16% of All Abortions Occur Via Telehealth as Restrictions Tighten

February 29, 2024 - In the post-Dobbs era, telehealth has become a vital abortion care resource, with telehealth abortions accounting for 16 percent of all abortion care nationwide, according to a new #WeCount report.

Released by the Society of Family Planning, the report tracks changes in abortion volume nationally and by state before and after the Supreme Court decision in the Dobbs v Jackson’s Women’s Health Organization case that led to overturning federal protections on abortion access. The ruling was issued on June 24, 2022, after which nearly half of US states severely restricted abortion care.

The report reveals that monthly abortions ranged from 81,000 to nearly 89,000 between July and September 2023. In the 14 states with total abortion bans, abortion volumes declined by 120,000 compared to pre-Dobbs volumes.

Though most abortion care is provided in person, telehealth has emerged as a critical tool in expanding abortion access. Abortions occurring via telehealth typically involve a healthcare provider conducting evaluations and prescribing abortion medications virtually. The medications are then shipped to the patient’s home.

There were 14,110 telehealth abortions in July 2023, decreasing slightly to 13,770 by September 2023. These numbers include telehealth abortions provided by brick-and-mortar clinics and virtual-only providers. Telehealth made up 16 percent of all abortions in September 2023.

Prior #WeCount reports only included telehealth abortion data from virtual care providers. This data shows abortions provided by virtual-only clinics rose from a monthly average of 4,045 abortions before the Dobbs decision, making up nearly 5 percent of all abortions, to an average of 6,950 abortions per month in the year after the decision, accounting for more than 8 percent of all abortions. The change represents a 72-percent increase in the number of abortions occurring through virtual-only clinics.

The new #WeCount report not only adds data on brick-and-mortar clinics’ telehealth abortion services but also data on telehealth abortions provided under shield laws and medications mailed to states with abortion restrictions. Shield laws protect clinicians providing abortion care via telehealth in states with restrictions, and in 2023, Massachusetts, Colorado, Washington, New York, and Vermont passed these laws.

“In the post-Dobbs era, healthcare providers in some states are forging innovative new solutions to provide abortion access,” said Ushma Upadhyay, PhD, MPH, #WeCount co-chair and professor at the University of California, San Francisco (UCSF) Advancing New Standards in Reproductive Health program, in a press release. “Telehealth abortion is now a central pillar in the abortion care landscape — and the continued availability of abortion care demands that we must ensure equitable access to this essential health care service.”

The report comes on the heels of a UCSF study showing telehealth abortions are safe and effective.

Published in Nature Medicine, the study included an analysis of data from more than 6,000 patients who obtained abortion pills from virtual clinics between April 2021 and January 2022. These clinics operated in 20 states and Washington D.C.

Researchers found that a vast majority (97.7 percent) of the 6,034 abortions studied were completed without another intervention or ongoing pregnancy after the initial treatment. Nearly all (99.8 percent) of abortions did not result in serious adverse events. Only 0.25 percent of patients experienced a serious abortion-related adverse event, and emergency department visits followed 1.3 percent of abortions.

Research also shows that telehealth abortions are associated with high patient satisfaction.

A study published last May examined data from 30 patients who sought medication abortion in Washington state between September 2021 and January 2022. Of the patient population, 20 used telehealth to obtain an abortion, and ten used in-person care.

Patents across the study sample reported a high level of satisfaction, but researchers noted that telehealth patients experienced a higher level of relaxation, while in-person patients said that their visits were lengthy, chaotic, and lacking comfort.