Well-Being Medical Advances

Pills are used for more than half of US abortions, survey says

Story at a glance

  • The Guttmacher Institute found medication abortions accounted for more than half of all U.S. abortions in 2020.
  • The U.S. Food and Drug Administration first approved medication abortion in 2000 in the form of a two-drug combination that became known as the “abortion pill.”
  • The medication can also be mailed to patients, but there are efforts underway in multiple states to ban and/or limit the distribution of abortion pills.

New data reveals that over recent years more women are using pills as a method of abortion, a major shift as more states implement strict restrictions on when and how women access abortion services.

The Guttmacher Institute published preliminary data that shows medication abortion accounted for 54 percent of U.S. abortions in 2020, a big jump compared to only 39 percent in 2017. The institute expects the proportion of medication abortion will continue to rise above 50 percent.

Data collected by the institute has shown a steady increase in medication abortion since 2001, starting at only 6 percent and growing to 24 percent by 2011.

The U.S. Food and Drug Administration (FDA) first approved medication abortion in 2000 in the form of a two-drug combination that became known as the “abortion pill.” The drugs are approved for use up to 10 weeks of pregnancy, but there is additional research showing provision beyond 10 weeks is safe and effective.


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A big advantage of medication abortion is that it can be taken outside of a medical setting within the comfort and privacy of one’s home. The FDA allowed the pills to be mailed to patients for the duration of the COVID-19 pandemic, which eliminated the need for patients to make an in-person trip to a health care facility. The move also allowed online-only abortion providers to mail pills to patients in more states. 

However, costs for abortion pills can still be an obstacle due to the federal Hyde Amendment, which bans the use of any federal funds for abortion unless the pregnancy is a result of rape, incest or an endangerment to the woman’s life. According to the Kaiser Family Foundation, private insurance plans’ coverage of abortion pills is inconsistent, with only six states requiring all state-regulated private health plans to include abortion coverage. 

That’s significant given the recent wave of states implementing strict abortion bans, like the state of Texas which passed S.B. 8, known as the fetal heartbeat law, which bans all abortions after fetal cardiac activity is detected. That usually happens around six weeks of pregnancy and before most women know they are pregnant.  

Florida is attempting to pass similar legislation that would ban abortions after 15 weeks of pregnancy, alongside Arizona. 

Anti-abortion policymakers are also attempting to take aim at abortion pills, with the institute noting that as of February 2022, there are 32 states that require clinicians who administer abortion pills to be physicians, limiting the distribution in rural or underserved areas where access to a physician may not be consistent. 

Notably, Texas prohibits the use of abortion medication starting at seven weeks of pregnancy, with is at odds with current medical guidance.  

Three states have outright banned the mailing of abortion pills to patients: Arizona, Arkansas and Texas. And mailing bans in three other states — Montana, Oklahoma and South Dakota — were eventually blocked by court decisions.  

The Guttmacher Institute says that medication abortion is likely to become even more critical in the delivery of care to many people who become unable to access care in a clinic, given the reality of the current anti-abortion majority on the U.S. Supreme Court. 


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