More than 60% of US abortions in 2023 were done by pill, study shows

Following a sharp drop in access to surgical abortions following the US Supreme Court’s overturning of Roe v. Wade, the percentage of medication-assisted abortions performed in the US increased to over 60% in 2023, according to a research released on Tuesday.

Following the Supreme Court’s 2022 decision to abolish abortion rights, over a dozen states were able to close their abortion facilities and outlaw the operation altogether, limiting access to surgical abortions.

As a result, using a two-pill regimen to end pregnancies became more common in the US. Since 2020, the number of abortions performed by pill has increased by 10%, according to the Guttmacher Institute, an organisation that supports abortion rights.

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The Institute uses information gathered from US abortion providers to compile a report every three years.

According to the poll, more over a million abortions were carried out via the US healthcare system in 2023—the highest figure since 2012.

“As abortion restrictions proliferate post-Dobbs, medication abortion may be the most viable option - or the only option - for some people, even if they would have preferred in-person procedural care,” said Guttmacher principal research scientist Rachel Jones, referring to the Supreme Court case that overruled Roe v. Wade’s 1973 precedent.

However, access to medication abortion also hangs in the balance.

The US Supreme Court is scheduled to hear oral arguments on March 26 dealing with a bid by President Joe Biden’s administration to preserve broad access to mifepristone, one part of the two-pill regimen that the Food and Drug Administration (FDA) approved in 2000 for terminating early pregnancies.

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The method involves two drugs, taken over a day or two. The first, mifepristone, blocks the pregnancy-sustaining hormone progesterone. The second, misoprostol, induces uterine contractions.

The New Orleans-based 5th US Circuit Court of Appeals decided in August to reimpose restrictions on mifepristone’s delivery and distribution that the FDA had loosened to ease access during the COVID-19 pandemic. That decision is on hold pending Supreme Court action.

The FDA maintains the drug is safe and effective, pointing to its decades of use by millions of American women with exceedingly rare adverse effects.

The Guttmacher survey found the 2023 increase in total abortions was concentrated in states where terminating a pregnancy remains legal and which are adjacent to states that have banned abortion.

The survey likely undercounted the number of abortions in the US since it did not account for terminations obtained outside the formal US healthcare system, such as those done with pills mailed from abroad.