Google searches for abortion medications reached an all-time high in the hours and days after the May 2 leak of a draft Supreme Court majority opinion in favor of overturning Roe v. Wade, and the searchers were more common in states with restrictive reproductive rights, according to a research letter published on June 29 in JAMA Internal Medicine.
The surge in searches highlights the importance of providing women with information on where they can legally and safely obtain abortion medications, including telemedicine consultations with health care professionals, researchers note.
“Elevated interest in abortion medications should alert physicians that many of their patients may pursue this option with or without them,” they write in “Internet Searches for Abortion Medications Following the Leaked Supreme Court of the United States Draft Ruling.”
Using Google Trends, which analyzes the popularity of individual Google searches and provides relative search volumes with a value between 0 to 100, the researchers retrieved Google searches in the U.S. for abortion pill or abortion medications mifepristone (brand name, Mifeprex) and misoprostol (brand name Cytotec) from Jan. 1, 2004, when Google began collecting data, to May 8, 2022.
They analyzed weekly national online search trends for the medications for the entire study period, finding that the weekly search volume reached its historic peak during the week of the Supreme Court draft leak, with 350,000 searches. The volume was 1.67 times higher than the prior week and twice as high as 2012, according to the researchers.
They also looked at hourly search volumes for the three days before and after the Supreme Court draft leak. The spike in searches for abortion medications were cumulatively 162% higher than they had projected for the 72 hours after the leak. The spike was immediate in the hour that Politico reported the leak, study co-author John W. Ayers wrote in an e-mail to The Journalist’s Resource.
Researchers also find a correlation between the volume of searches and women’s reproductive rights in states — such as public funding for abortion and access to abortion services providers.
For instance, Nebraska had the highest search volume for abortion medications in the three days following the leak, followed by Iowa and Missouri. The three states have received grades of F, C+ and D respectively, from the Institute for Women’s Policy Research, which assigns each state a letter grade based on the level of reproductive rights. Hawaii, which received an A- from the institute, had the lowest online search volume for the medications.
The study was accepted for publication on May 31, before the Supreme Court officially overturned Roe v. Wade in a 5-4 decision on June 24, ending five decades of federal abortion rights and sending back to the states the authority to ban or allow abortions.
The team has not analyzed the online search data after the official Supreme Court ruling on June 24, wrote Ayers, vice chief of innovation at U.C. San Diego Medicine, in the email to JR.
A search on Google Trends shows that the search volume for “abortion pill” on June 24 was more than twice as high as the peak on May 3.
Medication abortion, also known as medical abortion or abortion with pills, involves taking two different drugs, mifepristone and misoprostol, during the first 10 weeks of pregnancy, according to Kaiser Family Foundation, a nonprofit organization that conducts health and health policy research. Since the Food and Drug Administration approved the drugs in 2000, half of abortions at 8 weeks gestation or less have been medication abortions, according to KFF.
Mifepristone, sold under the brand name Mifeprex and also known as the abortion pill or RU-486, blocks progesterone, a hormone essential to the development of a pregnancy, and prevents an existing pregnancy from progressing. Misoprostol, marketed under the brand name Cytotec, is taken 24 to 48 hours after mifepristone and empties the uterus by causing cramping and bleeding, similar to an early miscarriage, according to KFF.
The researchers note their study is limited in that it can’t confirm whether the searches were linked to an abortion attempt, but the authors provide some potential reasons for the online searches.
“Although mifepristone/mifeprex or misoprostol/cytotec require a prescription and their use is restricted in some states, internet searches may reflect people exploring the safety and effectiveness of these medicines, how to obtain them, or stockpiling in anticipation of curtailed access,” the authors write. “Some searchers may be seeking substitute and/or illicit abortion medications as alternatives.”
Shortly after the Supreme Court ruling on June 24, the demand for the emergency contraceptive medicines known as “Plan B” or “morning after pills,” which prevent pregnancy, surged to such an extent that several retailers and drugstore chains, including Amazon, Rite Aid and CVS, began limiting the number of pills consumers can buy on their website or in their stores, according to CNBC and the Associated Press.
The ruling also led to a surge of social media posts offering women abortion pills, prompting Facebook and Instagram to swiftly begin removing them, according to NPR.
In 32 states, only physicians are allowed to prescribe abortion pills. In the rest of the states, rest advanced practice clinicians, including advanced practice registered nurses and physician assistants, can also prescribe them, according to Kaiser Family Foundation and the Guttmacher Institute, a sexual and reproductive health research organization.
Since January, at least 20 states have proposed bills to restrict or ban access to abortion pills, according to Pew Stateline.
Additional resources:
- Medication Abortion. This is a comprehensive explainer by the Guttmacher Institute.
- Lay of the Land: Abortion Policies and Access in the United States. The interactive map by the Guttmacher Institute shows each state’s abortion policies, demographic information and statistics.
- The Availability and Use of Medication Abortion. Provided by the Kaiser Family Foundation, this report provides an overview of medication abortion, insurance coverage and access by state.
- Medication Abortion and Telemedicine: Innovations and Barriers During the COVID-19 Emergency. This report by the Kaiser Family Foundation provides an overview of barriers and opportunities in using telemedicine to prescribing abortion pills.
- Medication Abortion Up to 70 Days of Gestation. This practice bulletin by the American College of Obstetricians and Gynecologists provides evidence-based guidance on the provision of medication abortion up to 70 days (or 10 weeks) of gestation.
- Medication Abortion: Q&A with experts. In May, SciLine, a free service for journalists and scientists based at the American Association for the Advancement of Science, asked experts about the fundamentals of medication abortion to help reporters cover the topic.
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