Respect Accessibility

As more states restrict abortion rights, access to the abortion pill is also at risk

“Medication abortion is not going to save the day,” said Rachel K. Jones, principal research scientist at the Guttmacher Institute.
Photo of a woman holding pills
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Story at a glance

  • Medication abortion accounted for over half of all U.S. abortions in 2020.

  • But states are now passing legislation to restrict how and when it’s dispensed. 


As more state legislatures take aim at abortion rights, lawmakers are poised to jeopardize medication abortions, the most popular method of abortion for women in the U.S.  

Medication abortion consists of two pills known as mifepristone and misoprostol. The two drugs work together to stop a pregnancy from growing and were approved for use in the U.S. by the Food and Drug Administration (FDA) back in 2000. Since then, medication abortion has become the most common method of abortion, accounting for more than 54 percent of abortions in 2020.  

In some circumstances, medication abortion is the only option for women who may live in areas lacking facilities where surgical abortion is readily available. It essentially allows health care providers to “provide abortion care without anybody having to go anywhere,” said Rachel K. Jones, principal research scientist at the Guttmacher Institute, an abortion rights advocacy and research organization. 

Jones said that since the two-dose regimen was approved by the FDA, health care providers have grown more comfortable prescribing it and more women have it as an available health care option.  

“It can also require less physical contact. It’s not an invasive procedure, it doesn’t involve touching a person’s body. And so that probably made it more appealing to those health care providers and to individuals seeking abortion care,” said Jones. 

The FDA also made a critical change to how Americans could access medication abortion during the coronavirus pandemic, allowing patients to obtain the pills by mail instead of requiring in-person visits with specific health care providers. In December, the FDA moved to make that decision permanent, removing the in-person dispensing requirement because it would “reduce burden on patient access and the health care delivery system.” 


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State legislatures across the country are writing new bills to restrict access in different ways to medication abortion, whether it’s by mail or in-person. 

In South Dakota, Gov. Kristi Noem (R) signed a bill in March requiring women to make three separate in-person trips to a doctor’s office to receive both doses of medication abortion. However, the law is facing a preliminary injunction that’s preventing it from taking full effect, though Noem’s administration has filed an appeal. 

Noem’s also signed legislation that bans medical abortions through telemedicine. 

“I look forward to the day when all life (born and unborn) is protected by law. This litigation will help,” said Noem in a tweet at the time.  

Similar laws requiring a prescribing clinician to be in the physical presence of a patient exist in 19 other states, including Alabama, Arkansas, Arizona, Indiana, Kansas and more. Guttmacher created a public tracker on states that have implemented restrictions on abortion. 

Last year, when Texas Gov. Greg Abbott (R) signed his state’s abortion bill, he tweeted a message that said in part, “this bill ensures the life of every unborn child with a heartbeat will be saved from the ravages of abortion.” 

Texas banned the use of the abortion pill starting at seven weeks of pregnancy, joining Indiana which banned the medication at 10 weeks.  

That’s despite the growing usage of medication abortion in the U.S. and research supporting it is a safe and effective healthcare option. Planned Parenthood describes the abortion pill as having been safely used in the U.S. for more 20 years with rare serious complications reported. Adverse effects occur in less than .3 percent of medication abortions in the U.S., making it safer than common medications like Tylenol and Viagra.  

“They don’t care about the people who need access to abortion care. They don’t care about safety, they don’t care about health, they don’t care about science. They just have this political agenda and they’re pushing it regardless of any rational or humanistic information that’s presented to them, unfortunately,” said Jones of lawmakers that continue to push anti-choice legislation. 

Many women believe that regardless of what laws are passed, medication abortion will always remain an option, a misconception that Jones warned was not true. 

“Medication abortion is not going to save the day,” said Jones. 

If states begin outlawing abortions, as they have already begun doing so, Jones warned that medication abortion is not going to be legal or accessible to most people in those states either. 

The current wave of anti-abortion legislation is riding on a monumental Supreme Court case — Dobbs v. Jackson Women’s Health Organization, taken up in 2021.  

The case directly challenges the court’s 1973 ruling on Roe v. Wade by calling into question a Mississippi law that bans abortions after 15 weeks of pregnancy. The justices have already heard oral arguments on the case and are expected to issue their ruling before the end of the court’s term in June.  

Given the conservative majority on the court currently, the case is expected to deal a blow to abortion rights.  

The Center for Reproductive Rights, which argued before the Supreme Court to defend the right to abortion, argues that this one Mississippi case would, “give the greenlight to anti-abortion lawmakers in other states looking to restrict or prohibit abortions.”  

The center said in 2021 alone, it had tracked more than 400 restrictive anti-abortion measures introduced in different states. 

“It’s still important that people have choices about the types of abortion that they obtain, not just medication, but also being able to decide if they prefer or want to have a procedural abortion. It’s important to have both of those options available,” said Jones. 


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