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Accessing medication abortion in advance or over the counter

With medication abortion restrictions on the rise in the U.S., patients are facing increasing barriers to accessing early abortion. A new study sought to understand abortion patients’ perspectives on alternative models of medication abortion service delivery. In particular, researchers explored the reasons why people with prior medication abortion experience are particularly interested in obtaining medication abortion both in advance of pregnancy or over the counter (OTC).

Key Findings

Participants identified how OTC access or advance provision could mitigate some of the hurdles they faced accessing abortion, such as the logistical and financial burdens of multiple appointments, long travel distances, taking time off work to access a clinic, and these models could increase privacy around decision-making.
The reasons behind participants’ interest in obtaining medication abortion in advance from a health care provider included how it could afford more freedom to decide if and when to use the medications, would afford a sense of preparedness, and would allow private decision-making.
Participants said that buying OTC medications is a familiar process for them, which was appealing. They thought OTC medication abortion could enhance privacy, save time, allow them to avoid judgment from a health care provider, and improve access more broadly.

Study Design

The researchers conducted 30 in-depth interviews with abortion patients who indicated support for alternative models, between October 2017 and August 2018. They recruited patients from 10 abortion clinics in states with a range of policy environments.


People who have previously had a medication abortion are interested in alternative methods of provision because of the logistical benefits and increased privacy around decision-making. Alternative models have the potential to improve access to abortion care, particularly for those most impacted by state abortion bans and restrictions.

The researchers conclude:

“Offering medication abortion through alternative provision models might improve access to abortion earlier in pregnancy and prioritize patient preferences, while maintaining patient safety.”

The publication, Perspectives on Alternative Models of Medication Abortion Provision Among Abortion Patients in the United States, is available in Women’s Health Issues.