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US abortions reach highest level in over a decade, sparked by surge in medication abortion
By Deidre McPhillips
CNN
Published 12:01 AM EDT, Tue March 19, 2024

Abortions are on the rise in the United States, despite bans that have
taken effect in more than a dozen states since the US Supreme Court's
Dobbs decision that revoked the federal right to abortion in June 2022.

There were more than 1 million abortions in the US in 2023, the highest
rate in more than a decade and a 10% jump from 2020, according to a
report released Tuesday by the Guttmacher Institute, a research and
policy organization focused on sexual and reproductive health that
supports abortion rights. The latest trends also suggest that
medication abortion is a more common option than ever.

Although abortions all but stopped in the 14 states with total bans,
nearly every other state had an increase in the number of abortions
provided from 2020 to 2023. As the geography of abortion care shifted
amid a fractured policy landscape, the 10% increase in abortions
nationwide meant that states without total bans saw a 25% increase in
those years.

The "drastic loss of access in states with bans has been
counterbalanced by monumental efforts on the part of clinics, abortion
funds and logistical support organizations to help people in ban states
access care through financial and practical support," the authors of
the report wrote.

States bordering those with bans had particularly large increases, but abortions also increased in other states where they remained legal.

"It is very possible that, while access was dramatically curtailed for
people living in ban states, access substantially improved for
residents of states without bans," the authors wrote.

In addition to states policies enacted to protect patients and access
to care and increased financial support from abortion funds,
researchers from the Guttmacher Institute suggest that improved access
to telehealth in recent years may have made medication abortion more
broadly available.

Medication abortion has become more common than ever post-Roe,
according to another new Guttmacher report. Nearly two-thirds of all
abortions in the US in 2023 -- an estimated 642,700 -- were medication abortions, the report says.

Medication abortion, also known as medical abortion, is a method by
which someone ends their pregnancy by taking two pills -- mifepristone
and misoprostol -- rather than having a surgical procedure.

This option has become steadily more common over the two decades it's
been available, rising from less than 10% of all abortions in the US in
2001 to 53% in 2020 and 63% in 2023.

But mifepristone, the drug that was approved for abortion use by the US
Food and Drug Administration in 2000, faces an unprecedented legal
challenge. On March 26, the US Supreme Court will hear oral arguments
in a case that puts access to the medication at stake -- even in states
where abortion remains legal -- and raises questions about the
authority that courts have to overrule determinations by FDA experts
about a drug's safety.

Misoprostol can be used on its own for a medication abortion and is a
safe alternative, but research suggests that using both pills together
is the gold standard.

Research has long found that medication abortion is safe and effective,
but another recent study found that to be true even when the patient
gets the medicine through a telehealth appointment.

"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," the Guttmacher researchers
wrote in the new report. "While the current court case only affects use
of mifepristone -- and a misoprostol-only regimen is also a safe and
effective method of medication abortion -- everyone seeking an abortion
should have access to the full range of safe, effective options."

The new reports from Guttmacher estimate abortion trends based on
responses from a sample of abortion providers in the US. They probably undercount the number of abortions in the US, as the data does not
include abortions that happen outside of the formal health care system
or medication abortions that were sent to people in states where
abortion is banned.

CNN's Jen Christensen and Tierney Sneed contributed to this report.

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