More than half of abortions in the U.S. are now done with pills rather than surgery, a growth trend that intensified during the pandemic with the rise of telemedicine, a report released Thursday shows.
In 2020, pills accounted for 54% of all abortions in the U.S., compared to about 44% in 2019.
Preliminary data come from the Gutmacher Institute, a research group that supports abortion rights. The group, turning to providers, collects more comprehensive data on abortions than the U.S. government.
The use of abortion pills has been growing since 2000, when the Food and Drug Administration approved mifepristone, the main drug used in medical abortions.
The new increase is “not surprising, especially during COVID,” said Dr. Margie Gold, a family doctor and abortion provider in New York City. She said patients who want to have an abortion at her clinic have long opted for pills rather than a medical procedure.
The pandemic has sparked a rise in telemedicine and FDA action that has allowed abortion pills to be sent by mail so patients can skip personal visits to get them. These changes could help increase usage, said Guttmacher researcher Rachel Jones.
Last December, the FDA made changes permanent, meaning millions of women can get a prescription through an online consultation and receive pills in the mail. The move has intensified efforts by abortion opponents to seek further restrictions on medical abortions through state legislatures.
The procedure includes mifepristone, which blocks the hormone needed to continue pregnancy, and after one or two days – misoprostol, a drug that causes cramps that empty the uterus. The combination is allowed for use during the first 10 weeks of pregnancy, although some health professionals offer it in the second trimester, a practice called over-the-counter use.
This year, 16 state legislatures have proposed banning or restricting medical abortion, the Gutmacher report said.
It is noted that in 32 states, medical abortions must be prescribed by physicians, even if other health care providers, including paramedics, may prescribe other medications. And distributing abortion pills to patients is banned in three states – Arizona, Arkansas and Texas, the report said.
According to the World Health Organization, about 73 million abortions are performed annually. In 2019, the U.S. Centers for Disease Control and Prevention reported 630,000 abortions, although information from some states is missing. Gutmacher’s last full report on abortion dates back to 2017; data presented on Thursday comes from an update due out later this year.
World figures on the number of drugs and surgical abortions are limited. Data from England and Wales show that medical abortions are ahead of surgical abortions by about 10 years.