A patient’s distance from abortion services strongly influences how they access medication, with those living farther from facilities increasingly turning to telehealth and mail delivery, according to new research published in the American Journal of Public Health.
The study found that for every 100 miles of distance from an abortion facility, the probability increased by 61% that a patient would seek medication through telehealth services. This finding emerges as telehealth abortion services now constitute 20% of all U.S. abortions.
Changing Patterns of Access
“Basically, the farther the patients resided from an abortion facility, the more they were depending on the pills being mailed to them,” explains Dr. Emily Godfrey, a UW Medicine OB-GYN and family medicine physician who co-led the study.
The researchers analyzed data from 8,411 individuals across 21 states and Washington, D.C., who sought telehealth medication abortion services between 2020 and 2022. The study focused on Aid Access, a nonprofit working with clinicians who provide FDA-approved abortion medications.
According to Anna Fiastro, a UW Medicine researcher and co-lead author, “I think it is remarkable that many using the mail and telehealth option were under six weeks of pregnancy duration.” She notes this finding suggests the access method is quick, cost-effective, and safe.
Demographics and Trends
The research revealed that most individuals seeking medication through telehealth were between 20-29 years old, did not have children, and were less than 6 weeks into pregnancy. More than half of the requests came from four states: California (21%), New York (17%), Nevada (10%), and New Jersey (10%).
The study showed that people living in lower socioeconomic counties were more likely to seek medication abortion via telehealth compared to those in higher socioeconomic areas. Cost played a significant role, with 51% of telehealth users choosing this option because it was less expensive than an in-clinic visit.
During the study period, requests for telehealth medication abortions that didn’t require in-clinic testing increased fifteenfold, reaching more than 1,000 requests monthly. This represented one-third of all virtual abortions before the Supreme Court’s Dobbs decision.
As of March 2024, the researchers note that licensed U.S. physicians are now fulfilling nearly 10,000 requests monthly in states with abortion restrictions or bans. The findings underscore that maintaining access to abortion medication remains particularly crucial for young, socially vulnerable individuals living far from abortion facilities.
The research was published in the American Journal of Public Health.
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