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l__main"><div class="l__region-inner"><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Reports</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/global/reports" hreflang="en">Global</a></li><li class="c-link-list__item"><a href="/united-states/reports" hreflang="en">United States</a></li></ul></div></div></div><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Articles</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/global/research-articles" hreflang="en">Global research</a></li><li class="c-link-list__item"><a href="/united-states/research-articles" hreflang="en">US research</a></li><li class="c-link-list__item"><a href="/policy-analysis" class="link--ruled" hreflang="en">Policy analysis</a></li><li class="c-link-list__item"><a href="/gpr?volume=24&language=en" hreflang="en">Guttmacher Policy Review</a></li><li class="c-link-list__item"><a href="/opinion" class="link--ruled" hreflang="en">Opinion</a></li></ul></div></div></div><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Fact Sheets</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/global/fact-sheets" hreflang="en">Global</a></li><li class="c-link-list__item"><a href="/united-states/fact-sheets" hreflang="en">United States</a></li><li class="c-link-list__item"><a href="/state-policy/laws-policies" hreflang="en">US State Laws and Policies</a></li></ul></div></div></div><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Data, Videos & Visualizations</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="https://data.guttmacher.org/regions" hreflang="en">Data center</a></li><li class="c-link-list__item"><a href="/videos" hreflang="en">Videos</a></li><li class="c-link-list__item"><a href="/infographics" hreflang="en">Infographics</a></li><li class="c-link-list__item"><a href="/public-use-datasets" hreflang="en">Public-use data sets</a></li></ul></div></div></div><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Peer-reviewed Journals</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/journals/ipsrh" hreflang="en">International Perspectives on Sexual and Reproductive Health (1975–2020)</a></li><li class="c-link-list__item"><a href="/journals/psrh" hreflang="en">Perspectives on Sexual and Reproductive Health (1969–2020) </a></li></ul></div></div></div></div></div></div></nav></div></div><div class="paragraph paragraph--type--layout-megamenu paragraph--view-mode--default"><div class="c-header-panel-container c-header-panel-container--left"><button class="c-header-tab c-header-tab--topics js-header__tab" role="tab" aria-selected="false" aria-controls="header-desktop__panel--topics">Topics</button><nav id="header-desktop__panel--topics" class="c-header-panel js-header__panel" role="tabpanel" aria-hidden="true" data-region="topics"><div class="Topics topics left l--megamenu"><div class="l__region l__main"><div class="l__region-inner"><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Global</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/global/abortion" hreflang="en">Abortion</a></li><li class="c-link-list__item"><a href="/global/contraception" hreflang="en">Contraception</a></li><li class="c-link-list__item"><a href="/global/hiv-stis" hreflang="en">HIV & STIs</a></li><li class="c-link-list__item"><a href="/global/pregnancy" hreflang="en">Pregnancy</a></li><li class="c-link-list__item"><a href="/global/teens" hreflang="en">Teens</a></li></ul></div></div></div><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>US</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/united-states/abortion" hreflang="en">Abortion</a></li><li class="c-link-list__item"><a href="/united-states/contraception" hreflang="en">Contraception</a></li><li class="c-link-list__item"><a href="/united-states/hiv-stis" hreflang="en">HIV & STIs</a></li><li class="c-link-list__item"><a href="/united-states/pregnancy" hreflang="en">Pregnancy</a></li><li class="c-link-list__item"><a href="/united-states/teens" hreflang="en">Teens</a></li></ul></div></div></div></div></div></div></nav></div></div><div class="paragraph paragraph--type--layout-megamenu paragraph--view-mode--default"><div class="c-header-panel-container c-header-panel-container--right"><button class="c-header-tab c-header-tab--regions js-header__tab" role="tab" aria-selected="false" aria-controls="header-desktop__panel--regions">Regions</button><nav id="header-desktop__panel--regions" class="c-header-panel js-header__panel" role="tabpanel" aria-hidden="true" data-region="regions"><div class="Regions regions right l--megamenu"><div class="l__region l__main"><div class="l__region-inner"><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Our Work by Geography</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/regions/global" hreflang="en">Global</a></li><li class="c-link-list__item"><a href="/regions/africa" class="link--ruled" hreflang="en">Africa</a></li><li class="c-link-list__item"><a href="/regions/asia" hreflang="en">Asia</a></li><li class="c-link-list__item"><a href="/regions/europe" hreflang="en">Europe</a></li><li class="c-link-list__item"><a href="/regions/latin-america-caribbean" hreflang="en">Latin America & the Caribbean</a></li><li class="c-link-list__item"><a href="/regions/northern-america" hreflang="en">Northern America</a></li><li class="c-link-list__item"><a href="/regions/oceania" hreflang="en">Oceania</a></li></ul></div></div></div></div></div></div></nav></div></div><div class="paragraph paragraph--type--layout-megamenu paragraph--view-mode--default"><div class="c-header-panel-container c-header-panel-container--left"><button class="c-header-tab c-header-tab--about js-header__tab" role="tab" aria-selected="false" aria-controls="header-desktop__panel--about">About</button><nav id="header-desktop__panel--about" class="c-header-panel js-header__panel" role="tabpanel" aria-hidden="true" data-region="about"><div class="About about left l--megamenu"><div class="l__region l__main"><div class="l__region-inner"><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Who We Are</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/about" hreflang="en">About</a></li><li class="c-link-list__item"><a href="/about/staff" hreflang="en">Staff</a></li><li class="c-link-list__item"><a href="/about/board" hreflang="en">Board</a></li><li class="c-link-list__item"><a href="/about/job-opportunities" hreflang="en">Job opportunities</a></li><li class="c-link-list__item"><a href="/newsletters" hreflang="en">Newsletter</a></li><li class="c-link-list__item"><a href="/about/history" hreflang="en">History</a></li><li class="c-link-list__item"><a href="/about/contact" hreflang="en">Contact</a></li><li class="c-link-list__item"><a href="/financial-conflict-interest-policy" class="link--ruled link--secondary" hreflang="en">Conflict of Interest Policy</a></li></ul></div></div></div><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Media</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/media-office" hreflang="en">Media office</a></li><li class="c-link-list__item"><a href="/search/site?f%5B0%5D=type%3ANews%20Release" hreflang="en">News releases</a></li></ul></div></div></div><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Support Our Work</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="https://give.guttmacher.org/give/550531/#!/donation/checkout" hreflang="en">Make a gift today</a></li><li class="c-link-list__item"><a href="https://give.guttmacher.org/give/110766/#!/donation/checkout" hreflang="en">Monthly Giving Circle</a></li><li class="c-link-list__item"><a href="/donate/support-our-work" hreflang="en">Ways to Give</a></li><li class="c-link-list__item"><a href="/guttmacher-guardians" hreflang="en">Guttmacher Guardians</a></li><li class="c-link-list__item"><a href="/donate/planned-giving" hreflang="en">Guttmacher Legacy Circle</a></li><li class="c-link-list__item"><a href="/about/financials" class="link--ruled link--secondary" hreflang="en">Financials</a></li><li class="c-link-list__item"><a href="https://www.guttmacher.org/2024-impact-report" hreflang="en">2024 Impact Report</a></li></ul></div></div></div><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Awards & Scholarships</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/darroch-award-excellence-sexual-and-reproductive-health-research" hreflang="en">Darroch Award</a></li><li class="c-link-list__item"><a href="/cory-l-richards-memorial-scholarship" hreflang="en">Richards Scholarship</a></li><li class="c-link-list__item"><a href="/bixby-international-leadership-fellowship" hreflang="en">Bixby Fellowship</a></li></ul></div></div></div></div></div></div></nav></div></div> </div> </div> <div class="c-header-desktop__donate"> <a href="https://give.guttmacher.org/give/462365/#!/donation/checkout?c_src=website&c_src2=header" class="c-header-donate-button">Donate</a> </div> </div> </div> </header> <header id="header--sticky" class="c-header c-header-mobile" aria-role="banner"> <div id="header-control-panel" class="header-control-panel"> <div class="c-header-mobile__branding"> <a href="/" class="c-header-mobile__logo link--block"> <img src="/themes/custom/gutt/logo.svg?gutt" alt="Guttmacher Institute"/> </a> </div> <div class="header__sticky--secondary"> <div class="header-donate"> <a href="https://give.guttmacher.org/give/462365/#!/donation/checkout?c_src=website&c_src2=header" class="c-header-donate-button">Donate</a> </div> <button class="header-toggle toggle" aria-expanded="false" aria-controls="header-drawer">Menu</button> </div> </div> <div id="header-drawer" class="c-header__drawer"> <div class="c-header__drawer-inner"> <div class="c-header-mobile__primary"> <div class="c-header-mobile__search"> <div class="c-header-search-form"> <div class="search-form search-api-form-block l--stack" data-drupal-selector="search-api-form" id="block-searchapiform-2"> <form class="search-form l--stack--tight" action="/search/site" method="get" id="search-api-form" accept-charset="UTF-8"> <form action="/search/site" method="get" id="search-api-form" accept-charset="UTF-8" class="l--stack--tight"> <div class="js-form-item form-item js-form-type-search form-item-terms js-form-item-terms form-no-label"> <label class="c-label form-item__label visually-hidden" for="edit-terms">Search</label> <input title="Enter the terms you wish to search for." class="search-form__input form-search form-element form-element--type-search form-element--api-search" data-drupal-selector="edit-terms" type="search" id="edit-terms" name="terms" value="" size="15" maxlength="128" placeholder="" /> </div> <div class="search-form__actions form-actions js-form-wrapper form-wrapper" data-drupal-selector="edit-actions" id="edit-actions"><input class="search-form__button button js-form-submit form-submit" data-drupal-selector="edit-submit" type="submit" id="edit-submit" value="Search" /> </div> </form> </form> </div> </div> </div> <div class="c-header-mobile__main-menu"> <div id="block-mainmegamenu" class="block-content-742b3d35-44d3-4923-9907-74ea192faecb c-header-main-menu js-header-main-menu" role="tablist"> <div class="paragraph paragraph--type--layout-megamenu paragraph--view-mode--default"><div class="c-header-panel-container c-header-panel-container--left"><button class="c-header-tab c-header-tab--our-work js-header__tab" role="tab" aria-selected="false" aria-controls="header-desktop__panel--our-work">Our Work</button><nav id="header-desktop__panel--our-work" class="c-header-panel js-header__panel" role="tabpanel" aria-hidden="true" data-region="our-work"><div class="Our Work our-work left l--megamenu l--megamenu--split"><div class="l__region l__highlights"><div class="l__region-inner"><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--highlighted"><div class="c-link-list__heading"><h2>Highlights</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/abortion-rights-supreme-court" hreflang="en">Roe v. Wade Overturned</a></li><li class="c-link-list__item"><a href="/reproductive-health-impact-study" hreflang="en">Reproductive Health Impact Study</a></li><li class="c-link-list__item"><a href="/adding-it-up" class="link--ruled" hreflang="en">Adding It Up</a></li><li class="c-link-list__item"><a href="/global/abortion" hreflang="en">Abortion Worldwide</a></li><li class="c-link-list__item"><a href="/guttmacher-lancet-commission" hreflang="en">Guttmacher-Lancet Commission</a></li><li class="c-link-list__item"><a href="/monthly-abortion-provision-study" class="link--ruled" hreflang="en">Monthly Abortion Provision Study</a></li><li class="c-link-list__item"><a href="/us-policy-resources" hreflang="en">US policy resources</a></li><li class="c-link-list__item"><a href="/state-policy-resources" hreflang="en">State policy resources</a></li><li class="c-link-list__item"><a href="/state-policy" hreflang="en">State legislation tracker</a></li></ul></div></div></div></div></div><div class="l__region l__main"><div class="l__region-inner"><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Reports</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/global/reports" hreflang="en">Global</a></li><li class="c-link-list__item"><a href="/united-states/reports" hreflang="en">United States</a></li></ul></div></div></div><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Articles</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/global/research-articles" hreflang="en">Global research</a></li><li class="c-link-list__item"><a href="/united-states/research-articles" hreflang="en">US research</a></li><li class="c-link-list__item"><a href="/policy-analysis" class="link--ruled" hreflang="en">Policy analysis</a></li><li class="c-link-list__item"><a href="/gpr?volume=24&language=en" hreflang="en">Guttmacher Policy Review</a></li><li class="c-link-list__item"><a href="/opinion" class="link--ruled" hreflang="en">Opinion</a></li></ul></div></div></div><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Fact Sheets</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/global/fact-sheets" hreflang="en">Global</a></li><li class="c-link-list__item"><a href="/united-states/fact-sheets" hreflang="en">United States</a></li><li class="c-link-list__item"><a href="/state-policy/laws-policies" hreflang="en">US State Laws and Policies</a></li></ul></div></div></div><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Data, Videos & Visualizations</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="https://data.guttmacher.org/regions" hreflang="en">Data center</a></li><li class="c-link-list__item"><a href="/videos" hreflang="en">Videos</a></li><li class="c-link-list__item"><a href="/infographics" hreflang="en">Infographics</a></li><li class="c-link-list__item"><a href="/public-use-datasets" hreflang="en">Public-use data sets</a></li></ul></div></div></div><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Peer-reviewed Journals</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/journals/ipsrh" hreflang="en">International Perspectives on Sexual and Reproductive Health (1975–2020)</a></li><li class="c-link-list__item"><a href="/journals/psrh" hreflang="en">Perspectives on Sexual and Reproductive Health (1969–2020) </a></li></ul></div></div></div></div></div></div></nav></div></div><div class="paragraph paragraph--type--layout-megamenu paragraph--view-mode--default"><div class="c-header-panel-container c-header-panel-container--left"><button class="c-header-tab c-header-tab--topics js-header__tab" role="tab" aria-selected="false" aria-controls="header-desktop__panel--topics">Topics</button><nav id="header-desktop__panel--topics" class="c-header-panel js-header__panel" role="tabpanel" aria-hidden="true" data-region="topics"><div class="Topics topics left l--megamenu"><div class="l__region l__main"><div class="l__region-inner"><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>Global</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/global/abortion" hreflang="en">Abortion</a></li><li class="c-link-list__item"><a href="/global/contraception" hreflang="en">Contraception</a></li><li class="c-link-list__item"><a href="/global/hiv-stis" hreflang="en">HIV & STIs</a></li><li class="c-link-list__item"><a href="/global/pregnancy" hreflang="en">Pregnancy</a></li><li class="c-link-list__item"><a href="/global/teens" hreflang="en">Teens</a></li></ul></div></div></div><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list c-link-list--default"><div class="c-link-list__heading"><h2>US</h2></div><div class="c-link-list__content"><ul class="c-link-list__list"><li class="c-link-list__item"><a href="/united-states/abortion" hreflang="en">Abortion</a></li><li class="c-link-list__item"><a href="/united-states/contraception" hreflang="en">Contraception</a></li><li class="c-link-list__item"><a href="/united-states/hiv-stis" hreflang="en">HIV & STIs</a></li><li class="c-link-list__item"><a href="/united-states/pregnancy" hreflang="en">Pregnancy</a></li><li class="c-link-list__item"><a href="/united-states/teens" hreflang="en">Teens</a></li></ul></div></div></div></div></div></div></nav></div></div><div class="paragraph paragraph--type--layout-megamenu paragraph--view-mode--default"><div class="c-header-panel-container c-header-panel-container--right"><button class="c-header-tab c-header-tab--regions js-header__tab" role="tab" aria-selected="false" aria-controls="header-desktop__panel--regions">Regions</button><nav id="header-desktop__panel--regions" class="c-header-panel js-header__panel" role="tabpanel" aria-hidden="true" data-region="regions"><div class="Regions regions right l--megamenu"><div class="l__region l__main"><div class="l__region-inner"><div class="paragraph paragraph--type--link-list paragraph--view-mode--default"><div class="c-link-list 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t-header-waves"> <div class="l__header l__inner u-container"> <div class="l--stack--normal l__region l--stack l--header__primary l--stack"><div class="entity-view-node l--stack"> <div class="c-meta-line" > <div class="c-meta-line"> <div class="c-metadata-tag c-metadata-tag--light-violet" > Policy Analysis </div> <div class="c-metadata-tag c-metadata-tag--default" > March 2024 </div> </div> </div> </div> <div class="field-block-node-policy-analysis-title l--stack"> <span> <h1 class="c-page-title c-page-title--article-title" >Medication Abortion Accounted for 63% of All US Abortions in 2023—An Increase from 53% in 2020</h1> </span> </div> </div> </div> </div> <div class="l__inner t-pane t-white"> <div class="l__main u-container"> <div class="l--stack--normal l__region l--stack l__image l__sidebar-region"> <div class="field-block-node-policy-analysis-field-shr-image l--stack"> <div class="field field--name-field-shr-image field--type-entity-reference field--label-hidden field__item"><div> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <img loading="lazy" src="/sites/default/files/styles/large/public/2024-03/Medication%20Abortion%203.13.24%20Preview.png?itok=E41H1x6Z" width="480" height="384" alt="Image of a medication abortion pill with an arrow pointing up. Text reads, "Medication abortion, 2000 to 2023"" /> </div> </div> </div> </div> </div> <div class="l--stack--normal l__region l--stack l__primary t-pane t-white "> <div class="field-block-node-policy-analysis-field-shr-authors l--stack"> <div class="t-pane t-gray-lightest u-p-28 l--stack--minimal t-pane-rounded"> <h3 class="c-label" > Authors </h3> <span data-component-id="gutt:author" class="c-author"><span class="c-author__name"><a href="https://www.guttmacher.org/about/staff/rachel-k-jones"><span>Rachel K. Jones</span></a></span><span class="c-author__separator">, </span><span class="c-author__organization">Guttmacher Institute</span></span> <span data-component-id="gutt:author" class="c-author"><span class="c-author__name"><a href="https://www.guttmacher.org/about/staff/amy-friedrich-karnik"><span>Amy Friedrich-Karnik</span></a></span><span class="c-author__separator">, </span><span class="c-author__organization">Guttmacher Institute</span></span> </div> </div> <div class="gutt-donate-callout l--stack"> <div class="t-gray-light c-donate-ad" > <div class="c-donate-ad__inner"> <p class="c-donate-ad__text"> Reproductive rights are under attack. Will you help us fight back with facts? </p> <div class="c-donate-ad__link"> <a href="https://give.guttmacher.org/give/550531/#!/donation/checkout">Donate</a> </div> </div> </div> </div> <div class="field-block-node-policy-analysis-field-content l--stack"> <div class="l--stack"> <div class="paragraph paragraph--type--basic-text paragraph--view-mode--default"> <div class="text-content c-content l--stack"> <p>New Guttmacher Institute research from the <a href="https://www.guttmacher.org/monthly-abortion-provision-study">Monthly Abortion Provision Study</a> shows that there were approximately 642,700 medication abortions in the United States in 2023, accounting for 63% of all abortions in the formal health care system. This is an increase from 2020, when medication abortions accounted for 53% of all abortions.  </p> <p> </p> <div> <div class="field field--name-field-media-image field--type-image field--label-hidden field__item"> <a href="/sites/default/files/2024-03/Medication%20Abortions%20Policy%20Analysis%20Fig%201%20Abortions%20in%20Formal%20US%20health%20care%20system%20300484.png"><img loading="lazy" src="/sites/default/files/2024-03/Medication%20Abortions%20Policy%20Analysis%20Fig%201%20Abortions%20in%20Formal%20US%20health%20care%20system%20300484.png" width="1800" height="1284" alt="Medication abortions accounted for more than 60% of all abortions in the formal US health care system in 2023"> </a> </div> </div> <p> </p> <p><a href="https://www.guttmacher.org/2024/02/medication-abortion-within-and-outside-formal-us-health-care-system-what-you-need-know">Medication abortion using mifepristone</a> was first approved for use in the United States by the U.S. Food and Drug Administration (FDA) in 2000, and reliance on medication abortion has increased steadily as it has become more accessible over time. The two-drug combination of mifepristone and misoprostol is the most common medication abortion regimen offered by US providers, and decades of research have established that medication abortion using mifepristone is <a href="https://www.supremecourt.gov/DocketPDF/23/23-235/299159/20240220110531937_23-235%2023-236%20tsac%20Over%20300%20Reproductive%20Health%20Researchers.pdf">highly safe and effective</a>. Increased access to and use of medication abortion is likely one reason why the overall number of abortions in the formal health care system <a href="https://www.guttmacher.org/2024/03/despite-bans-number-abortions-united-states-increased-2023">increased 10% nationally</a> between 2020 and 2023.</p> <p>The medication abortion counts for 2023 do not include <a href="https://www.guttmacher.org/2024/02/medication-abortion-within-and-outside-formal-us-health-care-system-what-you-need-know">self-managed medication abortions</a> that take place outside of the formal health care system or abortion medication mailed to people in states with total abortion bans. While there are no comprehensive data on the number of self-managed medication abortions in the United States, evidence suggests they <a href="https://jamanetwork.com/journals/jama/fullarticle/2797883">have been increasing</a> in the past several years. Therefore, the total count of medication abortions nationally is higher than our count of those offered within the formal health care system.</p> <p>Unfortunately, gains in access to and use of medication abortion are at risk. The US Supreme Court will hear a case on March 26—<em>Alliance for Hippocratic Medicine v. FDA</em>—that uses low-quality science to <a href="https://www.guttmacher.org/article/2024/02/why-flawed-study-medication-abortion-was-retracted ">challenge access to medication abortion</a> using mifepristone. The Court could restrict the ability to mail mifepristone directly to patients and reinstate the requirement for the drug to be provided in person. If outdated and medically unnecessary restrictions are placed on the provision of mifepristone—in contrast with the FDA’s evidence-based protocol—access to abortion across the country would be greatly impacted.</p> <h2><strong>Medication Abortion Has Become More Widely Available</strong></h2> <p>For many people, medication abortion is more accessible than a procedural abortion. In 2021 (the most recent year with available data), 40% of facilities known to provide abortion care <a href="https://www.ansirh.org/sites/default/files/2022-06/Trends%20in%20Abortion%20Care%20in%20the%20United%20States%2C%202017-2021.pdf">offered only medication abortion</a>. And, starting in 2021, the FDA lifted medically unnecessary restrictions that had required in-person provision of mifepristone. That <a href="https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2023/01/updated-mifepristone-rems-requirements">regulation change</a>, which the FDA finalized in January 2023, meant that health care providers and online pharmacies could mail abortion medication to patients, including those who live far from a provider or are otherwise unable to make an in-person visit. In addition, brick-and-mortar pharmacies can now become certified to <a href="https://www.nbcnews.com/health/health-news/cvs-walgreens-dispense-abortion-pill-mifepristone-rcna141396">dispense and fill mifepristone prescriptions</a>, so access is expected to continue growing.</p> <p>The number of US providers offering a telemedicine consultation—by video, phone call, text or online platform—and <a href="https://www.ansirh.org/sites/default/files/2023-06/AFD%20Telehealth%20Issue%20Brief%206-14-23%20Final.pdf">mailing abortion pills increased</a> from 7% of all providers known to offer medication abortion in 2020 to 31% in 2022. Online-only clinics, after first appearing as a new type of abortion provider in 2021, accounted for <a href="https://societyfp.org/wp-content/uploads/2024/02/SFPWeCountPublicReport_2.28.24.pdf">8% of all abortions</a> provided within the formal health care system in the first six months of 2023.</p> <p>Medication abortion provided via telemedicine is as <a href="https://www.nature.com/articles/s41591-024-02834-w">safe and effective</a> as provision in a health care facility. Offering options besides in-person care can reduce, or even remove, some of the secondary costs related to seeking an abortion, such as transportation, child care and missed wages from taking time off work. Like with other types of health care, having the option to access abortion care via telemedicine allows for more flexibility and can expand <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465833/">person-centered care</a> by meeting patients where they want to be served.</p> <h2><strong>Not All People Prefer Medication Abortion Over Procedural Abortion</strong></h2> <p>While broader access to medication abortion has likely contributed to its increased use, it does not necessarily indicate that all people are getting their preferred method. </p> <p>Since the Supreme Court’s <em>Dobbs v. Jackson Women’s Health Organization</em> decision in June 2022 ended a right to abortion nationally, there has been an increase in patients at clinics in states where abortion continues to be available. Sixteen percent of abortion patients <a href="https://www.guttmacher.org/monthly-abortion-provision-study">traveled out of state for an abortion</a> in 2023, and there has been increased demand on providers in states that border one of the <a href="https://states.guttmacher.org/policies/">14 states where abortion is totally banned</a>. At the same time, abortion has also increased among residents in almost all of these bordering states. In some places, these developments have led to <a href="https://experience.arcgis.com/experience/6e360741bfd84db79d5db774a1147815">wait times</a> of two weeks or longer for abortion care.</p> <p>Some individuals may opt to access care through telehealth options to avoid long wait times for appointments, even if they would have preferred in-clinic care. Even at brick-and-mortar clinics, wait times may be shorter for medication abortion than procedural abortion since the pills can be offered by methods such as “<a href="https://onlinelibrary.wiley.com/doi/10.1363/psrh.12215">quick pick-up</a>.” Finally, for some patients, the closest abortion provider may only offer medication abortion, limiting their access to a procedural abortion unless they can travel to a clinic where it is offered.</p> <p>When procedural abortion is harder to access relative to medication abortion, the impact of those restricted options falls hardest on groups of people historically marginalized within the health care system. For example, research suggests that Black individuals, people who have had a prior abortion and those with incomes below the federal poverty level are less likely than other groups <a href="https://www.sciencedirect.com/science/article/pii/S0010782420304637">to prefer</a>, and <a href="https://www.contraceptionjournal.org/article/S0010-7824(23)00231-7/fulltext">to have</a>, a medication abortion (vs. a procedural abortion).</p> <h2><strong>State Restrictions on Use of Medication Abortion</strong></h2> <p>Anti-abortion policymakers have been working to restrict access to abortion care on many fronts. Besides the 14 states that are <a href="https://states.guttmacher.org/policies/">enforcing a total ban on abortion</a>, five states where abortion remains legal until at least six weeks’ gestation have laws that restrict access to medication abortion via telemedicine. Arizona, Nebraska, North Carolina, South Carolina and Wisconsin require that a patient being prescribed medication abortion have an in-person visit with a physician, and Arizona and North Carolina also ban mailing medication abortion pills to a patient. Furthermore, 15 states require medication abortion to be provided by a physician, despite evidence that advanced practice clinicians can provide it safely, as they do in other states.</p> <h2><strong>It Is Critical to Ensure Full Access to Medication Abortion</strong></h2> <p>Medication abortion has proven to be a game changer in expanding abortion care in the United States. Unfortunately, legal attacks and restrictive policies continue to challenge access. When the Supreme Court rules on the case challenging access to mifepristone this spring, it will have to decide whether to ignore the FDA and reimpose unnecessary barriers to access or to respect the scientific evidence that mifepristone is safe and effective.  </p> <p>Any return to restrictions on medication abortion provision via telemedicine would be detrimental for people who either prefer or only have access to abortion using telemedicine. While the current court case only affects use of mifepristone—and a misoprostol-only regimen is also a <a href="https://societyfp.org/wp-content/uploads/2023/02/SFP_ScienceSays_misoprostol.pdf">safe and effective method</a> of medication abortion—everyone seeking an abortion should have access to the full range of safe, effective options.</p> <h2><strong>Methodology</strong></h2> <p>Data on medication abortion for 2023 are from Guttmacher’s <a href="https://www.guttmacher.org/monthly-abortion-provision-study">Monthly Abortion Provision Study</a>, which produces national and state estimates of the number of abortions provided within the formal health care system in the United States based on data collected from samples of abortion providers. Questions about medication abortion were included in versions of the survey distributed to providers in August and September 2023 and in February 2024 (with the latter asking providers for annual medication abortion figures for 2023). Estimates include abortions provided at brick-and-mortar facilities (including those that use telehealth) and online-only providers. These estimates do not include abortions obtained outside of the formal health care sector or any abortions—whether self-managed or provided by out-of-state clinicians—involving medication mailed to states with total abortion bans.</p> </div> </div> </div> </div> <div class="entity-view-node l--stack"> <section class="section--article l--stack--normal"> <div class="node_view"> </div> </section> </div> </div> <div class="l--stack--loose l__region l--stack l__sidebar-secondary l__sidebar-region t-pane t-white "> <div class="entity-view-node l--stack u-mt-28"> <div class="c-meta-extended" > <div class=""> <p class="c-verbose-publushed-date"> First published online: <time datetime="2024-03-19T12:00:00Z">March 19, 2024</time></p><div class="node_view"> </div> </div> </div> </div> <div class="gutt-social-share l--stack"> <div class="clear-both c-social-share"> <h3 class="c-social-share__heading">Share</h3> <div class="c-social-share__platforms"> <ul class="c-social-share__list"> <li 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<article class="c-simple-listing" > <span class="c-simple-listing__type">Initiative</span> <h4 class="c-simple-listing__title"> <a href="/monthly-abortion-provision-study" class="c-simple-listing__title-link"><span>Monthly Abortion Provision Study</span> </a> </h4> </article> </div> <div class="c-listing__item"> <article class="c-simple-listing" > <span class="c-simple-listing__type">News Release</span> <h4 class="c-simple-listing__title"> <a href="/news-release/2024/medication-abortions-accounted-63-all-us-abortions-2023-increase-53-2020" class="c-simple-listing__title-link"><span>Medication Abortions Accounted for 63% of All US Abortions in 2023, an Increase from 53% in 2020 </span> </a> </h4> </article> </div> <div class="c-listing__item"> <article class="c-simple-listing" > <span class="c-simple-listing__type">Policy Analysis</span> <h4 class="c-simple-listing__title"> <a href="/2024/03/despite-bans-number-abortions-united-states-increased-2023" class="c-simple-listing__title-link"><span>Despite Bans, Number of Abortions in the United States Increased in 2023</span> </a> </h4> <div class="c-simple-listing__byline"> <em></em> </div> </article> </div> <div class="c-listing__item"> <article class="c-simple-listing" > <span class="c-simple-listing__type">Policy Analysis</span> <h4 class="c-simple-listing__title"> <a href="/2024/02/medication-abortion-within-and-outside-formal-us-health-care-system-what-you-need-know" class="c-simple-listing__title-link"><span>Medication Abortion Within and Outside the Formal US Health Care System: What You Need to Know</span> </a> </h4> <div class="c-simple-listing__byline"> <em></em> </div> </article> </div> <div class="c-listing__item"> <article class="c-simple-listing" > <span class="c-simple-listing__type">Policy Analysis</span> <h4 class="c-simple-listing__title"> <a href="/2023/07/mifepristone-abortion-global-context-safe-effective-and-approved-nearly-100-countries" class="c-simple-listing__title-link"><span>Mifepristone for Abortion in a Global Context: Safe, Effective and Approved in Nearly 100 Countries </span> </a> </h4> <div class="c-simple-listing__byline"> <em></em> </div> </article> </div> </div> </div> </div> </div> <div class="gutt-divider c-divider__wrapper"> <div data-component-id="gutt:divider" class="c-divider" ></div> </div> <div class="gutt-divider c-divider__wrapper"> <div data-component-id="gutt:divider" class="c-divider" ></div> </div> <div class="entity-view-node l--stack"> <section class="terms__wrapper l--stack--normal"> <div class="c-terms__wrapper"> <h3 class="c-label" > Topic </h3> <div class="c-terms"> <h4 class="c-terms__subheading">United States</h4> <ul class="c-terms__list"> <li class="c-terms__item"> <a href="/united-states/abortion" class="c-terms__link--primary" hreflang="en">Abortion</a> </li> </ul> </div> </div> <div class="c-terms__wrapper"> <h3 class="c-label" > Geography </h3> <div class="c-terms"> <ul class="c-terms__list"> <li class="c-terms__item"> <a href="/regions/northern-america" class="c-terms__link--primary" hreflang="en">Northern America</a>: <a href="/regions/northern-america/united-states" hreflang="en">United States</a> </li> </ul> </div> </div> <div class="c-terms__wrapper"> <h3 class="c-label" > Tags </h3> <div class="c-terms"> <div class="c-terms__item"> <a href="/tags/supreme-court-scotus" hreflang="en">Supreme Court (SCOTUS)</a>, <a href="/tags/medication-abortion" hreflang="en">medication abortion</a>, <a href="/tags/provision-study" hreflang="en">provision study</a> </div> </div> </div> <div class="node_view"> </div> </section> </div> <div class="gutt-divider c-divider__wrapper"> <div data-component-id="gutt:divider" class="c-divider" ></div> </div> <div class="gutt-cta-simple l--stack"> <div data-component-id="gutt:cta-simple" class="gutt-cta gutt-cta-default bg--navy has-waves heading--ruled"> <div class="gutt-cta__content"> <h3 class="gutt-cta__heading">US 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