Abstract
BACKGROUND: Medication abortion has accounted for an increasing share of abortions in the United States (US) since the Food and Drug Administration's approval of mifepristone in 2000. This study offers updated estimates of medication abortions provided within the formal healthcare system in 2023 in US states without total abortion bans as well as a discussion of recent trends in medication abortion provision. METHODS: The Guttmacher Institute's Monthly Abortion Provision Study employs data from monthly samples of providers in a Bayesian hierarchical model to produce estimates of abortions provided within the formal healthcare system. We estimate the number and share of medication abortions provided in 2023 in states without total abortion bans and the share of abortions provided through telemedicine-only clinics. RESULTS: Clinicians provided 648,500 medication abortions within the formal healthcare system in 2023 in states without total bans (90% uncertainty interval: 640,720-657,860), representing 63% of all abortions. Ten percent of all abortions were provided by telemedicine-only clinics. The number of medication abortions provided in US states without total abortion bans increased by 19% between 2019 and 2020, and by 32% between 2020 and 2023. DISCUSSION: Medication abortion plays a critical role in the US abortion access landscape. Medication abortion provision has accelerated since 2019, likely due to COVID-era policies that facilitated the expansion of telemedicine medication abortion provision. This shift has created essential access for individuals navigating abortion bans and other barriers to care since the removal of federal abortion protections.