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At-home abortion medication requests soared after Texas restrictions

Requests for abortion medication sent by mail went up almost 1,200 percent after a restrictive Texas law went into effect last September.
Image: Texas abortion restrictions protest
A group gathers to protest abortion restrictions at the State Capitol in Austin, Texas, on May 21, 2019.Eric Gay / AP file

Requests for abortion pills skyrocketed in Texas after a state law that bans abortions around six weeks of pregnancy went into effect last September. 

A study published Friday in JAMA Network Open, by researchers at the University of Texas, found requests made by Texans to an international humanitarian organization called Aid Access, which provides abortion medication by mail, soared by nearly 1,200 percent the week Senate Bill 8 went into effect. 

During the following three weeks, that number fell, but daily requests remained significantly elevated — an average of 37.1 daily requests compared to 10.8 requests prior to the law going into place. Requests from all other U.S. states also increased during the same time period, but by much smaller amounts. 

“What we are seeing here is keeping in step with what we’ve seen in other places where abortion has been severely restricted,” said lead study author Dr. Abigail Aiken, an associate professor of public affairs at the University of Texas, Austin.

It’s unclear how many of the requests led to at-home abortions.

It’s possible that some of the requests were made pre-emptively, by women who were not yet pregnant but wanted to have the medication on hand, said Dr. Daniel Grossman, director of Advancing New Standards in Reproductive Health at the University of California, San Francisco, who was not involved in the new study. 

Medical abortions involve taking two pills — mifepristone and misoprostol — 48 hours apart. The pills can be used up to 10 weeks into a pregnancy, according to the Food and Drug Administration.

On Thursday, the abortion rights research group Guttmacher Institute reported that more than half of abortions in the U.S. are now done with medication, rather than in-clinic surgery. The spike has been partly driven by an increase in telemedicine during the pandemic, but medical abortion has been on the rise since 2000, when the FDA approved mifepristone. 

In December, the FDA said it would permanently allow patients to receive the abortion pills by mail. 

However, mail-order abortion medications are also being targeted by state lawmakers. 

Another Texas law, SB 4, which went into effect in December, bans mail-order abortion pills and telehealth consultations for abortions. Anyone who prescribes the medication through telehealth or by mail faces jail time and a $10,000 fine.  

Grossman said the pills are very safe from a medical perspective. “But I do have real concerns about the legal risks patients may be taking,” he said. 

Thirty-six states currently require abortions to be done by a licensed physician, according to the Guttmacher Institute, but it’s still unclear how state laws apply to organizations like Aid Access, which are not based in the U.S. 

Past data has shown that such restrictions do not reduce the number of abortions performed. 

“Globally, we’ve seen time and time again that legal conditions don’t determine the number of abortions performed, but they do have a huge impact on the safety of abortion,” said Dr. Caroline Moreau, an associate professor of population, family and reproductive health at the Johns Hopkins Bloomberg School of Public Health. “Abortion medication by mail is a safe, effective option for women and pregnant people who are provided the right information and high-quality medication.” 

A 2021 study on requests to Aid Access found that the distance from an abortion clinic and whether the person lived below the federal poverty level were the two main factors that drove pregnant women to seek abortion medication by mail, which is often much cheaper than in-office care. 

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