Pill-Induced Abortions on the Rise in America. Why That's a Good Thing

At Planned Parenthood clinics, 43 percent of all abortions are now drug-induced, not surgical.


Bill Greenblatt UPI Photo Service/Newscom

While the overall U.S. abortion rate continues to decline, a growing percentage of legal abortions in America are being induced via drugs, not surgery, with 43 percent of abortions at Planned Parenthood clinics relying on this method in 2014. That's up from 35 percent in 2010, according to a Reuters analysis of clinic data. And in states without strong legal restrictions on abortion pills, the rates relative to surgical abortion were even higher. In Michigan, they comprised 55 percent of all abortions and in Iowa, 64 percent.

The two medications used for drug-induced abortions in America—mifepristone and misoprostol—were approved by the U.S. Food and Drug Administration (FDA) 16 years ago. "The method was expected to quickly overtake the surgical option, as it has in much of Europe," Reuters notes. "But U.S. abortion opponents persuaded lawmakers in many states to put restrictions on their use."

Most of these state restrictions have been rooted in religion, ideology, and politics rather than good-faith concern for women's safety. Taking mifepristone and misoprostol to terminate a pregnancy—aka medical abortion (in contrast with surgical abortion)—has been found just as safe if not safer than surgical abortion, and it doesn't require a woman to be put under anesthesia or undergo an invasive procedure. Even more revolutionary, this sort of abortion doesn't require—at least not for medical reasons—a visit to a hospital or any sort of specialized abortion clinic, nor the employ of a specialized doctor. After a basic health check-up and an ultrasound to determine gestational age (the pill regimen is only recommended and approved up to 10 weeks pregnancy), the whole process involves ingesting one pill and, within the next 72 hours, ingesting another pill.

This isn't to say medical abortion is an easy process for women, who report extreme cramping, nausea, and other difficulties for a few hours to a few days after taking the pills. But it is, for many women, easier than obtaining a surgical abortion, with one of the biggest benefits being that it can cost significantly less. This, combined with its ability to take place outside a special health facility, makes it much more accessible to rural and low-income women. And increased accessibility may lead, in turn, to earlier pregnancy terminations.

Since medical abortion has been legal in the U.S., the percentage of abortions performed in the first six weeks gestation has grown significantly. According to the U.S. Centers for Disease Control and Prevention (CDC), the percentage of U.S. abortions occurring within the first six weeks of pregnancy rose 24 percent between 2003 and 2012. Meanwhile, the percentage of abortions occurring at or after 13 weeks remained relatively unchanged. This means the biggest shift was from abortions occurring between weeks six and 13 toward those occurring between weeks one and six.

This doesn't necessarily mean medical abortions drove the shift to earlier abortions, but it is one plausible (partial) explanation, given the simultaneous growth in medical abortions as a share of overall (and especially early-term) procedures. Between 2001 and 2011, medical abortions went from 6 percent of all abortions to 23 percent, according to the CDC's most recent report.

Some have worried that the increased availability of abortion drugs has or will lead to an increase in the total number of abortions that occur in America. But so far, these fears seem to be unfounded: between 2002 and 2011, the total number of U.S. abortions decreased 13 percent, according to the CDC. The abortion rate—the number of abortions per every 1,000 women ages 15- to 44-years-old—was also down, by 14 percent, to 13.9 abortions per 1,000 women. And this rate is down from nearly 30 abortions per 1,000 women in 1980.

The bottom line is that U.S. women are both getting fewer abortions and, when they do, having them earlier in their pregnancies. And a big part of the latter may be due to drug-induced abortion. But many state legislatures have passed or tried to pass laws strictly limiting where, when, and how it could be prescribed and administered, including insisting the pill must be prescribed in a building that meets the requirements for ambulatory surgical centers, banning partial-telemedicine appointments, and requiring doctors to use an outdated protocol that meant more medication and more in-person clinic visits than necessary. These are efforts that should be opposed by not just abortion-rights activists or the radically pro-choice but anyone who believes abortion should be legal in the first trimester at least, believes medical policy should be driven by science not religion, and/or wants to encourage women who do choose abortion to do so as early as possible.

There has been some good news on this front lately. Earlier in 2016, the FDA finally revised its outdated guidelines for prescribing the mifepristone and misoprostol regimen. Under the new rules, doctors can prescribe the abortion pills up to 10 weeks or pregnancy, among other things. The American Congress of Obstetricians and Gynecologists said it was "pleased that the updated F.D.A.-approved regimen for mifepristone reflects the current available scientific evidence and best practices."

Reuters suggests that drug-induced abortions likely make up a larger percentage of U.S. abortion procedures (at Planned Parenthood and elsewhere) since the FDA change, which took place after the most recent Planned Parenthood data was collected. "In three states most impacted by that change—Ohio, Texas and North Dakota—demand for medication abortions tripled in the last several months," Reuters found from talking to clinics, state health departments and Planned Parenthood affiliates in these states.

NEXT: Top Hillary Clinton Adviser Thinks U.S. Should Attack Iran To Benefit Saudi Interests In Yemen

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  1. I’m calling it: no less than 62% of the comments on this will be Eddie.

    1. Didin’t you hear: Eddie got retro-aborted.

      1. Oh! That’s a shame.

    2. Shit – i was going to ask for odds on what the chances are he posts *not at all*

      1. I hope you didn’t wager any large amounts.

  2. ENB, sigh… you done went and done it now…

    1. It’s Halloween. I guess she decided we get tricks instead of treats this year.

      1. Theyr’e not ‘tricks’, they’re ‘illusions!
        “Tricks” are something a whore does for money.

        1. A flaming bag of poop on your doorstep is no illusion!

  3. They got anything that works on teenagers?

      1. And booze; the combination has been shown to reduce the teenage population rapidly.

        1. Reminds me of my favorite P.J. O’Rourke quote:

          Giving money and power to government is like giving whiskey and car keys to teenage boys.

          1. Unless it’s in the form of a something like a carbon tax, that turns’em into alter boys.

  4. This post is going to induce an abortion in the comments section.

    1. Ah, good… one less future christanofascist eugenicist–not to mention the crime wave reduction.

  5. So, anyone read any good, new SF lately?

    1. Seriously, I’d like some recommendations for something that isn’t proggie propaganda. Also, has anyone here read anything by that Brad Thor guy who Reason has been promoting recently?

      1. I am out of touch. But if you havent yet read it, Vinge’s A Deepness in the Sky is the best libertarian themed sci-fi I have read in the last decade (it was published in 1999, sue me, I am slow).

        Its a sequel, but the first book takes place MUCH later in time so isnt necessary to it at all.

        The primary theme is “Fuck off, slavers.”

        1. Some good scifi right there. Qeng Ho FTW.

      2. I am out of touch. But if you havent yet read it, Vinge’s A Deepness in the Sky is the best libertarian themed sci-fi I have read in the last decade (it was published in 1999, sue me, I am slow).

        Its a sequel, but the first book takes place MUCH later in time so isnt necessary to it at all.

        The primary theme is “Fuck off, slavers.”

        1. Vinge is crap, IMHO. He writes like a depressed, whiny teenager with little grasp of reality.

          Libertarian-themed SF is better found with the likes of
          Weber, Ringo, Williamson, Heinlein, Stephenson.

          The Troy Rising series by Ringo is fun.

          And in general, just browsing books on the Baen website is a surefire way to find good libertarian themed SF.
          Tor, who published Vinge, tends to promote authors who lean hard prog/statist. Baen tends to promote authors who lean libertarian. Baen also publishes a lot of militaristic SF, although it is almost always anti-statist.

      3. I am out of touch. But if you havent yet read it, Vinge’s A Deepness in the Sky is the best libertarian themed sci-fi I have read in the last decade (it was published in 1999, sue me, I am slow).

        Its a sequel, but the first book takes place MUCH later in time so isnt necessary to it at all.

        The primary theme is “Fuck off, slavers.”

        1. Also, squirrels.

        2. A Fire Upon the Deep is a great SF read also. Vinge is a great writer.

      4. It’s old stuff, but have you read Christopher Anvil’s stories? His first book of Interstellar Patrol stories has a straight-out libertarian premise as setup for the initial story, and is a great piss-take on Campbellian “smart people have a problem, have a weird tech, figure out how to use tech to solve problem in creative manner” plot. Great dissection of how top-down plans fail because people you think will act one way act in a completely different (yet obvious in retrospect) manner.
        Baen published six books of his work, and there’s quite a non-leftie streak running through some of them.

    2. Not exactly new, but finally got around to reading Seveneves by Neal Stephenson. Lots of fine space nerdery.

      1. Thanks. I understand that he’s libertarian-friendly but soft-pedals that in his works.

        1. He’s so focused on things like overcoming the many problems with living in space that politics don’t enter into it too much. He might spend a couple of pages talking about how the governments of the world are responding to this apocalyptic event, then two dozen on the physics of simulated gravity.

          Anathem is one of my favorite novels of the past decade—the appendices contain mathematical proofs. My recommendation is based on whether that sounds like a good thing.

          1. Bryan Grazer and Ron Howard are producing a movie adaptation. Hopefully, it doesn’t share the fate of SyFy’s The Diamond Age miniseries.

          2. I liked both, but The Interface and Reamde both remind me more of this election season.

    3. Good? I don’t understand…

      Or are talking about Science Fiction?

    4. No, I’ve been trying to write some. But it’s closer to space fantasy.

      1. Good luck. And there is nothing wrong with space fantasy even though it’s not my go-to.

    5. Larry Correia’s Son of the Black Sword is a great fantasy novel. Which might just be SF and not fantasy (I have my suspicions). A vast departure in theme and style from his Monster Hunter International series, which I recommend because of its libertarian attitude to government and guns.

      David Drake has a new RCN novel out (Aubrey and Maturin in Space!), but I’d recommend starting with the first book (With the Lightnings) because characters are important, and are set up there.

      1. Son of the Black Sword is hella good. Got the recommendation from John C. Wright, who wrote another fantastic fantasy novel in Somewhither.

        1. I have Somehither on my Kindle app, but my commute time is currently taken up by History of Byzantium podcast.

          His Son of Swan Knight series so far has been fantastic, though. I love his modern take on Mallory’s Arthurian tales, and his “pre-Reformation Europe was great” attitude actually works there.

    6. So, anyone read any good, new SF lately?

      I can highly recommend John C. Wright’s Count to a Trillion and the books that follow it. First new SF I’d read in years; was ridiculously good (or maybe that’s just because there’s been a lot of dreck in the past decade or so). It’s got a space-gunslingers, a star princess, hyperintelligent AI, an alien civilization, goateed moustache-twirling villain heading a shadowy space-cabal, loaded with action. Really just solid, quality, hard SF.

  6. I think it’s time for a thread about nothing.

    1. I’ll pay you 50 bucks to go take a bite off of someone else’s plate. You go over there – you don’t say anything, you just smile, grab an egg roll, and take a bite. There’s 50 bucks in it for you if you do.

      1. Can they sue you and you have to be their butler?

        Not that there’s anything wrong with that…yada yada yada.

    2. it’s time for a thread about nothing.

      When i was a youngun an older friend was the drummer in a band called “Being Don and Nothingness

      He wasn’t Don. Don was the singer.

    3. What’s the deal with Ovaltine? It’s not oval, it’s served in a round cup and comes in a round can, they should call it Roundtine!

      1. +1 Orphan Annie Secret Decoder Ring

    4. And what’s the deal with these huge bags of potato chips, then you open them, and they’re like 1/3 full? Its all air!?

      (*technically this is called “weigh-outs”)

      1. Corporations! If Bernie would have won, he’d make them fill the bags all the way!

      2. The air in a chip bag keeps it from being crushed. Fill the bag with chips, and you end up with crumbs.

        I think it’s time for a thread about nothing.

        Reminds me of a cartoon showing a bunch of people in robes dancing around a big idol of a zero. The observer says, “Is nothing sacred?”

  7. I heard that Trump wants to ban the surgical abortion option, while Hillary is for outlawing this pill option.

    1. You are a terrible human being.

      1. You are a little late to the party.

        1. Aren’t the best parties the ones where the pills are getting passed around?

    2. Trump wants to pass a law saying abortions can only be conducted by kicking preggos in the gut.

      1. I was told stairs were involved.

      2. Or grabbing them somewhere

    3. I’d pay to see Trump shove handfuls of pills down Hillary’s throat while she pokes Trump’s eyes with a twisted coat hanger.

      But that’s just me…

  8. “[government] medical policy should be driven by science not religion”

    Isn’t the sticky point about abortion that “science” doesn’t have the answer to the central question of when one gains life and liberty protection? Not saying that religion is a better source, but I would hope government policy is driven by the directive to protect liberty, instead of religious notions such as AGW and minimum wage goodthink.

    Also, you know an election is a shitshow when an abortion thread is a welcome change of pace.

    1. Also, you know an election is a shitshow when an abortion thread is a welcome change of pace.

      1. I sure could go for some deep-dish pizza right about now.

    2. The best argument that I’ve ever read against ‘scientific fanaticism’, whereby we look to science to predict the future (hat tip, global warming doomsayers) and solve metaphysical questions (morals and meaning), was ‘God and the State’ by Bakunin.

      Science only explains the world around us. There are material limits to what it can tell us and suggesting that ‘government policy should be driven by science not religion’ is to discredit a lot of things that are not scientifically expedient and to justify some ugly government policies that have been justified through ‘science’ in the past. I’d say ‘ethics’ is far more important in government policy than ‘science’. Ultimately, anyone that falls back on ‘science’ as a defense is just declaring: “I can’t defend the indefensible through logic alone”.

      1. There are material limits to what it can tell us and suggesting that ‘government policy should be driven by science not religion’ is to discredit a lot of things that are not scientifically expedient and to justify some ugly government policies that have been justified through ‘science’ in the past.

        Hear hear.

        “To educate a man in mind and not in morals seems only to make him a more clever devil.” – C.S. Lewis

      2. That’s what I was driving at, though I’d say “science” and “logic” are not synonymous. Abortion is somewhat unique in libertarian land since the NAP – universal ethics if you will – doesn’t definitively inform the solution IMO. Personally there’s no other subject that gives me more conflict.

        1. I think the NAP can speak to this case. The chemical basically causes the woman’s placenta to shed and be expelled. This happens naturally all the time. It’s an eviction notice to a squatter.

    3. Political science answers clearly. Amendment 14: “All persons born…”
      Creation Science answers that that should really read “All ova fertilized…” This, however, would make omelettes, over-easy, even mayonnaise into murder raps, so the Agribusiness lobbyists are agin’ it.

  9. Of course, abortion procedures and abortion facilities being lightly regulated relative to every other medical procedure has absolutely nothing to do with politics and ideology, right?

    1. Would you like to be offered the dirty-closet-with-a-coat-hanger alternative? It’s unregulated and has nothing to do with politics and ideology. It’s even comparatively cheap. I don’t know why more people aren’t going DIY, it’s all the rage on the Internet these days.

    2. Abortion procedures and abortion facilities are not lightly regulated relative to other medical procedures of comparable safety. .

  10. ” believes medical policy should be driven by science not religion”

    What is the scientific case against eugenics?

    1. That it’s a pseudoscience based on an oversimplification of genetics?

      1. Parts of it are I suppose. Parts aren’t.

        Regardless, that opinion is missing the science I asked for.

      2. Frilly pink thing is right. There is no ‘scientific case’ against eugenics. Morality is the only basis for an argument about eugenics. The whole non-aggression principle and individual rights are not explained through ‘science’. Ethics and morality make the individual possible.

        1. Yep. Currently the only sure way to prevent more cases of conditions like Huntington’s or DRPLA is for people with the trait to be identified and prevented from reproducing, either by choice or by coercion.

          Of course, that presumes that people with the condition are somehow less desirable to society. So morality is already baked into the eugenic cake.

          By definition eugenics is not strictly scientific, so science cannot speak about it.

      1. I loled

    2. I believe that medical policy should be drive by TOP.MEN who know nothing about medicine or science.

      1. The likeliest of outcomes, to be sure.

        1. Whoever is next on the political merry-go-round.

    3. There is no scientific case against eugenics, so long as it is practiced in a scientifically-sound manner.

      And there is no ethical case against eugenics either, so long as it is practiced in a non-coercive manner.

      You could mount a program to encourage people to FREELY AND WILLINGLY get tested for the CF mutation, and to take measures to avoid passing it on to their offspring. This would be eugenic. but also ethical.

  11. These should be available in vending machines, preferably in pez dispensers with Trump’s head on them.

    1. They’re collectable! Collect all 20 Trumpez dispensers while aborting your troubles away!

  12. “just as safe if not safer than surgical abortion”

    Safe for whom?

    “Most of these state restrictions have been rooted in religion, ideology, and politics rather than good-faith concern for women’s safety.”

    Prochoicers are confused – they themselves know that they are sacrificing the interests of babies for the sake of what they consider the interests of women, so they assume that prolifers are simply the mirror image – deliberately subordinating the interests of women to the interests of some blob of tissue.

    Obviously, if your political philosophy includes killing children in the womb, you can’t claim you’re trying to protect both mother and child – at least not if you want to pass the laugh test (and sometimes choicers don’t want to pass that test).

    So if prolifers are simply a mirror image of choicers, they must have likewise made a binary choice to promote the interests of the unborn child while caring nothing about women, in the same way that choicers care nothing about the doomed child.

    But if this is so, why are so many prolifers actually women and mothers?

    Maybe women (and, for that matter, men) who try to pass laws to protect children *and* their mothers are being just as sincere as the pure-hearted people who want to kill off babies in the womb?

  13. Perhaps the science-lovers can tell us: When does a human being’s life begin, and at what point does a living human being become a person with human rights, including the right to life?

    1. Let me put it this way: Is there a class of living human beings who are legal unpersons, without human rights?

      It’s not as if such a concept is a foreign one in human history.

      1. No, there is no class of living human beings who are unpersons without human rights. All living human beings are persons with human rights.

        But their human rights are limited. There are some living human beings whose human rights do not entitle them to do what they need to do in order to remain alive. For instance,one such class is human beings who need organ transplants, when no one is willing to donate they organs they need. These patients have human rights, but NOT the right to take what they need. Too bad.

        Another such class is human beings who need to be located inside another person’s body when unwelcome there, and need to share the contents of another person’s bloodstream without ongoing permission, and need to subject another person to a major medical/surgical trauma against her will, in order to remain alive. If you are one of those human beings, then you are sht out of luck, EVEN THOUGH you are a person with human rights. Because your human rights do not include a right to do what you need to do, nor to be where you need to be, nor to take what you need to take, in order to remain alive.

        As Mick Jagger sang: “Ya can’t…always git…whatcha want!”

        1. Except for the teeny weeny little fact that a mother’s actions are responsible for that baby growing in her uterus. I know that libertarians are inexperienced with sex, but surely you learned this in health class. This is an objectively different situation than forcing someone to give up an organ to recitify a situation he didn’t create.

    2. Fusionist:

      Whenever it begins, the right to life is limited.

      You have a right to property, but your right to property does not entitle you to take another person’s property if he does not wish to give it to you.

      And you have a right to life, but your right to life does not entitle you to live inside another person’s body when you are unwelcome there.

      1. If you perform an action that results in damage to someone’s property they are absolutely entitled to recompense. You keep acting like a stork just jammed that baby into a woman’s uterus. Admittedly a lot of libertarians exposure to sex is exclusively through porn so maybe you don’t realize that what you are watching is literally how babies are made.

  14. Come on, ELB. Slate’s no friend to pro-lifers, but according to them, “the future of pro-life activism is young, female, secular, and ‘feminist.'”


  15. Hurrah! Rejoice! Now we can kill the unborn with a pill. Isn’t progress grand?

    1. I presume you’ve been all up in arms when women have “heavy periods” to review for at LEAST some degree of manslaughter, then? Women “get pregnant” all the time, but if the environment is hostile, then it naturally aborts. The hostility, more than likely, has to do with the “vim and vigor” of a woman, and a steady diet of booze, doritos, cigarettes, and zero exercise will likely create a hostile environment for a fertilized egg seeking and growing in a womb. If a pill, with knowledge aforethought is “killing” a preservable human life, some degree of murder, then slovenly living (I’m sure breaking several of the deadly sins) must be some degree of manslaughter at the very least, right? The only way we’ll know is if every woman who is sexually active (or rape-worthy if not voluntarily active) should have their periods and blood monitored for physical and chemical evidence of preservable human life. If it is not “issued’, but rather “sloughed”, then investigations should be done to review for charges on the murder/manslaughter “continuity”. Why have ten degrees of murder/manslaughter if we’re not going to use them? It’s the only way we’ll ever be sure we effectively protect ALL human life.

      AND, I trust you’ve NEVER spilled your seed on the ground. I’d hate to think of all the potential human life that went to waste THAT way.

  16. Instead of mifepristone + misoprostol, abortions can also be done using methotrexate + misoprostol. Methotrexate has an advantage: if the patient’s pregnancy is an ectopic pregnancy, which is a life-threatening condition, methotrexate will kill the pregnancy and save the woman; mifepristone will not. If you use mifepristone, you have to check to make sure the pregnancy is not ectopic.

  17. “Most of these state restrictions have been rooted in religion, ideology, and politics rather than good-faith concern for women’s safety.”

    This is a gross oversimplification. This is a broad recognition that abortion can have long lasting negative impacts on a woman’s self esteem, particularly in later years. There are a large number of women who have lasting psychological scars around “what-if” scenarios where they deeply regretted an abortion decision made too easily in younger years. Pro-choice feminazis absolutely refuse to acknowledge this, to the lifelong detriment of many women who are coerced into a decision they later deeply regret. Planned Parenthood and the like are more concerned about money and politics than they are about women’s health.

    Maintaining a high energy barrier to obtain an abortion is sound public policy. You can be pro-choice and still recognize that the ‘choice’ must not be made in haste or too easily. Abortion is a necessary evil, but not one that should be embraced or dehumanized to be on par with having a mole removed.

    1. NO public policy that uses Force should EVER be based on that someone MAY “regret it someday”. If that is the case, then every policy endeavoring to knock soda cups or cigarettes from your hands has the same traction. EVERYBODY has regrets, big and small. There’s nothing more potent than being zealous AFTER conversion. Sitting in a wheelchair with two bloody stumps, or gasping your last few breaths with rotten lungs, and “regretting it” isn’t the foundation for public policy. PERSUASION? fine. Public policy with agents wielding Force? Not in any libertarian world I am going to help construct or live in.

      And yet, I agree, as an anti-anti-abortion versus a pro-choice person. The choice is the woman’s to make, and she has to navigate herself through it, intellectually AND FINANCIALLY. It would be nice if she does it without people with books of Fearie Tales pointing their judgmental fingers at her, or the converse radicalized women who seem to want to run up the number of abortions to prove some sort of point. But that’s not the world we’ve ever lived in. A world of rational disinterest certainly would be grand.

  18. I wish every author would give an overview of what their article was about it the first paragraph. Otherwise, even with interesting titles like this one has, I won’t bother to read the rest of the article.

  19. my dads buddy recently bought a fantastic yellow Toyota Camry just by part-time work from a
    home pc… go right here>>>>>>>>>>> http://tinyurl.com/h5r9tme

  20. until I looked at the paycheck saying $4730 , I did not believe that…my… brother woz like actualy bringing in money part time from there computar. . there friend brother started doing this for less than 7 months and resently paid for the morgage on there home and bought a new Cadillac …….

    …….. http://www.jobprofit9.com

Please to post comments

Comments are closed.