Demand for Self-Managed Medication Abortion Through an Online Telemedicine Service in the United States

Am J Public Health. 2020 Jan;110(1):90-97. doi: 10.2105/AJPH.2019.305369. Epub 2019 Oct 17.


Objectives. To examine demand for abortion medications through an online telemedicine service in the United States.Methods. We examined requests from US residents to the online telemedicine abortion service Women on Web (WoW) between October 15, 2017, and August 15, 2018. We calculated the population-adjusted rate of requests by state and examined the demographics, clinical characteristics, and motivations of those seeking services, comparing those in states with hostile versus supportive abortion policy climates.Results. Over 10 months, WoW received 6022 requests from US residents; 76% from hostile states. Mississippi had the highest rate of requests (24.9 per 100 000 women of reproductive age). In both hostile and supportive states, a majority (60%) reported a combination of barriers to clinic access and preferences for self-management. Cost was the most common barrier (71% in hostile states; 63% in supportive states; P < .001). Privacy was the most common preference (49% in both hostile and supportive states; P = .66).Conclusions. Demand for self-managed medication abortion through online telemedicine is prevalent in the United States. There is a public health justification to make these abortions as safe, effective, and supported as possible.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortifacient Agents / administration & dosage*
  • Abortion, Induced / economics
  • Abortion, Induced / methods*
  • Abortion, Induced / psychology
  • Abortion, Induced / statistics & numerical data*
  • Adult
  • Confidentiality
  • Female
  • Gestational Age
  • Health Services Accessibility / economics
  • Health Services Accessibility / statistics & numerical data
  • Health Services Needs and Demand / statistics & numerical data
  • Humans
  • Internet / statistics & numerical data
  • Middle Aged
  • Motivation
  • Pregnancy
  • Privacy
  • Self-Management / psychology
  • Self-Management / statistics & numerical data*
  • Socioeconomic Factors
  • Telemedicine / statistics & numerical data*
  • United States
  • Young Adult


  • Abortifacient Agents