Evolving regulations surrounding abortions are altering the modes through which women obtain medical assistance.
In the spring of 2024, from April to June, approximately 97,500 abortions took place each month in the U.S., as per a fresh report by the Society of Family Planning. This organization, a non-profit, collects data on abortion volume from various sources such as clinics, private medical offices, hospitals, and virtual clinic providers, which are then featured in their quarterly #WeCount reports.
Much like previous years, the majority of abortions in the spring of 2024 occurred in-person, accounting for nearly 80%. However, there was a slight dip compared to the previous year, with an average of around 2,000 fewer in-person abortions per month.
On the other hand, telehealth abortions, involving medication dispensed via mail after remote consultation with a clinician, are seeing an upsurge, particularly medication abortions under shield laws for women residing in states with abortion bans or restrictions.
Shield laws provide certain legal protections for providers in some states where abortion remains legal and they can prescribe medication abortion drugs via telehealth to residents of states with bans or restrictions. Data from the Society of Family Planning reveals that shield laws have been contributing to an increase in such abortions since their inclusion in their reports a year ago.
In the summer of 2023, an average of about 5,700 abortions were performed under shield laws each month. By the spring of 2024, this number had risen to more than 9,700 abortions per month.
Abortions conducted under shield laws now account for approximately 1 in every 10 abortions in the spring of 2024, as opposed to 1 in every 16 in the summer of 2023. Dr. Ushma Upadhyay, co-chair of #WeCount and a professor at the University of California, San Francisco’s Advancing New Standards in Reproductive Health, stated that medication abortion provided via telehealth under shield laws is significantly contributing to abortion access in a heavily restricted environment.
In states with abortion bans, a combination of shield laws and out-of-state travel has assisted residents in accessing abortions at similar – and in some cases, higher – rates than before the Supreme Court Dobbs decision, which revoked the federal right to an abortion and paved the way for states to make it illegal.
For instance, in West Virginia, there were 835 abortions among state residents in the first half of 2020, with almost equal numbers performed in-state and out-of-state. In the second half of 2023, there were nearly twice as many abortions among West Virginia residents, with more than 1,000 obtained out-of-state and more than 200 provided under shield laws.
Similarly, in Tennessee, there were about 2,000 more abortions provided to state residents in the second half of 2023 than there were in the first half of 2020. More than 5,000 residents traveled out-of-state for an abortion in the second half of 2023, compared to about 1,100 in the first half of 2020, and more than 1,800 accessed medication abortion under shield laws.
However, this trend isn't consistent across all states with bans or restrictions.
In Texas, where travel time to an abortion facility increased substantially after the Dobbs decision, more than 17,000 women still traveled for an abortion in the second half of 2023, with more than 12,400 accessing abortions through shield laws, making Texas the state with the highest number. Nevertheless, there was still a decrease: About a thousand fewer abortions were provided to Texas residents in the last six months of 2023 than in the six months of 2020, as suggested by the new report.
State policies continue to evolve post-Dobbs decision. Voters in at least 10 states will determine the future of abortion access at the polls next month. However, the changing policies may not always keep up with the need for abortion access, as per the new report.
Florida's 6-week ban came into effect in May 2024. Between March and May, there were 2,500 fewer in-person abortions in the state, but only an increase of about 400 abortions provided under shield laws, as per #WeCount data.
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“As abortion bans limit access, the need for abortion care continues,” Dr. Alison Norris, co-chair of the #WeCount project and a professor at The Ohio State University’s College of Public Health, stated. “There is still a substantial unmet need for abortion care nationwide. Abortion bans leave a lasting, harmful impact, especially on those who must travel long distances for abortion care, postpone their care, or continue their pregnancy despite their wishes.”
Since March 2023, #WeCount has observed a minor but consistent increase in the average number of US abortions each month. However, the researchers note that the actual number of abortions does not account for many self-managed abortions, such as those obtained from online stores or volunteer networks, and many women are still unable to access any care whatsoever.
In fact, other recent research has shown that both birth rates and infant mortality have increased following the Dobbs decision.
“We cannot estimate the number of individuals who were unable to access abortion care and were forced to carry their unwanted pregnancy to term,” the #WeCount researchers wrote. “The inability to access abortion remains a reality for many, even in states where abortion is permitted.”
In this context, it's important to prioritize overall health and reproductive rights. Despite the increase in telehealth abortions under shield laws, many women still face challenges accessing necessary services due to travel distances or financial constraints, potentially leading to negative health outcomes as seen in the rise of both birth rates and infant mortality.
The unmet need for abortion care nationwide continues to pose significant health concerns, highlighting the importance of advocating for policies that support comprehensive reproductive health services and ensure equitable access for all.
