The news
A growing share of abortions are now being administered via telemedicine, with clinicians prescribing abortion pills by mail after online consultations, according to the first nationwide count of telemedicine abortions in the US medical system. At least one in six abortions, about 14,000 a month, were performed via telehealth from July to September, the most recent months for which data are available.
How does it work
The pills are prescribed by virtual-only providers and by clinics that also offer in-person services. Patients fill out an online questionnaire or meet with a clinician 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 development made possible by shield laws. These laws protect clinicians in states where abortion is legal when they prescribe and mail pills to patients in states where it is not. Shield laws were in place in Colorado, Massachusetts, New York, Vermont and Washington during the period covered by the new data, and California has since passed a law.
Because it matters
The growth of telemedicine abortions 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 significantly restricted abortion from 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 so far they have proved difficult to regulate.
The new data, from WeCount, a research group that collects abortion numbers from providers nationwide and advocates for abortion rights, suggests that the overall number of abortions provided by clinicians in the United States is slightly higher now than it was before the Dobbs decision.
Part of the reason the overall number of abortions has not decreased is that some women who live in states where abortion is prohibited travel to clinics in other states or order pills from out-of-state providers. The survey also shows that more women are obtaining abortions in states where they have always been legal, due to increased financial and logistical assistance, an explosion of publicity about ways to obtain abortions, and the expansion of telehealth.
An Upshot analysis of WeCount data shows that there were, on average, about 3.5 percent more abortions per month in the United States from July to September than in the two months before the Dobbs decision.
The pill is now the most common method of abortion and is often prescribed to women who visit clinics in person as well as those who seek consultations online.
“The attention everyone is paying to abortion since June 2022 has really exploded the public’s knowledge of all the issues surrounding abortion, especially the abortion pill,” said David S. Cohen, a law professor at Drexel University. “A lot of people are having abortions that they might not have otherwise.”
What We Don’t Know
WeCount did not report the number of telemedicine abortions covered by the shield laws because of agreements with some of the providers who gave them data. But the largest such provider, Aid Access, sent 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 the shield laws was somewhat higher.
It is also unknown how many abortions occur with pills purchased outside the US medical system, including from overseas providers. While demand for this service has probably shrunk since the shield 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 one have completed their pregnancies. However, recent research has found increases in birth rates in states after abortion is banned.
