By Nathaniel Weixel - 03/25/24

The number of abortion pills obtained outside the traditional U.S. health care system spiked considerably in the months after the Supreme Court overturned Roe v. Wade, according to new data.

There were nearly 28,000 additional doses of pills for “self-managed” abortions in the six months after the fall of Roe, more than four times the number of pills per month that were reported before the decision.

In the same six months after Roe ended, there were nearly 33,000 fewer abortions that took place within the formal health care system at licensed facilities and telehealth clinics, so medication abortion nearly offsets that.

Tracking self-managed abortion is not as easy as monitoring figures from inside the bounds of the traditional health system. The study looked at the three main sources people have been using to obtain abortion medications: overseas telemedicine organizations, online vendors and networks of community volunteers.

Before Roe was overturned, those sources provided abortion pills to about 1,400 women per month. The study reported that the average jumped to 5,900 per month six months afterward.

The safety and effectiveness of medication abortion is well-established — numerous studies have shown it’s just as safe through telehealth as through in-person clinics or even when self-managed.

“While self-managed medication abortion has long been considered a marginal practice in US, our findings suggest that this approach has become mainstream,” the authors concluded.

The figures show that despite the implementation of state-level bans and restrictions, women have been finding ways to access abortion medication and terminate pregnancies. However, in the face of abortion bans, those who self-manage may face legal risks or have trouble accessing post-abortion care within the formal health care setting, should they want or need it.

The study was published Monday in the journal JAMA, a day before the U.S. Supreme Court hears oral arguments on a challenge to one of the primary abortion pills’ widespread availability. Anti-abortion advocates want the court to eliminate the ability of people to access the drugs through the mail.

Data on self-managed medication abortion trends isn’t available yet beyond the first six months post-Dobbs, but a separate analysis released last week by the Guttmacher Institute showed medication abortion is driving an increase in abortion, despite bans and restrictions.

In 2023, medication abortions accounted for 63 percent of the more than 1 million abortions performed in 2023, the Guttmacher study showed.

In the period after the study ended, abortion medication has become even easier to access. One of the major telemedicine associations, Aid Access, no longer exclusively relies on pharmacies overseas. Instead, the organization now lets U.S.-based doctors prescribe and ship medications to states with bans, making use of “shield laws” passed by several Democratic-led states.