Characteristics of people obtaining mifepristone and misoprostol and misoprostol-only telehealth medication abortion services in the United States

Abstract

Objectives: This study compares the characteristics of people using mifepristone/misoprostol and misoprostol-only telehealth medication abortion regimens in the United States.

Study design: We abstracted and analyzed characteristics for all clients using a virtual clinic between April 27, 2020, and May 31, 2022. We compare sociodemographic characteristics between clients who used either mifepristone and misoprostol or misoprostol only. We conducted multivariable analyses to identify characteristics associated with using each regimen.

Results: The analytic sample included 8790 clients: 84% used mifepristone and misoprostol, and 16% used misoprostol only. Most clients (54%) were aged 26 to 35 years. Characteristics of having fewer years of education, living in the Mid-Atlantic or Midwest, and reporting a lower income were positively associated with using misoprostol only. Characteristics of identifying as White or a race other than Black or White, as well as having higher levels of education and reporting a higher income, were positively associated with using mifepristone/misoprostol. Although not directly tested, associated characteristics indicate that a difference in regimen price may have influenced regimen use.

Conclusions: Findings demonstrate the range of people who have telehealth medication abortions and suggest some differences between clients who used mifepristone/misoprostol and clients who used misoprostol only.

Implications: As mifepristone continues to be restricted and telehealth abortions are a growing share of the medication abortions provided in the United States, these findings inform service delivery for clinics considering expanding into telehealth to provide misoprostol-only regimens. Findings also inform expanding policies aimed at the affordability of services, including expanding coverage from private, public, and Medicaid insurance programs.

Keywords: Abortion; Barriers; Health equity; Misoprostol; Telehealth; Telemedicine.