Abortion Rates Keep Rising After Dobbs
Strict abortion bans do not seem to be seriously stopping abortions.
Three years ago this week, the U.S. Supreme Court struck down Roe v. Wade and conservative states rushed to pass strict new abortion bans or revive old ones still on the books but unenforceable under Roe. And for a short while, things went according to anti-abortion campaigners' wishes, with the U.S. abortion rate—which had been declining since the 1990s anyway—continuing to fall.
But over the past couple of years, the U.S. abortion rate has begun to creep back up, according to data from the Society of Family Planning. There were more abortions in the U.S. in 2024 than in either 2023 or 2022, according to the group's latest #WeCount report.
Strict abortion bans may be working to bolster conservative politicians (may being the operative word; a lot of pro-lifers are put off by the extremism baked into some of these policies). They do not, however, seem to be working at actually stopping abortions.
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1.14 Million Abortions in 2024
The latest #WeCount data, released Monday, show that the monthly number of abortions in the U.S. went from 83,930 in April 2022 to 102,040 in January 2024.
In total, there were 1.14 million abortions performed in the U.S. last year, according to the #WeCount report. Throughout 2024, the monthly abortion number mostly remained between 90,000 and 100,000, with only one month (January) seeing more abortions than that and only one month (September) seeing fewer.
The monthly average number of abortions in 2024 was 95,200, up from a monthly average of 88,000 in 2023 and a monthly average of 79,600 for April 2022 (when the #WeCount report started) through December 2022.
Comparing the #WeCount data to abortion data from years before 2022 is a bit difficult, since other estimates—like those from the U.S. Centers for Disease Control and Prevention (CDC)—were calculated differently. CDC data encompassing 46 states and the District of Columbia show 625,978 abortions performed in 2021 and 597,355 in 2020. The Guttmacher Institute also has measured abortion rates, finding 930,160 abortions in D.C. and all 50 states in 2020 and 916,460 abortions in 2019. The CDC's much lower numbers rely on reports from centralized state health bodies, notes the Pew Research Center, while the Guttmacher Institute attempted to tally data from all known abortion providers.
Like the Guttmacher Institute, the #WeCount researchers have counted abortions based on information given by doctors, clinics, and other abortion providers. Self-reported data from clinics, medical offices, hospitals, and virtual providers accounts for 83 percent of the abortions in the study, while the remaining data have been imputed. (See the Methods section here for more on how this was done.)
The Role of Remote Prescribing
"The #WeCount findings make clear that abortion bans haven't stopped people from seeking care," said Alison Norris, #WeCount co-chair and a professor at Ohio State University.
One reason this is possible is the abortion pill and the remote prescribing of it.
In April through June of 2022, just 5 percent of abortions involved remote appointments and prescriptions. From there, we saw a slight bump—between 7 and 8 percent—through the second quarter of June 2023. In subsequent quarters, abortions rose to 16 percent, then 19 percent, then above 20 percent.
In the last three months of 2024, a quarter of abortions involved remote appointments and prescriptions.
More doctors and services devoted to remotely prescribing abortion pills may help explain the overall increase in abortions, even though in-person procedures have declined somewhat.
Surely some women could not or would not visit a clinic for an abortion even where it was legal, due to things like work schedules, child care responsibilities, transportation difficulties, or fear of a partner or family member finding out. The increased availability of telehealth abortion may have made it possible for women in situations like these to obtain an abortion after all.
In any event, telehealth abortions make up the vast majority of abortions in states where abortion is generally banned.
"In states with 6-week bans, on average 28% of abortions were provided via telehealth each month," compared to 15 to 16 percent in states where abortion was more broadly permitted. And "in states where abortion was totally banned, there was a monthly average of only 30 abortions provided in-person, under so-called exceptions, and over 99% of abortions were provided by telehealth."
Nearly half of telehealth abortions in 2024 were provided under shield laws, which help protect abortion providers following laws in the states in which they're located from legal liability in states with bans.
Freedom and Vulnerability
The #WeCount data drive home how hard eradicating abortion will be as long as the abortion pill remains broadly legal and some states allow remote prescription. The report also demonstrates why these things remain such a target for anti-abortion activists and politicians.
No one can say for sure why abortion rates have risen since states started tightening abortion restrictions. But it is clear that state bans on abortion aren't actually curbing the total number of abortions sought or performed. And the rising percentage of abortion patients utilizing remote appointments and prescriptions suggests telemedicine has played a major role in people being able to circumvent state abortion bans.
On one level, the #WeCount data tell a positive story. It's a tale of technology and capitalism enabling individuals to get around government restrictions on bodily autonomy. Of federalism working. Of reproductive freedom winning.
But it's hard to read this report without thinking about the vulnerabilities here.
States with abortion bans have already been trying to restrict the ability of people in them to access out-of-state abortion providers and receive abortion pills through the mail. We've also seen efforts to target federal approval of abortion pills or prescribing rules around them. The state efforts have largely failed, so far, since states can't control the actions of doctors and clinics in other states where abortion is legal or change the fact that the abortion pill is still permitted by the federal government to be prescribed and mailed. And an attempt to change federal rules through the courts was also unsuccessful.
There are other ways to attack abortion pills, however, like getting the Food and Drug Administration to revisit its rules or reviving enforcement of the Comstock Act. And these ways wouldn't just restrict access for people in conservative states, but for people everywhere across the country.
If the #WeCount report suggests that advocates for abortion access are currently winning, it also makes all the more clear that ways that anti-abortion counterparts can strike back.
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My friend, the writer, artist, and cultural theorist Ruby Justice Thelot, brought up something important, something that almost every voice in the AI reporting ecosystem seems determined to miss: this always happens with new communication technology.
And with similar severity, too!
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Read the whole thing here.
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