In the last three years, abortions in the U.S. have steadily increased—despite a growing number of bans and restrictions.
The number of abortions in the first half of 2024 was significantly higher than the same period for the previous two years—according to the Society of Family Planning’s eighth #WeCount report, released last week, which measures the number of abortions in the U.S. each month from April 2022 through June 2024.
The total number of abortions obtained nationally through the formal healthcare system grew from a monthly average of 81,400 in the first half of 2022, to 88,000 in the first half of 2023, to 98,000 in the first half of 2024—a 20.4 percent increase in just three years, despite abortion bans in 14 states and severe restrictions in many others.
These numbers only include clinician-provided abortions. There are many more self-managed abortions occurring outside of the formal healthcare system.
A major reason for the rising number of abortions is greater access to telehealth abortion, which rose 155 percent from 22,430 in the second quarter of 2023 to 57,150 in the second quarter of 2024.
Telehealth abortion is now 20 percent of all abortions in the formal healthcare system, which is up from 4 percent nationally in April 2022.
Meanwhile, the number of in-person abortions decreased 3 percent from 238,00 in the second quarter of 2023 to 232,000 in the second quarter of 2024.
“Despite abortion opponents’ continued efforts to ban safe, effective abortion care, providers, advocates and abortion funds all continue to innovate new ways to help people access the abortion care they need,” said Dr. Ushma Upadhyay, #WeCount co-chair and professor at the University of California, San Francisco’s Advancing New Standards in Reproductive Health (ANSIRH).
In this heavily restricted abortion care environment, medication abortion provided via telehealth under shield laws is making a significant contribution to abortion access.
Dr. Ushma Upadhyay
From April to June 2024, the proportion of abortions provided by telehealth ranged from 8 percent in New York to 55 percent in Wyoming.
Research shows that telehealth abortion is safe and effective, and patients appreciate the privacy and convenience as well as the timeliness of receiving their abortion care in this way.
Eight states now allow clinicians to provide telehealth abortions to people living in states that ban or restrict abortion access. These eight states have shield laws that protect clinicians in those states from criminal and civil actions initiated in other states for telehealth abortion services they provide to patients located in states banning or restricting abortion. Those states include Massachusetts, Washington, Colorado, Vermont, New York, California, Maine and Rhode Island.
“In this heavily restricted abortion care environment, medication abortion provided via telehealth under shield laws is making a significant contribution to abortion access,” said Dr. Upadhyay.
According to the #WeCount report, during the second quarter of 2024, a monthly average of 9,700 people living in states banning or restricting abortion obtained telehealth abortion services from clinicians operating from provider shield states—a five percent increase over the first quarter of 2024.
The #WeCount report estimates that 56,880 people in states with severe abortion bans or telehealth restrictions received medication abortion by telehealth in the first half of 2024.
Several healthcare organizations now provide telehealth abortion services to people in states prohibiting or restricting healthcare professionals inside of their borders from providing abortion services.
- Aid Access
- Cambridge Reproductive Health Consultants’ The MAP
- Abuzz
- Armadillo Clinic
- We Take Care of Us
- A Safe Choice
For the first time, the #WeCount report included the number of abortions obtained through telemedicine abortion from each state banning or restricting abortion. Texas had the highest number of medication abortions via telehealth under shield law protections, averaging 2,800 medication abortions offered to people each month in the second quarter of 2024.
In Mississippi—the state that brought Dobbs v. Jackson Women’s Health Center to the Supreme Court—the number of people in the state obtaining abortions increased 16 percent between 2020 and 2023, despite a total ban on abortion. This increase was significantly fueled by telehealth abortion from providers located in shield states.
Other states with total bans where the actual numbers of abortions increased between 2020 and 2023 include:
- Alabama (4,460 to 5,115)
- Arkansas (2,220 to 2,250)
- Kentucky (2,805 to 3,160)
- Louisiana (3,805 to 4,180)
- Missouri (5,795 to 6,580)
- South Dakota (350 to 325)
- Tennessee (5,140 to 7,085)
- West Virginia (835 to 1,310)
The number of abortions decreased in Idaho (1,030 to 895), Oklahoma (4,130 to 2,800) and Texas (30,625 to 29,525).
Before COVID-19, patients had to travel hundreds of miles to brick-and-mortar clinics, walk a gauntlet of protesters and pay on average $560 for medication abortion. Now they can obtain these pills by telehealth from the privacy of their own homes and have them mailed directly to them in all 50 states with prompt delivery, for a sliding scale fee of up to $150.
The sliding scale fee structure for telehealth abortion for people living in states with abortion bans is supported by abortion funds, including the Abortion Pill Sustainability Fund and the Abortion Coalition for Telemedicine Fund.
Increasing access to telehealth abortion has been especially important for:
- young people and people living in rural areas who don’t have transportation to abortion clinics;
- people living in the 14 states banning abortion entirely (Alabama, Arkansas, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas and West Virginia);
- people living in the three states that ban abortion at six weeks (Florida, Georgia and South Carolina); and
- those living in the five states that allow some abortions but prohibit telehealth abortion (Arizona, Nebraska, North Carolina, South Carolina and Wisconsin).
“As abortion bans strip away access, the need for abortion care continues,” said Dr. Alison Norris, #WeCount co-chair and professor at The Ohio State University’s College of Public Health and co-principal investigator of the Ohio Policy Evaluation Network. “There is still an immense unmet need for abortion care across the country.”
The #WeCount numbers do not include people who obtained abortions outside of the medical system, including for free from community networks and online for as little as $30 with three- to five-day delivery. Most of those pills came from community networks that report they have given free abortion pills to over 70,000 people living in states with abortion bans and restrictions since Dobbs.
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