On March 26, abortion rights activists took up the case against the abortion drug mifepristone before the Supreme Court in Washington, D.C. A study shows an increase in abortions in the United States, surprising researchers.
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On March 26, abortion rights activists took up the case against the abortion drug mifepristone before the Supreme Court in Washington, D.C. A study shows an increase in abortions in the United States, surprising researchers.
Drew Angerer/AFP via Getty Images
In the 18 months since the Supreme Court decided to end federal protections for abortion, the number of abortions in the United States has continued to grow, according to Planned Parenthood’s WeCount project.
“We were very surprised to see a slow and small steady increase in the number of abortions per month,” said Ushma Upadhyay, a professor and public health scientist at the University of California, San Francisco, who co-led the study. The report said there will be an average of 86,000 abortions per month in 2023 and about 82,000 abortions per month in 2022. “It’s not a huge increase, but we expect a decline. ”
Although 14 states had outright abortion bans during the study period, abortion rates increased slightly. The number of abortions performed in these states has dropped by about 145,000 since 2017, the report said. Dobbs decision resulted in a number of restrictive state laws.
“We know that people who live in states with abortion bans are unable to access the abortion services they need,” Upadhyay said. “Our concern is that these increases may ignore that.”
Florida, California, and Illinois have seen the largest surges in abortions, which is especially interesting considering Florida recently implemented a six-week abortion ban starting on May 1.
Abortion rights opponents demonstrate in New York City on March 23.
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Kena Betancur/AFP via Getty Images
Abortion rights opponents demonstrate in New York City on March 23.
Kena Betancur/AFP via Getty Images
The latest report also captures for the first time the impact on telemedicine providers of the state’s protections for doctors and clinics, known as “shield laws” – regulations that say they cannot be charged for providing medical services to people in other states. Prosecuted or held liable for providing abortion care.
Between July and December 2023, more than 40,000 people in states with abortion bans and telemedicine restrictions received medical abortions through providers in states protected by shield laws. Abortion pills can be prescribed through telemedicine appointments and sent by mail; these medications can safely terminate a pregnancy early in pregnancy.
The report includes abortions that occur within the U.S. health care system but does not include self-administered abortions, in which people take medication at home without a clinician’s supervision.Therefore, researchers believe these numbers still underestimate the number of abortions occurring in the United States
Increased accounting
A major factor in rising abortion rates nationwide is the rise of telemedicine, driven in part by regulations that were relaxed for the first time during the coronavirus pandemic. According to the report, telemedicine abortions now account for 19% of all abortions in the United States. In comparison, the first WeCount report from April 2022 to August 2022 showed that telemedicine abortions accounted for only 4% of all abortions. Research shows that telemedicine abortion is as safe and effective as in-clinic care.
“It’s affordable, it’s convenient, and it feels more private,” said Jillian Barovick, a Brooklyn-based midwife and co-founder of Juniper Midwifery, which provides medical abortions via telemedicine to patients in six states where abortion is legal. . The organization admitted its first patient in August 2022 and now treats about 300 patients per month.
“To have an abortion in a clinic, even a medical abortion, you might be in the clinic for several hours, whereas here you can bypass all of that,” she said. Instead, patients can connect with clinicians using text messages or a secure messaging platform. Barovick noted that in addition to charging only $100 for consultations and medications, there are cost savings because there is no need to take off work or arrange child care to spend hours in the clinic.
She said her patients receive their medications within one to four business days, “often faster than your appointment at the clinic.”
A study published Monday in the journal JAMA Internal Medicine followed about 500 women who had medical abortions who had pills distributed through mail-order pharmacies after visiting their doctors in person. More than 90% of patients were satisfied with the experience; three serious adverse events requiring hospitalization occurred.
In addition to expanding telemedicine, states including Kansas, Illinois and New Mexico have opened new clinics and increased funding for abortion care, driven by private donors and abortion funds.
Impact of the Shield Act
Between October and December 2023, nearly 8,000 people per month received medical abortion services in states with bans or severe restrictions from clinicians who provided telemedicine in the five states with shielding laws at the time. This represents almost half of the total number of telemedicine abortions performed each month.
“In general, telemedicine meets the needs of people who want or need to stay in a prohibited or restricted state to receive care,” said Angel Foster, founder of MAP, a company in Group practices operating a telemedicine model under the Massachusetts umbrella. “If you want to get abortion care in your state, and you live in Texas, Mississippi or Missouri, right now, the Shield Act is by far the primary way you can get that care.”
Foster’s team provides medical abortions up to 11 weeks to about 500 patients each month. Approximately 90% of their patients are on prohibited or restricted status; approximately one-third are from Texas, their most common state of origin, followed by Florida.
“Patients are afraid we’re a scam,” she said. “They can’t believe we’re legitimate.”
Since WeCount data was collected, other states, including Maine and California, have passed laws protecting providers who provide care across the country. The new shield law circumvents traditional telemedicine laws, which typically require out-of-state providers to be licensed in the patient’s state. States that enact abortion bans or restrictions and/or telemedicine bans hold the health care provider, not the patient, at fault.
Existing lawsuits filed by abortion opponents, including cases awaiting a Supreme Court decision, threaten to disrupt the surge in telemedicine by limiting access to the drug mifepristone nationwide. If the Supreme Court upholds the appeals court ruling, providers would essentially be barred from mailing medications and would be required to see doctors in person.
Louisiana is also working to classify abortion pills as controlled substances.
