What Motivates People in the United States to Seek Medication Abortion Pills Outside of the Clinic Setting?
UT Austin Population Research Center
Dana M. Johnson, Melissa Madera, Rebecca Gomperts, Abigail R.A. Aiken, November 2021
For those wanting to end a pregnancy, the cost of in-clinic abortion care can be a significant barrier. Restrictive abortion laws in the U.S. add further economic burdens to people who would like to obtain an abortion in a clinic. As abortion has become increasingly restricted, evidence is mounting that some people in the U.S. forgo the clinic altogether. Instead, these people attempt to manage their abortion on their own, outside of the formal healthcare setting. In 2018, Aid Access became the first service to provide self-managed medication abortion in the U.S. via an online telemedicine service. In this brief, PRC trainee Dana Johnson, PRC faculty scholar Abigail Aiken, and colleagues report on a recent study of 80 U.S.-based people who self-managed their abortion using medications obtained from Aid Access. They found that the high costs of in-clinic abortion care, made more difficult by restrictive state abortion policies, motivated people to seek medication abortion via online telemedicine. They also found that mothers weighed their family’s economic wellbeing in their decisions. Finally, the suggested donation of $90 for the pills was still too much for many people seeking online medication abortion.
Evidence From Over 52,000 People in England and Wales Shows Telemedicine Abortion Without Ultrasound Is Safe, Effective and Improves Care
UT Austin Population Research Center
Abigail R.A. Aiken, Patricia A Lohr, Jonathan Lord, Nabanita Ghosh, and Jennifer Starling, February 2021
The Covid-19 pandemic prompted the United Kingdom’s Royal College of Obstetricians and Gynaecologists to publish guidelines to safeguard abortion care in the UK. These new guidelines allowed for the delivery of medical abortion via telemedicine for people with pregnancies up to 10 weeks’ gestation. The telemedicine model does not require ultrasound scans unless there are reported symptoms. Based on over 52,000 reports of abortion during the study period, the authors, led by PRC faculty research associate Abigail Aiken, found that telemedicine medical abortion without ultrasound is safe, effective and improves access. They argue that no-test telemedicine should become routine in the provision of abortion care.
Northern Ireland’s Abortion Laws Have Negative Consequences for Women’s Health and Wellbeing
UT Austin Population Research Center
Abigail R.A. Aiken, Elisa Padron, Kathleen Broussard, and Dana Johnson, October 2018
Abortion is not legal in Northern Ireland, except to preserve a pregnant woman’s life or to prevent permanent damage to her physical or mental health. Despite this, women who live in Northern Ireland have abortions. Unless they qualify for one of the few legal exceptions, women obtain a clinic-based abortion by traveling to a country where abortion is legal or they use telemedicine to access medications to self-manage an abortion at home. Reporting on 30 in-depth interviews with women living in Northern Ireland, PRC faculty research associate Abigail R.A. Aiken, undergraduate student Elisa Padron and PRC graduate student trainees Kathleen Broussard and Dana Johnson show that Northern Irish women experience travel barriers, fear and anxiety surrounding the criminalization of self-managed abortion, and a breakdown of the doctor-patient relationship that isolates women and prevents them from seeking care and support through the Northern Irish healthcare system.