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Over half of U.S. abortions now done with pills, not surgery

As the fate of abortion access remains uncertain, new preliminary data from the Guttmacher Institute released Thursday shows that medication abortions account for more than half of abortions across the country.

Guttmacher, a research group that supports abortion rights, reported that medication abortions accounted for 54% of abortions conducted in 2020. Up from 39% in 2017, 2020 marked the first year that medication abortion became the most common method.

Over two decades ago, the Food and Drug Administration approved the drug mifepristone to be used as an abortion method when combined with another drug, misoprostol. The drug combo has since been coined the “abortion pill”.

The pill is currently approved by the FDA to be taken up to 10 weeks of pregnancy, but Guttmacher says some research shows it could be safe and effective after that period.

A likely rise in the use of the pill can be traced back to COVID-19. In April 2020 the FDA allowed for abortion pills to be mailed out to patients rather than having them risk infection by going to a physician.

Principal research scientist Rachel Jones with Guttmacher says medication abortions are likely to become even more common given the political and legal climate.

“Medication abortion has been a game changer in expanding abortion care in the United States, and it will likely be an even more important option for people as many states continue to pass legislation to bar or restrict abortion access,” said Jones in a statement.

Elizabeth Nash, principal policy associate at the institute, echoed this sentiment.

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“Looking at this landscape, states with policies supportive of abortion rights must redouble their efforts to further codify, reinforce and expand those protective policies,” Nash said in a statement. “Federal action is also needed to put a stop to the barrage of state-level restrictions and attempts at outright bans on the use of medication abortion.”

Abortion has long been a debated topic, and despite precedent from the landmark case Roe v. Wade, many states are seeking to tighten abortion restrictions. Texas recently passed a bill that would ban abortions once a fetal heartbeat is detected and allows private citizens to sue anyone who assists a person trying to get an abortion.

The Texas law has been challenged in both the state’s high court and the U.S. Supreme Court, which both consist of either all or a majority of Republican-appointed justices.

As Guttmacher points out, Texas is not the only state putting restrictions on abortion access. This year alone 16 states have proposed legislation that would put restrictions on medication abortions.

In Arizona, Arkansas and Texas, sending abortion medication through the mail remains illegal. Three other states, including Montana, have tried to pass similar laws but have been shot down in courts.

Laura Briggs, a professor of women, gender and sexuality studies at University of Massachusetts Amherst, says limiting abortion access will not stop the procedures from happening, and that it is important to have safe and effective methods for individuals to use.

“Despite fear-mongering by the anti-abortion right about medication abortion, pregnant people who don’t want to or can’t continue their pregnancies have been using medical abortion safely and with ever-greater frequency over the last decade. Now people are frightened, not of mifepristone and misoprostol, but of lawmakers and activists who want to force them to be, and remain, pregnant — regardless of the health of their fetus or their own health and  well-being,” Briggs said in an email. “But limiting the right to abortion has never resulted in fewer abortions — in fact, the opposite is true. The more abortion is regulated, the more abortions there are."

She added: "Fortunately, people currently have a safe and effective alternative to abortion in the clinic or the hospital — medication abortion at home.”

Indeed, abortion has been on the decline within the last decade. According 2019 data from the U.S. Centers for Disease Control and Prevention — the most recent data available — nearly 630,000 abortions were performed nationally.

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Marko Javorac/CC BY 2.0

The Food and Drug Administration on Thursday, Dec. 16, 2021 loosened some restrictions on the pill mifepristone, allowing it to be dispensed by more pharmacies.