KFF Health Tracking Poll: Early 2023 Update On Public Awareness On Abortion and Emergency Contraception

Key Findings

  • The legality of medication abortion (mifepristone and misoprostol) and emergency contraceptives are a big source of confusion for adults in the U.S., including among women ages 18-49, who are their primary users. About half of adults report they are “unsure” as to whether medication abortion is legal in their state, including 41% of women ages 18 to 49. In addition, one in eight adults (13%), including one in 10 women, living in states where abortion is currently banned incorrectly believe medication abortion is legal in their state.
  • A popular type of emergency contraceptive pills, known commonly as the morning after pill or “Plan B,” is currently legal in all U.S. states and available over the counter, but a third of adults (32%) say they are “unsure” if emergency contraceptive pills are legal in their state and five percent incorrectly think emergency contraceptive pills are illegal in their state. Half of women living in states where abortion is currently banned either incorrectly think emergency contraceptive pills are illegal in their state (7%) or say they are unsure (43%).
  • Less than half of the public (39%) are aware that in states where abortion is legal, a prescription is still required in order to get medication abortion, including 44% of women ages 18-49. This leaves about 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 that have been 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 regarding the new option. This includes nearly eight in ten (77%) women under the age of 50, the most widely impacted group.

Awareness Around Legality and Availability of Medication Abortion in Post-Roe America

More than six months since the Supreme Court issued their Dobbs decision which overturned Roe v. Wade, the latest KFF Health Tracking Poll finds widespread public confusion around 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 accounts for more than half of all abortions in the U.S., including about half of women ages 18-49 (46%) have heard of the medication abortion pill.

Since the overturning of Roe, medication abortion has been the focus of policy debates at the state and federal level, yet there is widespread confusion on whether medication abortion is legal or illegal in states. Whether or not medication abortion is legal depends on state laws. Thirteen states have full bans on all abortions, which include both procedural and medication abortions. Across all states, at least four in ten U.S. adults say they are “not sure” whether the medication is legal where they live. Half of women (49%) are unsure as to whether medication abortion is legal in the state they live in, including 41% of women ages 18-49, and at least half of women ages 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 over half (56%) of women without a college degree saying they aren’t sure if it’s legal or not, compared to four in ten (38%) of women with a college degree or higher.

About half (47%) of adults living 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%) incorrectly believing medication abortion is legal in their state. Four in ten adults living in states with full abortion bans are aware medication abortion is illegal in their state. Most women living in states with full abortion bans either say they aren’t sure of the legality of medication abortion (50%) or incorrectly believe it is legal (10%).

There is also uncertainty about the legality of medication abortion in states without full abortion bans. Almost half (44%) of people living 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 living in states where abortion is legal incorrectly believe medication abortion is not legal in their state.

Over Half Are Unsure Or Incorrectly Say Medication Abortion Doesn’t Require A Prescription

The FDA requires medication abortion pills to be prescribed by a certified clinician. They have never been available over the counter. However, many people are uncertain about whether a prescription is required in order to get medication abortion. Two in five adults (39%) correctly identify that a prescription is still required to get a medication abortion. This leaves about 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 incorrectly think a prescription is not needed in order to get medication abortion pills (10%) or say they are “unsure” (46%).

Larger 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%) who say so compared to about a third (34%) of women without a college education.

Until December 2021, the FDA only permitted medical providers that were certified by the manufacturer to dispense mifepristone, the abortion pill, to patients in-person. In 2021, the FDA removed the in person dispensing requirement and expanded the 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-store or by mail, to people who have a prescription for it. CVS and Walgreens have announced their intent for certain pharmacies to become certified to dispense mifepristone.

Three-quarters of adults (73%) have not heard anything in the news regarding the updated FDA policy allowing certified pharmacies to dispense medication abortion pills to patients who have a prescription. This includes nearly eight in ten (77%) women under the age of 50.

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

Awareness Of Emergency Contraceptive Pills Is Widespread, But Many Are Unsure About Its Legality and Whether Or Not It Can End A Pregnancy

The vast majority of U.S. adults (93%) have heard of emergency contraceptive (EC) pills, sometimes called the morning after pill or “Plan B.” Yet, 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 emergency contraceptive pills are not the same as the abortion pill. However, a substantial share (73%) incorrectly think that emergency contraceptive pills can end a pregnancy in its early stages, while 27% know it can’t. This includes two-thirds (66%) of women ages 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 limits on the access to emergency contraceptive pills, emergency contraceptives like “Plan B” are legal in all 50 states. A third of adults (32%) say they are “unsure” if emergency contraceptive pills, or “Plan B” are legal in their state or not, and five percent of adults incorrectly 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-fourths (77%) of women ages 18-49 are aware that emergency contraceptive pills are legal in their state. Whether adults know the legality of emergency contraceptives differs by income, partisan identification, community type, and education. Smaller shares of adults who live in rural areas (49%), Republicans (52%), those with lower incomes (55%), and those without a college degree (58%) are aware that emergency contraceptives are legal.

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

Methodology

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