Self-managed abortion requests increased 1,180% in Texas during first week of S.B. 8

The demand for self-managed medication abortions increased substantially after the abortion law S.B. 8 went into effect in Texas, according to findings published in JAMA Network Open.

Starting Sept. 1, 2021, S.B. 8 banned abortions in Texas after 6 weeks of pregnancy. Similar legislation has been proposed in other states.

“Self-managed abortion may provide an important back-up option, as well as a pathway to care for those ultimately unable to access a clinic,” Abigail R. A. Aiken, MD, MPH, PhD, an associate professor of public affairs and a fellow of the Richter Chair in Global Health Policy at the University of Texas at Austin, and colleagues wrote.

In a cross-sectional study, Aiken and colleagues analyzed data from Aid Access on medication abortion requests between Oct. 1, 2020, and Dec. 31, 2021, to assess whether requests from Texas increased after S.B. 8 was implemented. Aid Access provides self-managed medication abortions via telehealth in the U.S. The nonprofit operates outside the health care setting and is accessed through an online consultation form. Requesters who are less than 10 weeks pregnant are mailed mifepristone and misoprostol for at-home use, with online assistance available.

During the study period, Aid Access received 45,908 requests for medication abortion nationally. From Texas specifically, Aiken and colleagues reported an average of 10.8 requests per day between Oct. 1, 2020, and May 9, 2021. A small increase in requests occurred in Texas in mid-May. This increase correlated with the timing of when S.B. 8 was returned to the House for final passage, the researchers noted.

During the first week after the implementation of S.B. 8, daily requests for medication abortions increased by 1,180% compared with baseline, from 10.8 to 137.7 (95% CI, 47.7-206.2) requests per day. During the subsequent 3 weeks, Aiken and colleagues reported a decline in requests compared with the first week. However, requests remained about 245% higher than before S.B. 8 was enacted, with an average of 37.1 (95% CI, 22.4-30.27) requests per day.

Overall, Aid Access received 1,831 requests for self-managed abortion in Texas in September 2021. From Oct. 1, 2021, to Dec. 31, 2021, the researchers reported an average of 29.5 (95% CI, 17-20.5) requests per month, 174% higher than before S.B. 8. Compared with Texas, other U.S. states experienced much smaller increases in self-managed abortion requests during the study period.

“Given that clinics in neighboring states, and even in states that do not border Texas, have reported an increased volume of patients from Texas, it seems likely that in the face of uncertain options, some people made requests to Aid Access as well as seeking in-clinic care,” Aiken and colleagues wrote.

References:

Aid Access. https://aidaccess.org/en/. Accessed Feb. 25, 2022.

Aiken ARA, et al. JAMA Netw Open. 2022;doi:10.1001/jamanetworkopen.2022.1122.