Babies Unprotected

A study published in November 2022 in the Journal of the American Medical Association reported on these rapidly increasing numbers by examining data provided by Aid Access, the single largest provider of SMA pills.[4] Among other things, the study reported on the number of requests Aid Access received for SMA pills in July and August 2022, the two months immediately succeeding the June 24 Dobbs decision.

The study showed a sharp increase in requests for abortion pills in the two months immediately following the Dobbs decision.

Per 100,000 female residents aged 15-44, Aid Access reported requests per week were 14.9 for Louisiana, 7.8 for Mississippi, 7.1 for Arkansas, 6.2 for Alabama, 6.0 for Oklahoma, and approximately 4.7 for Arizona, 4.1 for Kentucky, 2.6 for Missouri, 3.1 for South Dakota, 5.5 for Texas, 3.9 for West Virginia, and 2.7 for Wisconsin.

Factoring in the population of female residents aged 15-44,[5] this amounts to the following (rounded to the nearest whole number): Alabama (61/wk), Arizona (67/wk), Arkansas (42/wk), Kentucky (35/wk), Louisiana (136/wk), Mississippi (45/wk), Missouri (31/wk), Oklahoma (48/wk), South Dakota (5/wk), Texas (346/wk), West Virginia (33/wk), and Wisconsin (30/wk). Therefore, in total during this period, Aid Access reported receiving over 880 requests per week from these 12 states where abortion was “banned.”

Because these numbers only reflect requests, and because they are from only one SMA pill provider, they do not provide the full picture of the number of completed self-managed abortions.

In an interview with the New York Times, Professor Abigail Aiken, lead researcher for the study, explained that her research on SMA prior to Dobbs indicated that roughly 60 percent of initial requests to Aid Access ultimately resulted in shipment of pills.[6] In a study published in February 2022, Aiken and others reported that 88 percent of women who received shipments of pills from Aid Access actually took them to complete an abortion.[7] Aiken has since stated that the percentage after Dobbs could be higher because women had fewer options, but the calculations in this paper rely on the more conservative finding of 88%.[8]

While Aid Access is the largest supplier of abortion pills for SMA in the U.S., they are not the only supplier. The New York Times estimated that, for July through December 2022, Aid Access supplied 46 percent of the U.S. market for SMA pills, while Las Libres and a variety of online sellers provided the rest.[9]

Based on the foregoing numbers and rates, we can project the total number of self-managed abortions for these 12 states over a twelve month period that began in July 2022, as seen in Figure A.

One Year After Dobbs: SMA Numbers in States with “Bans” (July 2023)

The numbers in Figure A are 12-month projections based on the assumption that, after the initial spike in numbers following the Dobbs decision, SMA rates remained constant. However, more recent data indicates that SMA numbers have likely increased significantly.

Around one year after the Dobbs decision, Aid Access issued a press release self-reporting a 270% increase since July-August 2022 in average daily pill requests across the U.S.. Included in that report was a statement that, in just the previous 26 days, Aid Access had shipped abortion pills to over “3,500 people living in states where abortion is banned.”[10]

As of July 2023, 14 states had reportedly banned abortion: Alabama, Arkansas, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, and West Virginia.

While these numbers were self-reported by Aid Access and not evaluated by any professional researchers, if they are accurate, and if the market share of Aid Access was still 46%, this rate would add up to 93,996 self-managed abortions projected in those 14 states with “bans” over a 12-month period from June 18, 2023 through June 17, 2024.