Requests for At-Home Abortion Pills Have Nearly Tripled Since Roe Fell

In the months since the Supreme Court overturned Roe v. Wade, the number of Americans asking one organization for help ending their pregnancies at home nearly tripled, according to a study released Tuesday.

Conducted by researchers from the University of Texas, Austin, the study examined requests for abortion-inducing pills sent to Aid Access, an organization that mails the pills across the country. The study found that before Roe was overturned, Aid Access received an average of roughly 82 requests per day, according to data from 30 states. After a Supreme Court draft opinion overturning Roe leaked in May, that average spiked to 137. 

Finally, after Roe was overturned in late June and as at least 13 states implemented near-total abortion bans, the average number of daily requests shot up to about 214.

“This is a real increase driven by state policy,” said Abigail Aiken, the lead author on the study. “I think that’s quite clear from the results. There’s definitely a correlation just by the numbers. But then when you look at people’s actual reasons, they’re actually telling you, yes, this is because of those laws.”

The biggest leaps in requests for help came from people in Louisiana, Mississippi, Arkansas, Alabama, and Oklahoma—all states that have outlawed most abortions. In requests from people living in states with abortion bans, just under a third said that they wanted to induce their own abortions due to “current abortion restrictions.” 

The data from Aid Access is only a snapshot of the rapidly shifting landscape of abortion. Although Aid Access may be the most well-known source of abortion-inducing pills, it is far from the only one. People can still access telemedicine abortion services in states where the procedure remains legal, and they can order pills from international pharmacies in states where it is not. Abortion clinics may also offer both medication abortions, which rely on the same drugs often used by people who self-manage their abortions using pills, or surgical abortions. 

But the Aid Access data remains the best source of insight into people’s approach to self-managing their abortions, according to Aiken. (The definition of what constitutes a “self-managed abortion” can be a bit fuzzy, but it can generally be defined as an abortion that takes place outside of the formal U.S. healthcare system—and under that definition, Aid Access would qualify.)

Over the last four months, there have been 10,570 fewer legal abortions compared to estimates made before the end of Roe, according to data published this week by Five Thirty Eight. 

Aiken was not surprised by the increase in requests to Aid Access. Having tracked those requests for years, Aiken has found requests often spike when access to abortion clinics is cut off. After Texas passed a law in September 2021 that banned abortion as early as six weeks into pregnancy, Texans’ requests for help rose by 1,180 percent. During the height of coronavirus lockdowns, when it became extremely difficult to access clinics and some states even moved to temporarily shutter them, the rate of requests for help increased by 27 percent.

Expects have widely declared that self-managing an abortion in the first trimester of pregnancy can be safe, but it’s not without legal risk, especially in the post-Roe United States. Although self-managing your abortion is only explicitly illegal in a handful of states, prosecutors who are determined to go after you for doing so will likely find a statute that’s pliable enough to fit the supposed crime, according to experts from the organization If/When/How, which advocates for people’s right to self-manage abortions.  

At least 61 people across 26 states faced criminal consequences linked to alleged self-managed abortions between 2000 and 2020, If/When/How found.

A significant number of people who wanted help from Aid Access said that they wanted to take the pills at home, rather than go to a clinic, out of a desire for privacy, Aiken said. But while some people may simply be choosing to self-manage an abortion because they prefer it, they may also feel too ashamed to go to a clinic.

“When you make something illegal, it’s now something bad, and people feel that stigma,” Aiken said. “This internalized feeling that you’re doing something wrong can also lead people to wish for privacy.”

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