Data notebook: How old FDA guidelines stymied the abortion pill in Ohio

Nadja Popovich
Apr 11, 2016 · 3 min read

Sometimes I come across interesting data while researching for work— but there’s just not enough to the story to merit a full article on the Guardian. So I’m trying something new and starting a data notebook. From time to time, I’ll post a brief synopsis and/or data sketch here.

First up:

Could new FDA guidelines for the abortion pill help increase access ?—an Ohio case study

On March 30, the Food and Drug Administration (FDA) made an unexpected announcement: it was relaxing prescription guidelines for the abortion-inducing drug Mifeprex.

In an updated label for the abortion pill, the agency lowered the required dosage and licensed it for use later in pregnancy — up to 70 days after a woman’s last period instead of 49.

In practice, doctors in most states have been prescribing this way for some time, following research that has found the drug to be more effective and cause fewer complications at lower doses.

But in three states — North Dakota, Texas and Ohio—lawmakers require doctors to strictly follow FDA guidelines when it comes to abortion drugs—even if they’re outdated. In these states, new Mifeprex labels could mean better access to effective, early, and cheap medical abortions.

To find out more about the impact of such laws, I searched for data on medical abortion rates in each of the three states before and after FDA-guideline laws went into effect. (Three more states passed similar laws, but they were struck down in court before taking effect, according to the Guttmacher Institute.)

For Texas and North Dakota, whose laws went into effect in 2013 and 2014 respectively, data isn’t yet available.

But the Ohio data is available—and it paints a pretty clear picture.

After the state’s FDA-guideline law went into effect in 2o11, the Ohio Department of Health reported “a large decline in medical/non-surgical procedures between 2010 and 2011 (5,862 down to 1,234).” That’s a 75% drop in medical abortions in one year.

Before then, use of the pill had been increasing since it was first approved by the FDA in 2001. It accounted for 20% of all abortions in 2010.

Over at, Jessie Balmert explains this decline:

Many Ohio doctors had abandoned the abortion pill as an outdated, expensive option after state lawmakers required physicians to follow FDA directions for its use, which required extra office visits.

“It’s just not an abortion that many people were able to choose because of travel requirements,” said Kellie Copeland, executive director of NARAL Pro-Choice Ohio. “More women were choosing surgical over medication who might have preferred medical.”

The Washington Post notes that “the old protocol made abortions costlier and required four visits to the clinic,” while surgical abortions usually required only two.

— — —

Note: Just one day after the FDA announced the new guidelines, Arizona’s governor signed a bill into law that requires doctors to abide by the old rules when prescribing Mifeprex—as they existed on December 31, 2015. Ok then.

Nadja Popovich

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