WEDNESDAY, June 29, 2022 (HealthDay News) — Shortly after news broke in May of the announcement that Roe v. Wade was at risk of being overturned by the Supreme Court, internet searches for abortion pills have increased, according to a new study.
On May 2, a leaked draft ruling said the court was set to overturn the 1973 ruling that guaranteed a woman’s right to an abortion. And within the next three days, internet searches related to abortion pills soared 162%.
The highest search volumes were in the states that, even in Roe’s time, had the most restrictions on access to abortion – with Nebraska, Iowa and Missouri in the lead. first three.
It’s unclear who was doing the research or why, said lead researcher John Ayers, of the University of California, San Diego School of Medicine.
Some people may have tried buying abortion pills online, he said, while others may have searched for information.
But the bottom line, Ayers said, is that the three-day period saw a record number of drug-related searches — and that’s an early indicator of what’s to come.
“A lot of people will try to get a medical abortion, with or without a health care provider,” Ayers said.
Time will tell soon.
On June 24, the Supreme Court formally overturned Roe v. Wade with the publication of his decision on Dobbs Women’s Health Center vs. Jackson.
Hours later, nearly 100 appointment requests flooded Just the Pill, a nonprofit that provides patients with abortion pills in multiple states,the New York Times reported.
That was about four times the usual daily number of appointment requests for the organization, and many came from patients in Texas and other states who quickly halted abortions after the court ruling, the Time said.
Medical abortion is far from new: American women have had access to it for more than 20 years, using the drugs mifepristone and misoprostol. Mifepristone blocks the hormone progesterone, causing the lining of the uterus to break down and ending the pregnancy; misoprostol stimulates contractions that empty the uterus, essentially creating a miscarriage. Patients take one tablet of mifepristone, followed by four tablets of misoprostol one to two days later.
Access to telehealth is now permanent
The diet is approved by the United States Food and Drug Administration to terminate pregnancies up to the 10th week.
Historically, women had to obtain the drugs during an in-person appointment. But during the pandemic, the FDA allowed patients to book telehealth appointments and have medications mailed to them. Last December, the agency made this change permanent.
It’s no surprise that internet searches for abortion drugs increased after the Supreme Court bill was leaked, said Liza Fuentes, senior researcher at the Guttmacher Institute.
Already, more than half of abortions nationwide are performed with medication, according to Guttmacher, a pro-choice research organization. And interest will only grow, Fuentes said, as many states ban abortion. (Guttmacher expects 26 states to do so.)
What’s unclear, Fuentes said, is exactly how medical abortion will fit into the post-Roe landscape.
State bans that have already gone into effect include medical abortion, and the same is expected from laws that will be implemented in the coming weeks.
At the same time, Attorney General Merrick Garland said in a statement after the ruling that states may not be able to ban FDA-approved drugs. And the Biden administration has pledged to expand access to abortion pills, though exactly how is unclear.
“Everything is cloudy right now,” Fuentes said. “We don’t know how this is all going to play out.”
There is currently a “workaround” for women, she said: buy abortion pills online from international telemedicine companies, which face little legal risk in the United States.
One of these companies is Aid Access, where European doctors provide online consultations and medicines are mailed from a pharmacy in India. He said he would continue to provide medicine to women in every US state.
Dr. Paula Castano, associate professor of obstetrics and gynecology at Columbia University, agreed that such online companies are an option. But she also worried about the waiting time women might face.
There are US telehealth companies that offer medical abortions, but they face legal risks in states that ban abortion. One company, Just the Pill, operates in Colorado, Minnesota, Montana and Wyoming. He said he would set up mobile clinics along the borders of abortion-banning states, to make it easier for women to travel from those states for treatment.
Crossing state lines
Even before Roe was ousted, there were stories of how patients in states with strict abortion restrictions managed to get a medical abortion — just by driving across the border. to a state with wider access and having an online consultation while sitting in their car.
“People are getting creative,” Castano said. But the frustration, she added, is that patients have to do it at all.
“It adds so many burdens to a normal, routine medical procedure,” Castano said. “We don’t do this for any other medical procedure.”
And it’s the already vulnerable patients — low-income, often people of color — who will suffer the most, Castano and Fuentes said. They may have no means of getting around for treatment.
Medical abortion is about 95% effective and very safe, the three experts said. And that includes abortions with the pills that are done at home, after a telemedicine consultation.
A study published in March examined 3,800 American women who had medical abortions during the pandemic, many of them via telehealth. It revealed that 0.5% had had an ‘adverse event’, such as hospitalization for excessive pain or bleeding.
Another recent study, of nearly 2,800 Aid Access patients, found that 96% said they had successfully terminated their pregnancy without further medical intervention. One percent said they needed treatment for a side effect, such as excessive bleeding.
The latest study was published June 29 in the journal JAMA internal medicine.
Ayers stressed that women looking for drugs online should make sure they are dealing with a reputable source.
And while medical abortion may help fill a critical need for some women, “it’s not a silver bullet,” Fuentes said. Some women will not apply or be unable to access it, and others will want in-person care rather than telehealth.
“We live in a world where people won’t be able to choose the type of care they want or get it in a timely manner,” Fuentes said.
“We know for sure,” she added, “that people will face huge obstacles for a long time.”
The nonprofit Plan C says more about medical abortion.
SOURCES: John Ayers, PhD, associate professor, Division of Infectious Diseases and Global Public Health, University of California San Diego School of Medicine; Paula Castano, MD, MPH, associate professor, obstetrics and gynecology, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York; Liza Fuentes, DrPh, MPH, Principal Investigator, Guttmacher Institute, New York; JAMA internal medicine, June 29, 2022, online
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