Three years after the US supreme court overturned Roe v Wade, erasing the national right to abortion and paving the way for more than a dozen states to ban the procedure, the number of abortions performed in the US is still on the rise – including in some states that ban the procedure.
US abortion providers performed 1.14m abortions in 2024, according to new data released Monday by #WeCount, a Society of Family Planning project that has tracked abortion provision since 2022. That’s the highest number on record in recent years.
“We were really surprised to see the numbers go up over time,” said Ushma Upadhyay, a University of California, San Francisco professor who serves as co-chair of the #WeCount steering committee. “Abortion bans haven’t really stopped people from needing abortion care. It’s just made it harder for them to be able to get them.”
Although most of the abortions documented in #WeCount’s report took place in person, a growing number of abortions are occurring through telehealth, including among patients living in one of the dozen-plus states that ban virtually all abortions. In a telehealth abortion, patients generally meet virtually with a provider before receiving abortion pills through the mail. By December 2023, 19% of abortions took place through telehealth – but by December 2024, that share had risen to 25%.
In the last three months of 2024 alone, more than 70,000 abortions were performed through telehealth. These abortions are particularly popular in states with large rural regions, such as Montana, Nevada and Hawaii.
Much of the increase in telehealth abortions can be attributed to the spread of “shield laws”. Enacted by at least eight states since Roe’s fall, these controversial laws are designed to protect abortion providers who treat women in states with bans from prosecution by those states.
Demand for shield-law abortions has skyrocketed over the last two years. In July 2023, when the first shield-law abortion providers started operating, they facilitated fewer than 6,000 abortions for people living in states that ban almost all abortions or that restrict telehealth abortions. In December 2024, these providers performed almost 14,000 abortions.
“There’s more abortion taking place in Mississippi today than there was prior to Dobbs,” said Dr Angel Foster, a co-founder of the Massachusetts Medication Abortion Access Project (Map), which uses shield laws to ship abortion pills out to about 2,500 patients per month. “That really speaks to how little access some folks had to in-clinic abortion care prior to Dobbs and how shield law provision and telemedicine has really stepped into that space.”
#WeCount also collected information on how many abortions were reported to government authorities in states with abortion bans in 2024. On average, states where abortion is totally banned saw just 30 in-person abortions per month, #WeCount found.
All abortion bans permit abortions in emergency situations, but activists have long contended that that bans’ exceptions are written so narrowly and vaguely that they are unworkable in practice. Since Roe fell, dozens of women have come forward to say they were denied emergency abortions.
In Upadhyay’s view, the #WeCount data backs up the claim that exceptions don’t work.
“That seems very low,” Upadhyay said. “That is something that I think states with abortion bans should be paying attention to and be concerned about.”
The future of shield laws is now in doubt, as anti-abortion activists are trying to test their durability in court. Texas has sued a New York doctor over accusations that she mailed abortion pills to a woman in Texas, while Louisiana has indicted the same doctor for allegedly mailing a pill to that state.
Access to the common abortion drug mifepristone is also under assault. Martin Makary, the FDA commissioner, and Robert F Kennedy Jr, the US health secretary, have called for a “review” of mifepristone, which is typically used in telehealth abortions – and which has been deemed safe by more than 100 studies conducted across dozens of countries. Kennedy specifically cited the results of a flawed analysis pushed by anti-abortion groups that claimed the complication rates from taking mifepristone are higher than previously known.
“Clearly, it indicates that, at very least, the label should be changed,” Kennedy told the Missouri senator Josh Hawley, a Republican, during a congressional hearing.
For now, however, Foster remains optimistic about the future of her work.
“There will be a point where growth stops. There’s a finite number of people who have an abortion each year,” Foster said. “But I do think within our practice and within the shield law space we are anticipating that there will continue to be growth in demand.”