ANSIRH research

ANSIRH’s Evaluation of Restrictions Project aims to examine the effects on women of state-level abortion restrictions and to identify strategies to mitigate the negative impacts. The project started in 2013 and has so far conducted research in ten states and evaluated the effects of a variety of restrictions. We continue to identify states and restrictions to evaluate.

In 2017, abortion in Chile was decriminalized. Now women can legally access abortion in cases of rape, lethal fetal anomaly, and to preserve a woman’s life.

This study is assessing whether future women’s health professionals in Chile welcome or are prepared for this legal change. A better understanding of their attitudes about and willingness to provide abortion is critical to identifying reproductive health training needs and the barriers that would need to be overcome if abortion were liberalized in Chile. 

Medication abortion is a simple, safe, and effective abortion method that makes up about one in four abortion procedures taking place in the United States. The nature of medication abortion gives it the potential to be accessible outside of the traditional healthcare setting – meaning women would have more control and autonomy over their abortion experience. However, abortion access is restricted in the US, including how medication abortion pills can be dispensed.

Current regulations restrict access to medication abortion and contribute to the perception that people cannot safely take medication abortion pills (mifepristone and misoprostol) on their own without clinician supervision. Yet, mifepristone and misoprostol meet many of the FDA’s criteria for being available over the counter. They are safe, have no risk of overdose, are not addictive, and people are already using them safely on their own in many parts of the world. The possibility of an over-the-counter medication abortion model would involve the medications being available without a prescription in a drug store or grocery, similar to emergency contraception or condoms and pregnancy tests. The pills would come with detailed instructions as well as information about access to a number of different resources, such as a 24-hour telephone number to call with questions about the medication. 

Pharmacists play an important role in the provision of reproductive health care, including prescribing hormonal contraception and emergency contraception in some states. But pharmacists have limited involvement in abortion care, primarily due to the FDA’s dispensing restrictions on mifepristone. There is increasing interest in removing the dispensing restrictions on mifepristone in the United States, which would enable pharmacists to dispense the drug directly to patients with a prescription from their clinician. We are conducting a study, under an Investigational New Drug (IND) application to the FDA, examining the effectiveness and acceptability of pharmacist dispensing of medication abortion.

Nearly half of the countries with liberal or liberally interpreted abortion laws had public funding for abortion, including most countries that liberalized their abortion law in the past 20 years. Outliers remain, however, including among developed countries where access to abortion may be limited due to affordability.

ANSIRH’s work in Reproductive Autonomy investigates women’s power to control matters regarding contraceptive use, pregnancy, abortion, and childbearing.  Our research is done in the U.S. and internationally and involves measurement development, social science research, and literature reviews.

Since 2010, restrictions passed by state legislatures may have affected millions of women and caused at least 70 abortion providing facilities to close. ANSIRH’s Evaluation of Abortion Restrictions project is examining how abortion laws affect women’s access to and experience with abortion.

Abortion in the United States has become increasingly difficult to access, particularly with the closure of abortion clinics and an already insufficient number of abortion providers. A recent study by ANSIRH researchers found that there are 27 “abortion deserts” in the US, or cities where the lack of abortion facilities may force people to travel over 100 miles to get abortion care. Provision of medication abortion by telemedicine has the potential to fill some of those deserts, especially when combined with delivery of mifepristone and misoprostol by mail-order. Research in several states is evaluating the impact of telemedicine on abortion care.

The Turnaway Study is a prospective longitudinal study examining the mental health, physical health, and socioeconomic consequences of receiving an abortion compared to carrying an unwanted pregnancy to term. From 2008 to 2010, we recruited from 30 abortion facilities around the country to recruit about 1,000 women who sought abortions, some who received abortions because they presented for care under the gestational limit of the clinic and some who were “turned away” and carried to term because they were past the gestational limit.