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 (US).

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 8,790 clients: 84% used mifepristone and misoprostol, and 16% used misoprostol-only. Most clients (54%) were aged 26-35. 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 US, 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.