Behind the numbers
Data from September 2021 to April 2023 showed 48,404 anticipated benefit claims and 147,112 claims from women seeking to terminate an existing pregnancy. (Women in both categories completed telehealth visits and Aid Access assessed their medical information before prescribing pills.)
Early benefit applicants were more likely than those already pregnant to be age 30 or older, white and childless, and to live in urban neighborhoods where poverty rates were lower than the national average. This could be due in part to the fact that Aid Access offers free or discounted services to pregnant patients who need financial assistance, while early benefit applicants had to pay the full cost of $110, a said Dr. Aiken.
And because few organizations offer advance benefits, women from marginalized or low-income communities may be less aware “that this is even a thing you can do,” she said.
Medical abortion usually involves two pills: mifepristone, which has a shelf life of three to five years, followed a day or two later by misoprostol, which has a shelf life of 18 to 24 months.
Dr. Aiken said a subset of early benefit applicants — 937 women, two-thirds of them in states that ban or restrict abortion — responded to follow-up questions. Most still had the pills, but 58 had taken them and 55 had given them to someone else.
About 60 percent took the pills before seven weeks of pregnancy, at the start of the recommended time frame. A large majority said they had enough information, including about expected bleeding and cramping. All 58 people said the pills were effective. Five subsequently saw health care providers, but none went to the hospital or had serious complications.
Legal experts say early benefits may be legal in some states that ban abortion. “Many state abortion laws require a provider to know that a person is pregnant,” three law professors – David S. Cohen, Greer Donley and Rachel Rebouché – wrote in a forthcoming article in the Stanford Law Review. However, they added, in some states, abortion providers could be legally vulnerable since they know that “the pills are prescribed to terminate a future pregnancy.”
Opponents of abortion oppose early benefit and claim that abortion drugs are dangerous. Proponents of abortion rights say prescribing it for future needs, like antibiotics for traveler’s diarrhea, increases access and emphasizes that the pills are safe, as many studies show.