Women in States with Bans Are Having Abortions at Roe-Like Rates, Report Says

Women living in states with abortion bans get the procedure in the second half of 2023, at about the same rate as before the U.S. Supreme Court overturned Roe v. Wade. Wade, according to a report released Tuesday.

Women did this by traveling out of state or getting prescribed abortion pills in the mail, according to the #WeCount report from the Society for Family Planning, which advocates for abortion access. They increasingly used telehealth, the report found, as medical providers in states with laws designed to protect them from lawsuits in other states used online consultations to prescribe abortion pills.

“Abortion bans do not eliminate the need for abortion,” said Ushma Upadhyay, a public health social scientist at the University of California, San Francisco, and co-chair of the #WeCount survey. “People are overcoming these obstacles because they have to.”

The #WeCount report began surveying abortion providers across the country monthly shortly before Roe was overturned, creating a snapshot of abortion trends. In some states, a portion of the data is estimated. The effort makes the data public less than six months late, giving a picture of trends much more quickly than the U.S. Centers for Disease Control and Prevention, whose most recent annual report covers abortion in 2021.

The report chronicled rapid changes since the Dobbs v. Jackson Women’s Health Organization of the Supreme Court, which ended the national right to abortion and opened the door to enforcing state bans.

The number of abortions in states with bans on all stages of pregnancy has dropped to nearly zero. It has also plummeted in states where bans take effect around six weeks into pregnancy, which is before many women know they are pregnant.

But the national total has been roughly the same or higher than the level before the decision. The study estimates that 99,000 abortions occurred every month in the first half of 2024, up from 81,000 monthly abortions from April to December 2022 and 88,000 in 2023.

One reason is telehealth, which got a boost when some Democratic-controlled states last year began implementing laws to protect prescribers. As of April 2022, about 1 in 25 miscarriages were caused by pills prescribed via telehealth, the report concluded. In June 2024, it was 1 in 5.

The latest report is the first time #WeCount has broken down abortion pill prescription numbers state by state. About half of telehealth abortion pill prescriptions now go to patients in states with abortion bans or restrictions on telehealth abortion prescriptions.

In the second half of last year, the pills were sent monthly to about 2,800 women in Texas, more than 1,500 in Mississippi and almost 800 in Missouri, for example.

Data from another group, the Guttmacher Institute, shows that women in states with bans still rely primarily on travel for abortions.

By combining the results of the two surveys and comparing them to Guttmacher’s 2020 in-person abortion counts, #WeCount found that women in states with pregnancy bans were getting abortions in similar numbers to 2020. The numbers do not take into account pills obtained outside the medical system in the previous period, when these prescriptions most often came from abroad. They also don’t count people who received pills but didn’t use them.

West Virginia women, for example, had nearly 220 abortions per month in the second half of 2023, mostly while traveling — more than in 2020, when they had about 140 per month. For Louisiana residents, monthly abortion numbers were about the same, with just under 700 from July through December 2023, mostly through protective laws, and 635 in 2020. However, Oklahoma residents got fewer abortions in 2023, with the monthly number falling to minus 470 from around 690 in 2020.

One of the leading providers of telehealth pills is the Massachusetts Abortion Access Project. Co-founder Angel Foster said the group prescribed for about 500 patients a month, mostly in states with bans, from its launch in September 2023 until last month.

The group charged $250 per person but allowed people to pay less if they couldn’t afford it. Starting this month, with the help of grants that pay operating costs, he’s trying a different approach: setting the price at $5 but letting patients know they’d appreciate it most if they can afford it. Foster said the group is on track to perform 1,500 to 2,000 abortions monthly with the new model.

Foster called the 2020 Supreme Court ruling “a human rights and social justice catastrophe,” while also saying “there is an irony to what has happened in the post-Dobbs landscape.”

“In some places, abortion care is more accessible and accessible than it used to be,” she said.

So far there have been no major legal challenges to the protection laws, but abortion opponents have tried to remove one of the leading pills from the market. Earlier this year, the U.S. Supreme Court unanimously preserved access to the drug, mifepristone, while also finding that a group of doctors and anti-abortion organizations had no legal right to challenge the drug’s 2000 federal approval.

This month, three states asked a judge for permission to file a lawsuit aimed at overturning federal decisions that allowed easier access to the pill — including through telehealth.