US abortion rates stable even as states that restrict procedure see steep decline

<span>Abortion-rights supporters protest on 8 October 2023 in Columbus, Ohio.</span><span>Photograph: Joe Maiorana/AP</span>
Abortion-rights supporters protest on 8 October 2023 in Columbus, Ohio.Photograph: Joe Maiorana/AP

Abortions have dramatically declined in the 14 states that have criminalized the health procedure since the supreme court overturned Roe v Wade in 2022, with thousands of women traveling out of state for reproductive care, new figures reveal.

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Overall, the total number of abortions carried out with medical supervision in the US remained consistent at about 80,000 a month between June 2022 and September 2023 – but where and how patients access this urgent medical care has changed, according to #WeCount, a research initiative measuring the impact of the supreme court’s Dobbs v Jackson Women’s Health Organization decision, which allowed states to ban abortion at any point in pregnancy.

Pregnant people in the south are struggling the most to access abortion, which can be life-saving, with the steepest declines in procedures recorded in Texas, Georgia, Tennessee, Louisiana and Alabama.

If abortion had not been banned in 14 states, an estimated 120,930 abortions would have been carried out in Alabama, Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, West Virginia and Wisconsin.

The data suggests that people were forced to travel long distances in order to access safe, legal medical care. States with the largest cumulative increases in abortion over 15 months included Illinois (28,665), Florida (15,155) and California (12,515).

In most cases, abortions rose in the states bordering states with total bans. But there were also significant increases in New Jersey, New York and Massachusetts, suggesting that some pregnant people are crossing multiple state lines for medical care.

The findings are consistent with research by the World Health Organization and the Guttmacher Institute, which found abortion rates in countries with total bans like El Salvador and the Dominican Republic are more or less the same as in countries where the procedure is legally available. In other words, criminalizing abortion makes it harder and more dangerous for people to obtain the procedure, but it does not stop them from accessing the medical care they need.

The report also reveals an uptick in telehealth or virtual abortion care as pregnant people and professionals look for innovative ways to provide urgent medical care. There were about 14,000 US telehealth abortions a month between July and September 2023 – triple the number before the supreme court decision and amounting to 16% of all abortions. This number includes virtual abortion care by bricks-and-mortar clinics and virtual-only providers, and includes patients living in states with total or partial abortion bans which have shield laws protecting telehealth.

“In the post-Dobbs era, healthcare providers in some states are forging innovative new solutions to provide abortion access,” said Dr Ushma Upadhyay, #WeCount co-chair and professor at the University of California, San Francisco’s Advancing New Standards in Reproductive Health program.

“Telehealth abortion is now a central pillar in the abortion care landscape – and the continued availability of abortion care demands that we must ensure equitable access to this essential healthcare service.”

The #WeCount data includes clinician-provided medication or procedural abortions completed by a licensed clinician within the formal healthcare system in a clinic, private medical office, hospital or virtual-only clinic. It does not reflect self-managed abortions, defined as ending a pregnancy outside the formal healthcare system using medications, herbs or other medicaments, or obtaining pills from friends or online without clinical assistance.