Despite state bans, abortions nationwide are up, driven by telehealth
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The number of abortions in the U.S. has continued to grow, according to research released today. The increase is driven by the rise of telehealth abortions, where patients receive medication in the mail after consulting with a clinician. Those now account for almost 1 in 5 abortions in the U.S. NPR's Elissa Nadworny reports.
ELISSA NADWORNY, BYLINE: The new data comes from the Society of Family Planning's WeCount project. According to the report, across the country, there were on average about 4,000 more abortions per month in 2023 compared with 2022. Ushma Upadhyay is a public health scientist at the University of California San Francisco who co-led the research.
USHMA UPADHYAY: It's not huge, but it's - you know, we were expecting a decline. That's what is surprising.
NADWORNY: The slight increase comes despite the fact that abortions have plummeted in the 14 states that ban the procedure.
UPADHYAY: We're seeing 180,000 fewer abortions in states with abortion bans or restrictions.
NADWORNY: Access in other places, including new clinics, offset that decline. But the biggest factor is the rise of telehealth, which now makes up 19% of all abortions in the U.S. Jillian Barovick is a midwife in Brooklyn and one of the co-founders of Juniper Midwifery, which offers medication abortion via telehealth to patients in six states where abortion is legal.
JILLIAN BAROVICK: It's affordable. It's convenient, and it feels more private.
NADWORNY: The organization saw its first patient in August of 2022 and now treats about 300 patients a month. Research has shown that telehealth abortions are as safe and effective as in-clinic care.
BAROVICK: Having an in-clinic abortion, even a medication abortion, you could potentially be in the clinic for hours. You're having an ultrasound. They might be doing blood work. There could be a long wait.
NADWORNY: Instead, patients fill out an intake form with their medical history and then connect with a clinician using text messages or a phone call.
BAROVICK: So most patients will have their medication mailed out that day and can receive it as early as the next day.
NADWORNY: That's often faster than it takes to get an appointment at a clinic. But for abortion opponents, the rise in telehealth highlights a concerning trend and is at odds with what they say is a praiseworthy drop in abortion rates in banned states. Tessa Longbons Cox is a senior research associate at Charlotte Lozier Institute, which opposes abortion.
TESSA LONGBONS COX: Nationally, extreme policies are boosting abortion rates, including a sharp increase in dangerous mail-order abortion drugs in violation of pro-life state laws. By recklessly removing in-person medical visits and safeguards, abortion advocates have put women's health and safety last.
NADWORNY: For Katie, a 34-year-old nurse in Michigan, forgoing the in-person visit and using telehealth made more sense for her and her family than a clinic.
KATIE: It was going to be at least a week and a half - could have been longer before I could have had it.
NADWORNY: We're not using Katie's last name because she hasn't told some of her colleagues and family members about her experience.
KATIE: I had my water bottle. I had a hot pad, and I had "Schitt's Creek" cued up on Netflix. My plan was to just sit on the couch and just wait it out.
NADWORNY: The pain wasn't as bad as she anticipated. Katie used a company called Aid Access that sent her pills in the mail and connected her with a doctor.
KATIE: So I was able to text and say, hey. This is the situation. This is when I took my pill. Is this normal? And I got somebody within three minutes texting back, saying, yep.
NADWORNY: Still, dozens of states limit telehealth services. Abortion opponents have also backed several lawsuits, including one case awaiting a Supreme Court decision aimed at restricting the use of the abortion drug mifepristone for the whole country. If the Supreme Court upholds an appeals court ruling, providers would be essentially barred from mailing the drug, and an in-person doctor visit would be required. That decision is expected this summer.
Elissa Nadworny, NPR News.
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