Telehealth accounted for nearly 1 in 5 abortions in December 2023

Telehealth is playing a significant role in expanding access to abortion care, making up 19 percent of all abortion care nationwide in December 2023, according to a new #WeCount report.

The Society of Family Planning released its sixth #WeCount report on May 14. The report presents monthly abortion volume data by state to better understand the effects of the Supreme Court’s decision to end the constitutional right to abortion — as enshrined in the 1973 landmark Roe v. Wade decision — in June 2022. #WeCount data includes clinician-provided abortions, both medication and procedural abortions, completed in a clinic, private medical office, hospital, or virtual-only clinic.

The latest report shows that there were about 17,000 telehealth abortions per month between October and December 2023. Telehealth abortions made up 18 percent of all abortions in October, 19 percent in November, and 19 percent in December.

The 17,000 monthly telehealth abortions include 930 provided by brick-and-mortar clinics, 5,800 provided under shield laws to people in states with total abortion bans or six-week abortion bans, and nearly 2,000 provided under shield laws to people in states with restrictions on telehealth abortions.

Colorado, Massachusetts, New York, Washington, and Vermont enacted shield laws in 2023. From July to December 2023, over 40,000 people in states with total or six-week abortion bans and those with telehealth abortion restrictions accessed medication abortions under shield laws.

Within states where telehealth abortions are legal, these types of abortions accounted for 7 percent of all abortions in the District of Columbia and 50 percent in Wyoming between July and December 2023.

“Access to medication abortion through telehealth continues to play an ever-increasing role in abortion care nationwide — even as the Supreme Court weighs the fate of telehealth abortion care,” Ushma Upadhyay, PhD, MPH, #WeCount co-chair and professor at the University of California, San Francisco’s Advancing New Standards in Reproductive Health (ANSIRH), in a press release. “The need for abortion care across the country demands that providers, advocates, and lawmakers continue to come together to innovate new strategies to help people access abortion care.”

Telehealth abortions have jumped since the three-month period of July to September 2023, when telehealth abortions decreased from 14,110 to 13,770.

Before that, #WeCount reports only included telehealth abortion data from virtual care providers. Virtual-only clinic abortions rose from a monthly average of 4,045 before the Supreme Court decision, making up nearly 5 percent of all abortions, to an average of 6,950 abortions per month in the year after the decision, accounting for more than 8 percent of all abortions.

Research shows that patient satisfaction with telehealth abortions is generally high. A study published in 2023 revealed that patients receiving medication abortions through telehealth felt more satisfied than those who received abortions in person. The study involved 30 patients who sought medication abortion in Washington state between September 2021 and January 2022. Of the patient population, 20 used telehealth, and ten used in-person care.

Researchers noted that telehealth patients felt more relaxed during their clinical encounters, while in-person patients reported that their visits were lengthy, chaotic, and uncomfortable.

Another study published in 2023 shows that individuals who identified as multiracial were more likely to use telehealth to obtain medication abortion services than their White peers.

For the study, researchers analyzed EMR data from 1,241 individuals, of which 383 received telehealth medication abortion services (tele-MAB), and 858 received in-clinic abortion services at a reproductive healthcare clinic in Washington State between April 23, 2020, and January 31, 2022.

They found that individuals who self-reported as multiracial or "other race" were 4.5 times more likely to use tele-MAB compared with White individuals. However, Black individuals were an exception, as they were more likely to receive in-clinic services.