KFF Health Tracking Poll: Early 2023 update on public awareness of abortion and emergency contraception

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Key findings

  • The legality of medication abortion (mifepristone and misoprostol) and emergency contraception is a major source of confusion for adults in the US, including women ages 18-49, who are their primary users. About half of adults report that they are “unsure” about whether medication abortion is legal in their state, including 41% of women ages 18 to 49. Additionally, one in eight adults (13%), including one in every 10 women. in states where abortion is currently prohibited, mistakenly believe medication abortion is legal in their state.
  • A popular type of emergency contraceptive pill, commonly known as the morning after pill or “Plan B,” is currently legal in all US states and available over the counter, but a third of adults (32%) say they are “unsure” or emergency contraceptive pills are legal in their state and five percent mistakenly think emergency contraceptive pills are illegal in their state. Half of women who live in states where abortion is currently banned either mistakenly think emergency contraceptive pills are illegal in their state (7%) or say they are unsure (43%).
  • Less than half of the public (39%) is aware that in states where abortion is legal, a prescription is still required to obtain a medication abortion, including 44% of women ages 18-49. This leaves around six in ten either incorrectly saying a prescription is not needed (11%) or saying they are not sure whether a prescription is needed or not (49%).
  • A recent FDA policy change allows pharmacies certified by the manufacturer to dispense mifepristone, or medication abortion pills, to patients who have a prescription. Three quarters of adults (73%) have not heard anything in the news about the new option. This includes almost eight in ten (77%) women under the age of 50, the group most affected.

Awareness surrounding the legality and availability of medication abortion in Post-Roe America

More than six months since the Supreme Court issued their Dobbs decision that reversed Roe v. WadeThe latest KFF Health Tracking poll finds widespread public confusion about the use of mifepristone, the medication abortion pill, and the legality of the medication in their state.

Three in ten adults (31%) have heard of mifepristone, which is responsible for more than half of all abortions in the US, including about half of women ages 18-49 (46%) heard of the medication abortion pill.

Since the overthrow of Roe, medication abortion has been the focus of policy debates at the state and federal level, yet there is widespread confusion about whether medication abortion is legal or illegal in states. Whether medication abortion is legal depends on state laws. Thirteen states have complete bans on all abortions, which include both procedural and medication abortions. In all states, at least four in ten American adults say they are “not sure” if the medication is legal where they live. Half of women (49%) are unsure whether medication abortion is legal in the state they live in, including 41% of women ages 18-49, and at least half of women age 50 and older (58% ), black women (57%), Hispanic women (51%) and 48% of white women.

Women with lower levels of education are more likely to say they are “unsure” about the legality of medication abortion in their state, with more than half (56%) of women without a college degree saying they are not sure if it’s legal or not , compared to four in ten (38%) of women with a university degree or higher.

About half (47%) of adults who live in one of the states where abortion is banned are “unsure” whether medication abortion is legal in their state, with an additional one in ten (13%) mistakenly believing that medication abortion is legal in their state. Four out of ten adults living in states with full abortion bans are aware that medication abortion is illegal in their state. Most women living in states with full abortion bans say they are either unsure of the legality of medication abortion (50%) or mistakenly believe it is legal (10%).

There is also uncertainty about the legality of medication abortion in states without full abortion bans. Nearly half (44%) of people who live in those states said they are “unsure” whether medication abortion is legal in their state, while the same share are aware that medication abortion is legal in their state. One in ten adults who live in states where abortion is legal mistakenly believe that medication abortion is not legal in their state.

More than half are unsure or incorrectly say that medication abortion does not require a prescription

The FDA requires that medication abortion pills be prescribed by a certified clinician. They have never been available over the counter. However, many people are unsure whether a prescription is needed to get a medication abortion. Two in five adults (39%) correctly identify that a prescription is still needed to obtain a medication abortion. This leaves around six in ten either incorrectly saying a prescription is not needed (11%) or saying they are not sure (49%). More than half of women ages 18-49 either mistakenly think a prescription is not needed to get medical abortion pills (10%) or say they are “unsure” (46%).

Greater shares of college-educated women than those without a college degree know that a prescription is required for medication abortion in states where abortion is legal, with about half of women with a college degree (51%) This compares to about a third (34%) of women without a college education.

Until December 2021, the FDA allowed only medical providers certified by the manufacturer to dispense mifepristone, the abortion pill, to patients in person. In 2021, the FDA removed the personal dispensing requirement and expanded distribution to include certified pharmacies in addition to certified clinicians. On January 3, 2023, the FDA formally approved a new protocol to certify pharmacies to dispense mifepristone directly to the patients, in the store or by mail, to people who have a prescription for it. CVS and Walgreens have announced their intention to require certain pharmacies to be certified to dispense mifepristone.

Three-quarters of adults (73%) have heard nothing in the news about the updated FDA policy allowing certified pharmacies to dispense medication abortion pills to patients with a prescription. This includes almost eight out of ten (77%) women under the age of 50.

A slightly higher share of Democratic women than Republican or independent women have heard about the new FDA policy that will impact how abortion pills are dispensed, with a third of women who identify as Democrats having heard about the new policy compared to about two in ten Republican women (21%) and independent women (19%).

Awareness of emergency contraceptive pills is widespread, but many are unsure about their legality and whether or not they can terminate a pregnancy

The vast majority of American adults (93%) have heard of emergency contraceptive (EC) pills, sometimes called the morning-after pill or “Plan B.” Still, while most adults have heard of the pills, knowledge gaps remain when it comes to accessing the medication and how it works.

Eight in ten (81%) of those who have heard of emergency contraceptive pills are aware that some types are available over the counter without a doctor’s prescription. In addition, a majority (62%) are aware that emergency contraceptive pills are not the same as the abortion pill. However, a significant proportion (73%) mistakenly think that emergency contraceptive pills can end a pregnancy in its early stages, while 27% know they cannot. This includes two-thirds (66%) of women aged 18-49 who incorrectly say emergency contraceptive pills can end a pregnancy in its early stages.

While some state lawmakers have discussed the possibility of placing additional restrictions or restrictions on access to emergency contraceptive pills, emergency contraceptives such as “Plan B” are legal in all 50 states. A third of adults (32%) say they are “unsure” whether emergency contraceptive pills or “Plan B” are legal in their state or not, and five percent of adults mistakenly think emergency contraceptive pills are illegal in their state. Six in ten adults (62%) correctly identify that emergency contraceptive pills are legal in their state.

Large shares of women (65%), especially those under the age of 50, are among the groups most likely to be aware that emergency contraceptive pills are legal in their state. Three-quarters (77%) of women ages 18-49 are aware that emergency contraceptive pills are legal in their state. Whether adults know the legality of emergency contraception varies by income, partisan identification, type of community, and education. Smaller shares of adults living in rural areas (49%), Republicans (52%), those with lower incomes (55%) and those without a college degree (58%) are aware that emergency contraception is legal.

Additionally, smaller shares of women living in states where abortion is banned are aware that emergency contraception is legal (49%) than those living in a state where abortion is not banned (70%).