Since the U.S. Supreme Court’s 2022 decision allowing states to regulate access to abortion, a fresh study by Journal of the American Medical Association.
A sample of more than 7,000 women ages 15 to 49 from across the country participated in surveys in December 2021 before the Dobbs decision, and a random sample of half of the same population was surveyed again in June 2023 after the decision.
The surveys assessed support for two models for greater access to medication abortion: advance provision – where medications are received before pregnancy and reserved for future operate if needed – and over-the-counter access at a local pharmacy or other retailer.
The number of supporters of both models increased from approximately 49% in 2021 to 55% in 2023, while the number of supporters of both models decreased from approximately 35% to 32%.
“Although states with abortion bans are unlikely to provide preemptive medication abortions or sell them over the counter in retail pharmacies, if the FDA approves them, these models could still improve access to abortion for people living in such states,” the study authors said. “By expanding abortion access to brick-and-mortar and/or online pharmacies and via telehealth in states with protected abortion access, these alternatives would provide more opportunities to travel… or receive medications from friends or family members living in states with such access.”
The study also found a slight raise in barriers women face with reproductive health care, including finding a clinic.
Support is growing as anti-abortion groups seek to restrict access to the pill across the country
Led by Antonia Biggs, acting director of Advancing New Standards in Reproductive Health at the University of California, San Francisco, the study comes just days before President-elect Donald Trump takes the oath of office for a second term and Republicans now control Congress. Litigation is pending that could severely limit nationwide access to abortion drugs, and there could also be restrictions on mail distribution, which is the main point of access for people in at least a dozen states with near-total abortion bans. Anti-abortion organizations have this he promised to keep trying to withdraw the approval of the US Food and Drug Administration for the drug mifepristone and expressed their willingness to support Robert F. Kennedy Jr. Trump’s nominee to head the U.S. Health and Human Services because of his hostile approach to pharmaceutical drugs and vaccines.
At the same time, states where abortion is widely legal are working to expand access. The strategies include: pilot program in Washington state, allowing pharmacists to prescribe medications via telehealth and shield law that prevent prohibited states from attempting to obtain medical records or otherwise investigate when their residents seek abortions in legal states.
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Women generally supported greater access, even without personal interests
People can often obtain abortion medications before a positive pregnancy test by placing an order online, even in states where the procedure is banned, or in some cases through telehealth in legal states. Mifepristone and misoprostol are not currently sold over the counter.
About 10% of study participants had a procedural or medical abortion in the past. The remaining respondents either never gave birth or never had an abortion. About 42% lived in a state with a total ban or restriction between six and 18 weeks of pregnancy.
After describing both models, the women were asked to express their personal interest in either model. Most respondents were not personally interested in obtaining abortion pills before becoming pregnant, with about 26% saying they were definitely or probably interested, an raise of about 3%. However, many more people were personally open to over-the-counter access, with 42% saying they were definitely or probably interested.
“The (over-the-counter) model was particularly attractive to people experiencing marginalization in the health care system, including those living in states with complete abortion bans, non-urban areas, living in poverty, and those who experienced barriers to health care. reproductive health and maltreatment medicine,” say the authors of the study. “Unlike the (advanced offer) model, the OTC model may be particularly attractive to people who do not have access to high-quality, non-judgmental and respectful health care because it does not require interaction with a clinician.”
More respondents report barriers to accessing reproductive health care post-Dobbs
Respondents also largely indicated that the barriers they face in reproductive health care have increased since 2021. The study identified 10 potential barriers, which included difficulty finding a clinic that offered services or accepted insurance, finding a clinic they felt comfortable attending, finding transportation, accessing time off from work, and getting to the clinic if a partner or family member did not I want them to go there. The number of women who said they faced three or more such barriers to reproductive health care increased from 15% in 2021 to almost 18% in 2023.
“Consistent with previous research, support for these models of care varied significantly by ideological perspective, including political party affiliation and religion, with Catholics, evangelicals, and Protestants reporting significantly less but increasing interest in the OTC model compared to individuals declaring no religion,” the study said.
The work was funded by the Susan Thompson Buffett Foundation, the David and Lucile Packard Foundation, and the William and Flora Hewlett Foundation, but the funders had no role in the design or implementation of the study. English and Spanish speakers were eligible for the survey, which was conducted online by a market research company.
