Demand for abortion-inducing medication spiked after Texas’ near-total ban on the procedure

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The demand for abortion-inducing medication spiked in the month after Texas significantly limited abortion access and has remained high since, according to new data from a researcher at the University of Texas at Austin.

The study reviewed requests for abortion-inducing medication made to Aid Access, an international nonprofit that provides the medication via the internet to people who cannot otherwise legally access the procedure. Prior to September 2021, the organization typically received an average of 10.8 requests a day from Texans.

Then, the Texas Legislature passed Senate Bill 8, which prohibits abortions after about six weeks of pregnancy, a point at which many people do not know they are pregnant. In the first week after the law went into effect on Sept. 1, Aid Access received an average of 137.7 daily requests from Texas, an increase of over 1000%.

“That big of a spike in requests shows us the uncertainty and chaos created by Senate Bill 8 going into effect,” said Abigail Aiken, the lead researcher on the study. “If it’s not certain that you can go to a clinic and get the care that you need, people will be looking around for what other options they have.”

The demand for the medication has remained higher than normal in the months since, Aiken found.

Medical abortion is typically a two-drug regimen of mifepristone and misoprostol that has been shown to be effective at terminating a pregnancy through the first 10 weeks of pregnancy. In December, the federal government lifted a requirement that the medication be dispensed in person, allowing it to be prescribed by telemedicine and sent through the mail.

But Texas law does not allow the medication to be prescribed through telemedicine or mailed and has limited its use to the first seven weeks of pregnancy.

A spokesperson for the anti-abortion group Texas Alliance for Life said the organization is looking into ways to pursue legal action against international or out-of-state groups like Aid Access.

“It is concerning to us to see people try to find ways to work around the law,” the spokesperson, Amy O’Donnell, said. “We believe it’s significantly important for girls and women to see a physician in person before obtaining chemical abortion drugs.”

But as abortion access has narrowed in Texas, many providers say they are hearing from patients who feel that accessing this medication outside of the health care system is worth a potential risk.

“What option has the state given them?” said Amy Hagstrom Miller, president and CEO of Whole Woman’s Health. “The same amount of people still need abortions as they did before they started all these bans.”

Whole Woman’s Health operates four abortion clinics in Texas. For nearly six months, they have been unable to provide abortions after fetal cardiac activity is detected, usually around six weeks of pregnancy.

Hagstrom Miller said there has been an uptick in patients detecting their pregnancies earlier — in time to access the procedure — but the clinics are still seeing less than one-third of their typical case load. Some patients are able to travel out of state to access abortions, but Hagstrom Miller said that’s just not feasible for most.

“Almost 70% of our patients are parents already,” she said. “They’re managing work and kids [and] school during a pandemic. They can’t travel a few days to a different state. It just basically means abortion … is off the table.”

And the influx of Texans has led to long wait times at clinics in neighboring states, sometimes pushing patients beyond the window in which they can legally access care.

Hagstrom Miller said she’s not surprised there’s been an increase in demand for self-managed abortions — and that the actual increase is probably greater than any data can capture.

“These folks are a little bit invisible,” she said. “They’re either ordering pills online or they’re going to Mexico. … Most of the time, a self-managed abortion is effective, especially earlier in pregnancy, and so we’re only going to see the folks for whom it didn’t work.”

Aiken, the researcher behind the study, said it’s impossible to know how and when patients use the medication they access through Aid Access — or how many patients are terminating pregnancies through other means.

But as the U.S. Supreme Court considers whether to overturn the constitutional protection for abortion, Aiken said this Texas data serves as a snapshot of what whole swaths of the country may be facing.

“It’s clear from this research and many studies that just because you make abortion harder to get, it doesn’t mean the need for abortion goes away,” she said. “And many people, they will look for other ways of doing that.”

Disclosure: The University of Texas at Austin has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.