Although their states severely restrict abortion or place restrictions on its use via telehealth, about 8,000 women a month were receiving abortion pills by mail from states with legal protections for prescribers late last year, a new study shows.
The release of the #WeCount report on Tuesday marks the first time figures have been provided on how often the solution is used for the medical system. The research was conducted for the Society of Family Planning, which supports abortion rights.
The group found that health care providers in states with the protection in place by December 2023 were prescribing pills to about 6,000 women per month in states where abortion was banned at all stages of pregnancy or as soon as heart activity can be detected — about six weeks, often before women realize they are pregnant. The prescriptions also went to about 2,000 women each month in states where local laws restrict prescribing abortion pills via telemedicine.
“People … use the different mechanisms to get pills that are out there,” said David Cohen, a law professor at Drexel University. This “is not surprising, based on what we know throughout human history and around the world: people will find a way to end pregnancies they don’t want.”
Medication abortions typically involve a combination of two drugs: mifepristone and misoprostol. The rise of these pills, now used for most abortions in the US, is one reason why the overall number of abortions increased even after the Supreme Court overturned Roe v. Wade in 2022. The study found that the total number of monthly abortions hovered around 90,000 in 2023 – higher than the previous year.
After Roe was overturned, abortion bans went into effect in most Republican-controlled states. Fourteen states now ban it, with some exceptions, while three others ban it after about six weeks of pregnancy.
But many Democratic-controlled states went in the opposite direction. They have passed laws intended to protect people in their states from investigations of abortion-related crimes by authorities in other states. By the end of last year, five of those states — Colorado, Massachusetts, New York, Vermont and Washington — had introduced such protections specifically to cover the prescribing of abortion pills via telemedicine.
“If a Colorado provider provides telehealth to a patient located in Texas, Colorado will not participate in any criminal action or civil lawsuit in Texas,” Cohen said. “Colorado says, ‘The care provided in our state was legal. It follows our laws because the provider was in our state. ”
Wendy Stark, president and CEO of Planned Parenthood of Greater New York, called the shield law “a critical victory for abortion access in our state.”
James Bopp Jr., general counsel for the National Right to Life Committee, said the law of where the abortion occurs — and not where the prescriber is located — should apply to telemedicine abortions. It’s the same with other laws, he said.
But unlike many other aspects of abortion policy, this issue has not yet been tested in court.
Bopp said the only way to challenge a shield law in court would be for a prosecutor in a state with a ban to charge an out-of-state prescriber for providing an illegal abortion.
“It will probably happen, and we will have a legal challenge,” Bopp said.
Researchers note that before the shield laws went into effect, people obtained abortion pills from sources outside the formal medical system, but it is not clear exactly how many.
Alison Norris, an epidemiologist at Ohio State University and lead researcher on the #WeCount report, said the group is not breaking down how many pills were shipped to each state with a ban “to maintain the highest level of protection for individuals who care received. and providers who provide that care.”
Dr. Rebecca Gomperts, director of Aid Access, an abortion pill provider that works with U.S. providers, said having more protections will make the health care system more resilient.
“They are extremely important because they make doctors and healthcare providers feel safe and protected,” says Gomperts, whose organization numbers are included in the #WeCount report. “I hope that eventually we will see all states that do not ban abortion pass shield laws.”
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