A new analysis from the Guttmacher Institute reveals that medication abortion was the primary method for terminating pregnancies in most U.S. states in 2023, underscoring the increasing reliance on abortion pills amid ongoing legal battles.
The study, published on Feb. 27, found that in states without the most restrictive abortion policies, 63% of all abortions were medication abortions. The data, broken down by state, showed that medication abortions accounted for 95% of procedures in Wyoming and 84% in Montana. The lowest rates were reported in Washington, D.C. (44%) and Ohio (46%).
Telemedicine’s Role in Medication Abortion
The report also highlighted the growing role of telemedicine in abortion access. In states without total bans or telemedicine restrictions, 10% of abortions were conducted through online-only clinics, with the rate as high as 60% in Wyoming.
“Medication abortion is a critical option for patients in most states without total bans,” said Isabel DoCampo, a senior research associate at the Guttmacher Institute and co-author of the study. She emphasized that policymakers should work to protect and expand access to both abortion pills and telemedicine services.
The two-pill regimen of mifepristone and misoprostol is the most widely used method for medication abortions. Mifepristone, approved by the U.S. Food and Drug Administration (FDA) over two decades ago, has been deemed safe and effective through extensive research. However, legal challenges from anti-abortion activists and some lawmakers continue to threaten its availability.
A Shifting Landscape of Abortion Access
Guttmacher’s study is part of its Monthly Abortion Provision Study, an initiative launched in response to rapidly changing abortion policies following the U.S. Supreme Court’s decision to overturn Roe v. Wade. The research focused on states without near-total bans, excluding those with the strictest restrictions to protect the confidentiality of providers.
Some states, such as Georgia, Florida, and Iowa, enforce bans on abortion after approximately six weeks of pregnancy, yet medication abortion still accounted for a large share of procedures—83% in Georgia, for instance.
According to Dr. Ushma Upadhyay, a professor at the University of California, San Francisco, the data demonstrate that abortion restrictions do not eliminate demand. “People are accessing abortion care despite increasing restrictions, and medication abortion is a key reason why,” she said.
Ongoing Legal and Policy Challenges
The study also pointed to state-level variations influenced by abortion policies, insurance coverage, and clinic availability. Wyoming, for example, briefly enacted the nation’s first explicit ban on medication abortion before courts blocked the measure. Despite its restrictions, 95% of Wyoming’s abortions in 2023 were medication-based.
Legal challenges continue to shape the future of abortion access, including a case in Louisiana and Texas challenging New York’s abortion shield laws, which protect providers prescribing pills via telemedicine for patients in states with bans.
The Guttmacher Institute cautioned that its findings likely undercount the true prevalence of medication abortion, as self-managed abortions and procedures in states with near-total bans were not included.
As debates over abortion rights persist, experts emphasize that medication abortion remains a preferred method for many, offering a private, accessible, and safe option for individuals seeking reproductive healthcare.
