Abortion rates have remained stable in America despite full and partial bans in some states — largely because of increased mobility across the country and a huge increase in health options, a new report says.
US regulatory officials are evaluating changes to how mifepristone, an abortion drug, can be administered, but have reportedly delayed their review until after the midterm elections, given widespread support for abortion across the US.
The number of abortions in the United States increased slightly last year, from 1.124m to 1.126m, according to a report by the Guttmacher Institute. There is also a shift away from travel and toward telehealth, where retailers can deliver mail-order pills.
One major change in this report is the provision of telephone for patients in states with complete restrictions – those with doctors in states such as New York or Massachusetts, which have protective laws to protect providers, see and give orders to patients who live in states such as Texas or Alabama.
Shield laws have been “very important” for protecting providers and increasing access, said Joanne Rosen, a professor at the Johns Hopkins School of Public Health and co-director of the Center for Law and Public Health.
“Essentially, these shield laws allow people to circumvent the impact of their state’s abortion ban,” Rosen said. It makes medical abortion accessible and affordable while providing legal protection.
Nationwide, 142,000 people crossed state lines for abortion care in 2025 – a decrease from 154,000 in 2024 and from 170,000 in 2023. About half of the people who visited for abortion were citizens of states with complete restrictions.
That drop is almost among the population of counties with full restrictions, where 12,000 people went for an abortion last year compared to 2024.
But the total number of people who traveled for abortions from the banned states last year, 62,000, was still more than double the number of people who came from those states before Dobbs’ decision. Another 47,000 people in 2025 have left the states on six- or 12-week restrictions.
The 2025 estimates are based on physician data, and do not include fully controlled abortions, meaning the true number is likely to be higher.
Telehealth visits are also seeing a significant increase in countries with restrictions. That makes sense because people who get telehealth services no longer need to travel for care, said Isaac Maddow-Zimet, a data scientist at the Guttmacher Institute and co-author of the report. “So it’s not surprising, but it’s the first time we’ve been able to produce unique numbers that show this change almost in real time.”
Two trends emerge immediately, Maddow-Zimet said. It has become more difficult to travel – it is more expensive to drive or fly and to find childcare; and with partial or complete restrictions imposed across the country, patients often have to travel long distances to receive care.
“Of course, people are traveling a lot farther than in the past,” Maddow-Zimet said. “They need to travel hundreds of miles and cross multiple state lines.”
At the same time, telehealth is becoming widely available and often very affordable.
“As long as abortion is prohibited or prohibited in many countries, there will always be people who need or want to travel for individual care – for example, people who are late in pregnancy, or who need or choose procedural care,” said Maddow-Zimet. “But for those who can afford or choose telecare, it can be a huge relief, and it can be an important means of access.”
Some patients also use telehealth in areas where abortion is not restricted but have in-person delivery requirements, because they prefer remote appointments, Rosen said. Abortion medications are approved by the US Food and Drug Administration (FDA) up to 10 weeks of pregnancy, although evidence shows they may be effective when used off-label up to 12 weeks.
Although the shield laws provided legal protection to donors, they are now being tested in court; Texas has brought civil actions against doctors in New York and California.
Rosen said: “We don’t know yet what the courts will find.
The FDA is considering placing restrictions on telehealth prescriptions of mifepristone, even though the drug is more effective and safer than Tylenol. Several states have filed lawsuits against the federal government to challenge these laws.
“They argue a lot of things — partly that it’s unsafe and partly that it undermines national sovereignty,” Rosen said.
Even before the Dobbs decision and the restrictions that followed, people often didn’t have a good understanding of their state’s abortion laws until they needed care, Maddow-Zimet said. It’s now “more complicated” with regulations across the country, which means patients also need “navigating support” to understand how to access reproductive health care, she said.
“We’re at a policy point where access to abortion is very restricted in many countries, and as a result, it’s very important that people have multiple avenues of access, whether it’s by phone or travel, because individual circumstances are clear,” Maddow-Zimet said.
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