by Elevated Science Communications

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There has been widespread speculation about the potential effects of a leaked Supreme Court of the United States (SCOTUS) draft ruling overturning Roe v. Wade.

A new study published in JAMA Internal Medicine led by Dr. John W. Ayers from the Qualcomm Institute within the University of California San Diego and Dr. Adam Poliak from Bryn Mawr College, finds evidence of record high demand for abortion medications in wake of the draft SCOTUS ruling being leaked. The results foretell changes that may come as federal and state laws change in wake of the now released ruling.

Identifying trends in demand for abortion medications

The research team analyzed Google search queries that mentioned "abortion pill" or specific medication names (mifepristone/mifeprex, misoprostol/cytotec) emerging from the United States from January 1, 2004 through May 8, 2022. These included queries like "how to get misoprostol," "order abortion pills" or "buy mifepristone."

"Discussing abortion openly is not something many are eager to do," said Dr. Eric Leas an Assistant Professor in the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science, Co-Founder of Data Driven Health at the Qualcomm Institute, and study coauthor. "But searching online is anonymous. By examining aggregate internet searches, decision makers can understand the needs of the public based on the content and timing of their queries."

Evaluating trends before and after the SCOTUS draft opinion was leaked, the team discovered that internet searches for abortion medications reached record national highs, and searches were more common in states with more restrictive reproductive rights.

Searches for abortion medications spiked the hour Politico published the leaked draft SCOTUS ruling online with searches 162 percent higher during the 72-hour period following the leak compared to before. Moreover, searches for abortion medications were substantially higher than ever recorded (since January 1, 2004).

In practical terms, during the week of the SCOTUS ruling alone there were an estimated 350,000 searches for abortion medications in the United States.

There were significantly more searches (after adjusting for population size) in states with more restrictive reproductive rights in the 72-hour period following the leak. States given failing grades (F) by the Institute for Women's Policy Research's "Reproductive Rights Index" had 163 percent more searches than states with an A letter grade. The institute assigns each state a letter grade based on access to abortions, public funding for abortions, percent of women living in counties with an abortion services clinician, and other attributes.

"In states with restrictive reproductive rights and where abortion will likely become criminalized, women appear more likely to search for abortion medications in the wake of the SCOTUS leak," added Dr. Poliak, Assistant Professor of Computer Science at Bryn Mawr College and first author of the study. "Although abortion medications require a prescription, women may be attempting to stockpile medication or hazardous black-market options in anticipation of curtailed access."

A call to action to address women's health in wake of the SCOTUS leak

"Elevated interest in abortion medications should alert physicians that many of their patients may ultimately pursue abortions with or without them," said Dr. Davey Smith, a physician-scientist and Chief of the UC San Diego Division of Infectious Disease and Global Public Health and study coauthor.

"Failure to meet the needs of online searchers may result in more unsafe abortion attempts," Dr. Steffanie Strathdee, Distinguished Professor in the UC San Diego Division of Infectious Disease and Global Public Health and study coauthor, noted. "Already 7 percent of women of reproductive age have attempted a self-managed abortion in their lifetimes and that figure could be on the rise following the SCOTUS decision."

The team notes informing people about how they can legally and safely obtain abortion medications is one strategy to prevent a rise in unsafe abortion attempts. "Accessible information about abortion medications should be prioritized online; including encouraging evidence-based telehealth for those seeking abortion medications," said Nora Satybaldiyeva a doctoral student at UC San Diego and study coauthor. "Providing abortion medications via telehealth under the care of a physician is a safe alternative to in-person care, especially for women in states where abortion will be illegal."

Foretelling changes as abortion laws change

The changes observed during the study may foretell what changes will come as the SCOTUS ruling is implemented and state abortion laws change.

The team speculates how these needs will be met going forward, especially when President Joe Biden has stated that women would continue to have access to abortion medications following the SCOTUS ruling. "Women in states where abortion is illegal or extremely difficult to access may be forced online to access remote services for abortion, such as abortion medications," added Ms. Satybaldiyeva.

"As abortion policies change and new laws are enacted, research tracking the needs of the public in near real time must be prioritized to inform responsive public health strategies," concluded Dr. Ayers, Co-Founder of Data Driven Health at the Qualcomm Institute and Vice Chief of Innovation in the Division of Infectious Disease and Global Public Health, both at UC San Diego, and senior study author. "Investments in public health surveillance systems tracking abortion-related needs could become integral to supporting women's rights."

More information: Adam Poliak et al, Internet Searches for Abortion Medications Following the Leaked Supreme Court of the United States Draft Ruling, JAMA Internal Medicine (2022). DOI: 10.1001/jamainternmed.2022.2998

Journal information: JAMA Internal Medicine 

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