Despite the U.S. Supreme Court overturning Roe v. Wade in 2022—and numerous states enacting bans or strict limits—abortion appears to be slightly more common nationwide than it was in the lead-up to the landmark Dobbs v. Jackson Women's Health Organization ruling. Below is an in-depth look at how women are accessing abortions now, the evolving legal framework, and the challenges faced by both patients and providers.
Post-Roe Shifts: A Nationwide Perspective
No Decline in Overall Abortions
Surprisingly, the total number of abortions in the U.S. has not dropped. Monthly abortion counts across the country have increased slightly compared to the months just before the Supreme Court’s decision in June 2022. That’s even as numbers in Republican-led states with bans have dropped close to zero.
“Abortion bans don’t actually prevent abortions from happening,” says Ushma Upadhyay, a public health social scientist at the University of California San Francisco. “But they do change care.”
Why Are Abortions Still Increasing?
Where bans are in place, women are traveling out of state or turning to medication abortions—often prescribed via telehealth. This makes it easier for some women to obtain abortions despite restrictions but also highlights the inequities for low-income, minority, and immigrant women who struggle more to travel or pay for related costs.
The Rise of Medication Abortions and Telehealth
More Pills, More Telehealth
Even before the Dobbs ruling, medication abortions (typically using two drugs, mifepristone and misoprostol) accounted for about half of all abortions. Recent research from the Guttmacher Institute shows that number has climbed to around two-thirds. A key driver is telehealth: by summer 2024, about 1 in 10 abortions nationwide was conducted via abortion pills prescribed online to patients in states with bans.
State and Federal Legal Hurdles
Texas recently sued a New York doctor for prescribing abortion pills via telemedicine to a patient in Texas, underscoring the heated legal battles over mailing and prescribing these medications across state lines. Meanwhile, Idaho, Kansas, and Missouri have moved to classify these pills as “controlled dangerous substances,” and some federal officials have been urged to revisit a 19th-century law that could ban mailing them entirely.
Traveling for Abortions: Obstacles and Networks
Clinic Closures and Travel Pressures
Many clinics have shut down or halted abortions in states with near-total bans. As a result, women often travel hours—or even out of state—to access care. Advocates warn that the burden falls heaviest on the most vulnerable populations.
Strengthened Abortion Funds and Support Networks
Private and nonprofit “abortion funds” have expanded since 2022, using donations to cover travel and procedure costs. However,
some have had to limit how much financial help they can provide due to unprecedented demand.
Florida’s Six-Week Ban
Florida, the country’s second most-populous state, enacted a ban on abortions after six weeks of pregnancy on May 1. This drastically changed its role from a regional haven—where patients in other Southern states would go for care—to a state where pregnant women now travel elsewhere. In May and June, abortions in Florida dropped by about 30% and 35%, respectively, compared to the early months of 2024.
Where Clinics Stand Now
New Facilities in Abortion-Friendly States
While some clinics in ban states have closed, others have opened or expanded in regions where abortion remains legal until viability (generally considered after 21 weeks of pregnancy, though not a fixed threshold). Illinois, Kansas, and New Mexico have seen notable growth in abortion clinics or hospital services.
Complex Numbers
In May 2022—just before Dobbs—there were 799 publicly identifiable abortion providers nationwide, according to data from Middlebury College economics professor Caitlin Myers. As of November 2024, there were 792, though Myers notes some hospitals that provided abortions quietly have begun advertising, adding complexity to the tally.
Emergency Care Concerns
Life-Threatening Pregnancy Complications
The Biden administration insists that hospitals must provide necessary abortion care when women’s lives are at risk—regardless of state bans. Yet states like Texas have challenged these guidelines, and the Supreme Court has declined to intervene in certain cases.
Real-World Consequences
According to investigative records from The Associated Press, more than 100 pregnant women were turned away or left unstable in emergency departments since 2022. Complaints include a Texas woman who miscarried in an ER lobby restroom after being refused care, and a North Carolina woman who gave birth in her car after failing to receive an ultrasound in time—resulting in the baby’s death.
“It is increasingly less safe to be pregnant and seeking emergency care in an emergency department,” Dr. Dara Kass, an emergency medicine physician and former U.S. Health and Human Services official, told the AP earlier this year.
Ballot Measures and Public Opinion
Statewide Votes on Reproductive Rights
Since the overturning of Roe, there have been 18 statewide ballot questions about reproductive rights. Abortion-rights advocates won on 14 measures and lost on four. In 2024, five states successfully amended their constitutions to protect the right to abortion, while proposals failed in Florida (requiring 60% approval), Nebraska (where competing proposals existed), and South Dakota (lacking strong national support).
Public Sentiment vs. Political Outcomes
AP VoteCast data shows that more than three-fifths of voters in 2024 believe abortion should be legal in all or most cases—up slightly from 2020. Interestingly, this support for abortion rights coexists with voter support for Republican control of the White House and Congress.