Searches for abortion medications have soared

Google searches for information on medications that induce abortion spiked after POLITICO published the Supreme Court’s draft opinion overturning Roe v. Wade, a study published today in JAMA Internal Medicine found.

In the 72 hours after the news, searches for abortion medications jumped 162 percent compared to the three days prior. The week of the POLITICO report, Americans conducted 350,000 searches for abortion pills, the highest level recorded in any equivalent time span, the researchers said.

The authors of the study said the results indicate that the shift toward medication abortions would continue, but also warned that Americans frightened about abortion’s availability might seek to manage their own care without the help of a doctor or turn to a black market for abortion medications.

Searches were especially high in states that more strictly regulated abortion and have now banned it, or may soon do so, following the Supreme Court’s decision last week.

The lead researchers, John Ayers, an adjunct professor of medicine at the University of California San Diego, and Adam Poliak, an assistant professor of computer science at Bryn Mawr College, tallied Google searches for “abortion pill” or for specific drugs — mifepristone, mifeprex, misoprostol or cytotec — between Jan. 1, 2004 and May 8, 2022. They did not determine whether searchers attempted to get an abortion.

Searches in restrictive states

States with poor grades for abortion access from the Institute for Women’s Policy Research, an abortion-rights group, were disproportionately represented among those with big increases in searches. The grades reflect restrictive policies in place before the Supreme Court’s decision gave states the ability to ban abortion.

Nebraska, which saw the biggest increase in searches per capita, had an F grade from the group. Iowa, with a C grade, was second on the list, followed by Missouri and Michigan, which the institute gave Ds.

Overall, states with failing grades from the institute had 163 percent more searches than states with A grades.

The researchers also reported finding that searches for abortion pills often rose in connection with previous moves in the states to restrict abortion. For example, they found an increase in searches in 2010 when Oklahoma mandated that women get an ultrasound before getting an abortion. The second largest jump in searches for medication abortion came in September 2021, the week a Texas law severely restricting abortion access took effect.

Black market fears

Ayers said the results suggest the Supreme Court’s decision will prompt an acceleration of an existing trend, with pharmaceutical abortions further outstripping surgical ones. In 2020, more than half of abortions were induced with medication, according to the Guttmacher Institute, a research group that favors abortion rights.

Poliak said he feared the findings indicate that people may seek to stockpile abortion drugs or emergency contraceptives, raising the prospect of shortages and “hazardous black-market options in anticipation of curtailed access.”

Already emergency contraceptives are selling out. The Wall Street Journal reported Tuesday that major pharmacy chains are rationing Plan B, the emergency contraceptive that stops pregnancy, but does not end one after conception. CVS and Rite Aid are limiting bulk purchases to three pills, while Walmart allows up to ten.

Ayers said that he’s concerned the Supreme Court decision could prompt more people to manage their own abortions without seeking a physician’s help. If people seeking abortion drugs go to the internet first, they’ll find a mix of resources, some accurate and some that misinform, he said: “The harm here is access to bad [information] and people using illicit medications on the black market.”

For example, searching for medication abortion on Google might direct a person to Plan C, an abortion-rights group that provides a vetted list of online abortion services. However, Google also misdirects one in ten searches for abortion clinics or abortion pills to web sites seeking to dissuade people from ending their pregnancies, according to data from the Center for Countering Digital Hate.

On social media, individuals have begun offering to send abortion pills to others in need, though Meta has been pulling down those posts on its Facebook and Instagram sites. While activists may be trying to connect patients who need abortion medication, Meta said the posts violated its policies on regulated goods.

Ayers said companies like Google should elevate information about abortion and medication abortion from trusted health care providers — as it does for information about Covid-19 and suicide. “What we need to be thinking about is not letting this go to the Wild West, but thinking strategically about how we can reduce harm,” he said.