Abortion Pills, the Latest Battleground, Have Been Little Known to Americans

Abortion pills have dominated headlines in the past week, but until recently, relatively few Americans were familiar with the concept of medication abortions, even as the use of pills like mifepristone has surpassed surgical procedures as the most common method to terminate pregnancies and as national support for abortion rights has grown in recent years.

Medication abortions, a method typically used in the first 12 weeks of pregnancy, accounted for more than half of all abortions in the United States as of 2020, according to the Centers for Disease Control and Prevention, up from 40 percent in 2018. Two conflicting rulings on mifepristone, the first pill in a two-drug regimen used to terminate pregnancy, have put the long-term availability of the medication in limbo. The Justice Department has asked the Supreme Court to step in.

About one in three Americans said they had heard of mifepristone or a medication abortion in a January survey from the Kaiser Family Foundation, a nonpartisan research group that focuses on health issues. But that share is most likely growing, Ashley Kirzinger, the organization’s director of survey methodology, said.

“Once the Dobbs decision came down, there was increased media attention about the accessibility across state lines,” she said, referring to the Supreme Court decision from June that ended the federal right to an abortion. “And that has translated into knowledge.”

Voters are not particularly supportive of state-level efforts to restrict access to medication abortion. Just 29 percent of Americans — and only 38 percent of Republicans — support these efforts, according to a Reuters/Ipsos poll conducted in the days after the court rulings.

The poll also showed how the ongoing court battles related to medication abortion are likely to reduce Americans’ already-sinking confidence in courts as impartial arbiters. Only a third of Americans believed that the ruling by a federal judge in Texas to invalidate the Food and Drug Administration’s approval of mifepristone was an impartial decision, and more than half felt the decision was politically motivated.

Even many Republicans — about 50 percent — saw the ruling as a political one.

And there is already wide distrust of the Supreme Court and dissatisfaction with its past decisions.

A New York Times/Siena College poll last July, shortly after the Dobbs decision, found that a majority of Americans held an unfavorable view of the Supreme Court, and more than 60 percent of voters, including 39 percent of Republicans, viewed the Supreme Court’s decisions as politically motivated. Overall, 61 percent of voters disagreed with the Dobbs decision, including 30 percent of Republicans.

Nearly half of Americans were unsure if medication abortion was legal in their state, according to the Kaiser Family Foundation survey, which was conducted before the court rulings on mifepristone raised the profile of the drug.

There was particular confusion among respondents in states where abortions were illegal: 10 percent of women living in states where abortion was banned incorrectly believed medication abortion was legal in their state, and another 50 percent were unsure.

Views on abortion tend to change little over time and are mostly divided along partisan lines. About 60 percent of Americans support some form of legalized abortion, with about 80 percent of Americans who are Democrats or say they lean toward Democrats supporting legalized abortion in all or most cases, and about 40 percent of Republicans or Republican-leaning Americans supporting abortion rights, according to Pew Research Center. Support for abortion access has increased slightly in recent years, largely among Democrats, according to Pew’s data.

Views on medication abortion also differ by party, but there’s not a clear majority of Republicans who say it should be illegal. About a third of Republicans do hold that view, according to a poll by Pew taken before the rulings, while roughly a third thought medication abortions should be legal and the remaining 29 percent weren’t sure. About half of all Americans, and more than 70 percent of Democrats, supported legalized abortion medication.

“As we have long seen with abortion overall, partisanship is the driver of differences in views more so than gender,” said Hannah Hartig, a researcher at Pew who studies abortion. “We do not see much difference, for example, between Republican men and women in their views on medication abortion.”

There are wide differences within parties, however, based on the particular circumstances of an abortion. The Reuters/Ipsos poll found Republicans would be significantly more likely to support abortion medication if the pills were obtained at a doctor’s office, clinic or pharmacy as opposed to mailed. And significantly more Americans — across the partisan spectrum — are more supportive of a national abortion ban at 16 weeks of gestation than a national ban at six weeks.