On Monday morning, the Journal of the American Medical Association released a study. It purportedly shows a large increase in the demand for self-managed abortions outside formal medical settings after the Supreme Court’s Dobbsdecision in June 2022. The researchers obtained data on abortion medications from online telemedicine organizations, community networks, and online vendors. The purported increase in the amount of chemical pills ordered nearly offset the reported decline in the number of abortions performed in 2022. This JAMA study has already been covered the New York Times and the Washington Post.
It should be noted that there are reasons to question the reliability and accuracy of the data. The data that appears in the JAMA article are self-reported by organizations that provide chemical-abortion pills through the mail or outside a formal medical setting. These organizations support legal abortion. They have an interest in showing that pro-life lawsfail to prevent abortions. They also have an interest in showing that there is a high demand for self-managed chemical abortions when strong pro-life laws are passed.
Furthermore, taking the data at face value, we see that chemical-abortion pills ordered does not necessarily equal chemical abortions obtained. Some women who ordered chemical-abortion pills might have changed their minds about obtaining an abortion. Others might have requested a chemical-abortion pill for future use. In their calculations, the researchers do consider how often chemical-abortion pills are used. However, much of the usage data is either estimated or self-reported.
Interestingly, in March 2022, the New York Times collected data on online abortion-pill orders to analyze abortion trends in Texas after the Texas Heartbeat Act took effect in September 2021. The Times argued that the in-state declinein abortion was largely offset by increases in out-of-state abortions and online orders for chemical-abortion pills. However, three subsequent analyses of Texas birth data all found an increase in the Texas birth rate months after the Texas Heartbeat Act took effect. That provides strong statistical evidence that the Texas Heartbeat Act prevented abortions and saved lives.
Overall, this JAMA study is meant to affect the coverage and the outcome of litigation pertaining to chemical-abortion pills. On Tuesday, the Supreme Court will hear oral arguments in Food and Drug Administration v. Alliance for Hippocratic Medicine. The Court is considering whether recent FDA policy changes allowing greater access to chemical-abortion drugs are constitutional. Specifically, the Court could change FDA policy and lower the gestational age limit for chemical abortions from ten to seven weeks. The Court could also reverse an FDA policy change and ban delivery of chemical-abortion pills by mail. Through this study, the authors are implicitly arguing that legislative andpolicy efforts to limit access to chemical-abortion drugs will be unsuccessful.
The fact that this study was released one day before oral arguments in FDA v. Alliance for Hippocratic Medicine is another sad example of the increasing politicization of academic journals. Other examples of this include the recent decision by Sage publishing to retract three studies by Charlotte Lozier Institute scholars that provided evidence of the health risks of chemical-abortion drugs. Also, in 2016 prior to the oral arguments in Zubik v. Burwell over the HHS contraception mandate, the New England Journal of Medicine released a study claiming that Planned Parenthood funding cuts increased the Texas birth rate. Finally, before the 2010 vote on the Affordable Care Act, the New England Journal of Medicine published a very superficial analysis of abortion trends in Massachusetts to argue that insurance coverage of abortion would not increase abortion rates.
Overall, academic journals should focus on publishing high-quality research. They should not be releasing politicized studies to influence the outcomes of Supreme Court cases.