National Support for Medication Abortion Access Increased Since Dobbs Decision

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Support for and personal interest in expanded access to advance provision and over-the-counter medication abortion has increased significantly since the constitutional right to abortion was overturned by the Supreme Court.

National support for and personal interest in expanded access to medication abortion in the US has increased since the constitutional right to abortion was overturned in the Supreme Court’s ruling of Dobbs v Jackson Women’s Health Organization, according to a new study published in the journal JAMA Network Open.1

National Support for Medication Abortion Access Increased Since Dobbs Decision / New Africa - stock.adobe.com

National Support for Medication Abortion Access Increased Since Dobbs Decision / New Africa - stock.adobe.com

Since the Dobbs decision in June of 2022, 12 states have banned abortions outright and several others have implemented bans based on gestational duration.2 Many people have increasingly begun to use telehealth services to access medication abortion, with data suggesting that 20% of all abortions in the country were through telehealth as of March 2024. Research has shown that medication abortions are safe and effective, with very few patients ever experiencing an adverse event.3

READ MORE: Opill Marks a New Era for Birth Control Access

“Advance provision (AP) and over-the-counter (OTC) access to medication abortion are 2 additional models of care that have the potential to further increase access to abortion,” the authors wrote. “Although unlikely to be sold OTC in retail stores in states with abortion bans, both AP and OTC models have the potential to reduce travel and ensure earlier access to abortion care for people in states with and without bans, and unlike the telehealth provision, these 2 models do not require internet access or a mailing address, which may pose a barrier for some people.”

A team of investigators from the University of California, San Francisco conducted a study to examine changes in national support for and personal interest in AP and OTC access to medication abortion. Data for the cross-sectional study was gathered from 2 nationally representative online surveys administered before the Dobbs decision from December 2021 to January 2022 and after the decision from June to July 2023.

The study cohort included 10543 participants who were assigned female at birth and were between the ages of 15 to 49 years. The surveys included questions regarding people’s personal interest in and support for AP and OTC access, including asking if they would be interested in getting abortion pills ahead of time or from a pharmacy without a prescription, and if they would be in favor of this option even if they were not interested in it themselves.

The study found that support for AP increased from 48.9% to 55.1% and support for OTC increased from 49.4% to 55.2%. Personal interest in AP increased from 23.6% to 26.4% and personal support for OTC increased from 36% to 42.5%. The most common advantages that patients selected for AP and OTC were privacy, convenience, and potential to access abortion earlier in pregnancy. The most common disadvantages were that people might take the pills incorrectly, people may have unanswered questions before the abortion, and concerns that someone might be forced to take the pills without their consent.

Additionally, population groups with the largest increases in personal interest in AP included being White and living in the Midwest or in a state with a total abortion ban. People with a history of procedural abortion but no medication abortion were the only group to report a significant decline in personal interest in AP. Most population groups reported significant increases in personal interest in OTC.

“Future research should further examine the safety, acceptability, appropriateness, adoption, and feasibility of implementing these models of care,” the authors concluded. “Given the high level of interest and support for AP and OTC access, policymakers and regulators should support and facilitate the research needed for the approval of an OTC product, as well as prioritize policies that will ensure that both AP and OTC products are covered by insurance so that these approaches can become broadly available to the general public.”

READ MORE: Women's Health Resource Center

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References
1. Biggs MA, Schroeder R, Kaller S, et al. Changes in Support for Advance Provision and Over-the-Counter Access to Medication Abortion. JAMA Netw Open. 2025;8(1):e2454767. doi:10.1001/jamanetworkopen.2024.54767
2. Abortion in the United States Dashboard. Report. KFF. December 30, 2024. Accessed January 16, 2025. https://www.kff.org/womens-health-policy/dashboard/abortion-in-the-u-s-dashboard/
3. Upadhyay UD, Koenig LR, Meckstroth K, et al. Effectiveness and safety of telehealth medication abortion in the USA. Nat Med. 2024 Apr;30(4):1191-1198. doi: 10.1038/s41591-024-02834-w. Epub 2024 Feb 15. PMID: 38361123; PMCID: PMC11031403.
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