions, especially if they live far from an abortion clinic or in one of the roughly one-third of states that have banned or significantly banned abortions since the Supreme Court ruling are limited. Dobbs decision in 2022.
Activists, lawmakers and prosecutors in states with bans are trying to stem the flow of these mail-order pills. But so far they have proven difficult to regulate.
The new data from WeCount, a research group that collects abortion rates from providers nationwide and supports abortion rights, suggests that the total number of abortions performed by doctors in the United States is now slightly higher than before the Dobbs decision.
Part of the reason the overall number of abortions has not decreased is that some women who live in states with abortion bans travel to clinics in other states or order pills from out-of-state providers. Research also shows that more women are getting abortions in states where it has always been legal, due to increased financial and logistical assistance, a wave of publicity about ways to get abortions, and the expansion of telehealth.
An Upshot analysis of WeCount’s data shows that there were an average of about 3.5 percent more abortions per month in the United States from July through September than in the two months before the Dobbs decision.
“The attention everyone has paid to abortion since June 2022 has really increased public knowledge about all the issues surrounding abortion. specifically abortion pills” said David S. Cohen, professor of law at Drexel University. “Many people are having abortions that otherwise might not happen.”
What we don’t know
WeCount did not report the number of telehealth abortions under the shield laws, due to agreements with some of the providers that provided them with data. But the largest supplier, Aid Access, shipped about 5,000 prescriptions a month from July through September, said Abigail Aiken, an associate professor of public affairs at the University of Texas at Austin who studies the effects of abortion restrictions.
There are several other smaller providers that operate this way, so the total number of abortions under shield laws was slightly higher.
It is also unknown how many abortions occur with pills purchased outside the U.S. medical system, including from foreign providers. Although demand for the service has likely shrunk since the shield laws were passed, some people still order pills this way, Professor Aiken said.
Finally, researchers do not know how many women in states with bans who wanted an abortion but did not have access to one completed their pregnancies. But recent research has shown an increase in birth rates in states after they banned abortions.