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Use of abortion pills increased significantly after Roe, study finds

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A study published Monday in the medical journal JAMA finds that the number of abortions using pills obtained outside the formal health system skyrocketed in the six months after the nation’s right to abortion was abolished. Another report, released last week by the Guttmacher Institute, a research organization that supports abortion rights, found that medical abortions now account for nearly two-thirds of all abortions performed by the country’s formal health system. country, which includes clinics and telemedicine abortion services.

The JAMA study evaluated data from foreign telemedicine organizations, online sellers and community volunteer networks that typically obtain pills from outside the United States. Before Roe was overturned, these facilities provided abortion pills to about 1,400 women per month, but in the six months since, the average increased to 5,900 per month, according to the study.

Overall, the study found that while abortions in the formal health system declined by around 32,000 between July and December 2022, much of this decline was offset by around 26,000 medical abortions in the formal health system. Using pills provided by sources outside the formal health system.

“We’re seeing what we’re seeing elsewhere in the world, in the United States: when anti-abortion laws come into effect, it’s often outside of formal health care that people look, and the locus of care is out of place,” said Dr. Abigail. Aiken, associate professor at the University of Texas at Austin and lead author of the JAMA study.

The co-authors were a university statistics professor; the founder of Aid Access, a Europe-based organization that helped pioneer telemedicine abortion in the United States; and leader of Plan C, an organization that provides consumers with information about medical abortion. Before publication, the study underwent the rigorous peer review process required by a major medical journal.

Telemedicine organizations participating in the study assessed potential patients using written medical questionnaires, issued prescriptions from doctors who were typically in Europe, and had pills shipped from pharmacies in India, typically charging about 100 dollars. Community networks typically requested information about pregnancy and delivered or mailed pills with detailed instructions, often for free.

The online sellers, who supplied a small percentage of the study pills and charged between $39 and $470, generally did not ask women’s medical histories and shipped the pills with the least detailed instructions. The study providers were reviewed by Plan C and found to be providing genuine abortion pills, Dr. Aiken said.

The Guttmacher report, focused on the formal health care system, included data from clinics and telemedicine abortion services in the United States that provided abortion to patients who lived or traveled to states where abortion was legal between January and December 2023.

It found that pills accounted for 63 percent of these abortions, up from 53 percent in 2020. The total number of abortions listed in the report exceeded 1 million for the first time in more than a decade.

Overall, the new reports suggest how quickly abortion provision has adapted amid post-Roe abortion bans in 14 states and strict restrictions in others.

The numbers may be an underestimate and don’t reflect the most recent change: Protection laws in six states allow abortion providers to prescribe and mail pills to tens of thousands of women in states prohibited without forcing them to travel. Since last summer, for example, Aid Access has stopped shipping medicines from abroad and operating outside the formal health system; instead, it sends pills to banned states in the United States, under the protection of protective laws.

In the case to be argued Tuesday before the Supreme Court, anti-abortion plaintiffs are suing the Food and Drug Administration, seeking to block or drastically limit the availability of mifepristone, the first medical abortion pill. with two drugs. diet.

The JAMA study suggests that such a move could lead more women to use means outside the formal U.S. health care system, such as pills from other countries.

“There are so many unknowns about what will happen with this decision,” Dr. Aiken said.

She added: “It is possible that a Supreme Court ruling in favor of the plaintiffs could have a ripple effect, as more people seek access outside of the formal healthcare setting, either because they fear so that access does not disappear. or they have more difficulty accessing medications.

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