Since the U.S. Supreme Court’s 2022 decision to allow states to regulate access to abortion, support for expanded access to abortion pills has increased significantly, including among those living in states with abortion bans, according to a new study from the Journal of the American Medical Association. .
A sample of more than 7,000 women nationwide between the ages of 15 and 49 responded to surveys in December 2021 prior to the Dobbs decision, and a random sample of half of the same population was re-surveyed in June 2023 after the decision.
The surveys gauged support for two models of expanded access to medication abortion: advance dispensing – when medication is obtained before a pregnancy and reserved for future use if necessary – and over-the-counter access at a local pharmacy or other retailer without a prescription.
Those in favor of both models rose from about 49% in 2021 to 55% in 2023, while those opposed fell from about 35% to 32%.
“While it is unlikely that states with abortion bans would offer pre-medication abortions or sell them over the counter at pharmacies if the FDA were to approve them, these models could still improve access to abortion for people living in such states,” according to the study authors. . “By expanding access to abortion to brick-and-mortar and/or online pharmacies and through telehealth in states with protected access to abortion, these alternatives would provide more options where people can travel… or get the medications from friends or family members who are in the live in the country. states with such access.”
The study also found that the barriers women faced to reproductive health care, including finding a clinic, increased slightly.
Support is growing as anti-abortion groups strive to limit access to pills 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 days before President-elect Donald Trump takes the oath of office for his second term, and Republicans now control Congress. There are pending lawsuits that could severely limit access to abortion drugs nationwide, and possible restrictions on mail distribution, a key access point for people in at least a dozen states with near-total abortion bans. Anti-abortion groups have vowed to continue trying to revoke the U.S. Food and Drug Administration’s approval of the drug mifepristone, and have expressed their willingness to remove Trump’s nominee to lead the U.S. Health and Human Services, Robert F. Kennedy Jr., because of his hostile approach to pharmaceutical drugs and vaccines.
At the same time, states where abortion is largely legal are working to expand access. Among the strategies is a pilot program in Washington state that would allow pharmacists to prescribe the medication via telehealth and protect laws that prevent states with bans from obtaining medical records or otherwise investigating cases of their residents seeking abortions in legal states.
Women generally supported greater access, even without personal interest
Individuals can often obtain abortion medications before a positive pregnancy test by ordering online, even in states where the procedure is banned, or in some cases via telehealth in a legal state. Mifepristone and misoprostol are not currently sold without a prescription.
Approximately 10% of survey participants had a history of procedural or medication abortion. The remaining respondents had never given birth or had never had an abortion. About 42% lived between six and eighteen weeks of pregnancy in a state with a total ban or restriction.
The women were asked to express their personal interest in either model after it was described. A majority of respondents had no personal interest in obtaining abortion pills before becoming pregnant, with about 26% saying they were definitely or probably interested, an increase from about 3%. But 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 especially attractive among people who were marginalized by the health care system, including people who lived in states with total abortion bans, in non-metropolitan areas, who lived in poverty, and those who experienced barriers to reproductive health and medical care. abuse,” the study authors said. “Unlike the (advance) 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 physician.”
More respondents report barriers to accessing reproductive health care after Dobbs
Respondents also largely indicated that the barriers they experienced to reproductive health care had increased since 2021. The survey listed ten potential barriers, including difficulty finding a clinic that offered services or accepted their insurance, finding a clinic where they felt comfortable, finding transportation, finding time off work and going to a clinic if a partner or family member did not want them to go. The number of women who say they face three or more of these types of 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 perspectives, including political party membership and religion, with Catholics, Evangelicals, and Protestants reporting significantly lower but increasing interest in an OTC model compared to people who did not religion reported. ,” 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 to participate in the survey, which was conducted online by a market research company.