One in six abortions are performed with online prescription pills, data shows


A growing proportion of abortions are now performed via telemedicine, with doctors prescribing abortion pills by mail after online consultations, according to the first national count of telehealth abortions in the US medical system. At least one of every six abortions, about 14,000 a month, were performed via telehealth between July and September, the most recent months with data available.

The pills are prescribed by exclusively virtual providers and 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 mail pills without a clinic visit during the pandemic.

Some of the prescriptions included in the new count were given to patients in states where abortion is prohibited, a new development made possible by protective laws. These laws protect doctors in states where abortion is legal when they prescribe and ship 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.

The growth of telemedicine abortion has made it easier and often less expensive for women to obtain abortions, particularly if they live far from an abortion clinic or in one of the roughly one-third of states that have banned or substantially restricted abortions since the decision of the Supreme Court. Dobbs decision in 2022.

Activists, lawmakers and prosecutors in states with bans are working to stem the flow of these mail-order pills. But until now they have proven difficult to regulate.

The new data, from WeCount, a research group that compiles abortion figures from providers across the country and supports abortion rights, suggests that the total number of abortions performed by doctors in the United States is slightly higher now 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 request pills from providers in other states. Research also suggests that more women are getting abortions in states where it has always been legal, due to increased financial and logistical assistance, a surge of advertising about ways to perform abortions, and the expansion of telehealth.

A final analysis of WeCount data suggests that there were, on average, about 3.5 percent more abortions per month in the United States between July and September than in the two months before the Dobbs decision.

“The attention that everyone has been paying to abortion since June 2022 has really increased public knowledge about all issues related to abortion, particularly abortion pills,” said David S. Cohen, a law professor at the University from Drexel. “A lot of people are having abortions and they wouldn’t have done it otherwise.”

WeCount did not report the number of telehealth abortions performed under the protective laws, due to agreements with some of the providers who provided them with data. But the largest such provider, Aid Access, shipped about 5,000 prescriptions a month from July to 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 protective laws was somewhat higher.

It is also unknown how many abortions occur with pills purchased outside the American medical system, including from foreign suppliers. While demand for this service has probably reduced since protective laws were passed, some people still order pills this way, Professor Aiken said.

Finally, researchers don’t know how many women in states with bans who wanted an abortion but couldn’t access it have carried their pregnancies to term. But recent research has found increases in birth rates in states after they banned abortions.

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