ADOLESCENT DEMAND FOR MEDICATION ABORTION FROM AN ONLINE TELEMEDICINE SERVICE BEFORE AND AFTER THE DOBBS V JACKSON WOMEN’S HEALTH ORGANIZATION DECISION

Objectives

We sought to understand adolescent demand for medication abortion from an online telemedicine service, and to understand if demand varies due to state-level abortion bans and state-level parental involvement laws.

Methods

This cross-sectional study used data from an online telemedicine organization providing medication abortion in the US. We compared average weekly request rates by adolescent (under 18, 18-21) and adult (22+) age- groups and state policy environment pre and post the Dobbs vs. JWHO decision.

Results

From September 1, 2021 and October 31, 2023, 232,089 people in 50 states requested medications, and 6% of requestors were under 18, 24% were 18-21, and 70% were 22+. The average per-capita weekly request rate among ages 18-21 increased from 8.3 in the baseline period to 25.7 post-Dobbs, a 17.4 increase (15.6-19.2, p<0.001); average requests among adults increased from 3.3 in the baseline period to 11.1, a 7.8 increase (7.1-8.4, p<0.001). The most restrictive abortion law states saw the highest increase in post-Dobbs requests among adolescents (25.4, 20.7-30.0; p<0.001), compared to smaller increases among adolescents in states without restrictions (8.3, 7.2-9.5; p<0.001). Among adolescents under 18, requests in states with parental involvement laws were higher than in states without, both at baseline (1.1, 0.8-1.4; p<0.001) and post-Dobbs (4.4, 3.7-5.1; p<0.001).

Conclusions

Demand for medications among adolescents increased post-Dobbs in similar patterns to adults, and requests among 18-21 were higher than other ages groups. This may be because of internet engagement or fewer financial resources for clinic-based care. Specialized support is needed to assist adolescents pursuing medication abortion via online telemedicine.