Background: Mifepristone did not “revolutionize” access to abortion in the ways originally anticipated. However, in the 17 years since its approval it has changed the face of abortion care, potentially in ways that have increased access. In 2014, nearly-one third of abortions were early medication procedures, and 26% of clinic facilities provided only early medication abortion (EMA-only). Medication abortion has been integrated with new medical technologies such as telemedicine, and, importantly, advanced practice clinicians in some states are able to provide medication (but often not surgical) abortions.

Methods: This study will utilize two comprehensive data sources to investigate the ways that mifepristone has increased access to abortion between 2008 and 2017: de-identified sales data from the sole US distributor of mifepristone (Danco Laboratories) and the Guttmacher Institute’s Abortion Provider Census (APC) studies.

Proposed analysis: Using these data, we will explore three primary issues: First, we will examine trends in the incidence and availability of medication abortion for the time period of 2008-2017. Second, we will explore whether EMA-only clinic facilities have increased access to abortion and, if so, which regions and states have benefited from this development. Finally, we will examine the potential impact of state laws on the accessibility of medication abortion. Through this study, Guttmacher aims to generate and widely disseminate evidence that can be used to improve policies, programs and medical practice to ultimately expand access to medication abortion in the US.