Abortion Rates Rise in U.S. Despite Bans Telehealth and Shield Laws Drive Increase

Since the Supreme Court’s decision to end federal protection for abortion 18 months ago, the number of abortions in the U.S. has continued to climb, defying expectations of a decline.

According to The Society of Family Planning’s WeCount project, led by Ushma Upadhyay, a professor at the University of California, San Francisco, there has been a slow but steady increase in abortions per month.

In 2023, there were, on average, 86,000 abortions per month compared to approximately 82,000 per month in 2022.

This slight uptick is noteworthy, especially considering that 14 states had implemented total abortion bans during this period. Despite these bans, the report indicates a surge in abortions, particularly in states like Florida, California, and Illinois.

Interestingly, Florida saw a significant increase despite enacting a 6-week ban on abortions starting May 1. The rise in abortions can be attributed in part to telehealth services, which have become more accessible due to regulations loosened during the pandemic.

Telehealth abortions, which accounted for 19% of all abortions in the U.S. according to the report, have become increasingly popular due to their affordability, convenience, and privacy.

Providers offering telehealth abortions from states with shield laws, which protect doctors and clinics from prosecution for providing abortion care to people from other states, have seen a surge in demand.

Between July and December 2023, over 40,000 people in states with abortion bans and telehealth restrictions received medication abortion through providers in shield law states.

This method allows patients to receive abortion pills via telehealth appointments and mail, safely ending pregnancies in the first trimester.

However, the report acknowledges that these numbers only represent abortions within the formal healthcare system and do not include self-managed abortions, which are likely undercounted.

Despite criticisms from organizations opposing abortion, research indicates that telehealth abortions are as safe and effective as in-clinic care.

Expansions in telehealth, along with the establishment of new clinics in states like Kansas, Illinois, and New Mexico, have contributed to the rise in abortions. Additionally, increased funding for abortion care, driven by private donors and abortion funds, has played a role in expanding access to services.

The implementation of shield laws in several states has also facilitated access to abortion care for individuals living in states with bans or restrictions.

Shield laws protect providers offering care nationwide, bypassing traditional telemedicine laws that often require out-of-state health providers to be licensed where patients are located.

However, legal challenges, including cases awaiting Supreme Court decisions, pose a potential threat to the continued expansion of telehealth abortions.

Restrictions on the drug mifepristone, if upheld by the Supreme Court, could disrupt the surge in telehealth services by requiring in-person doctor visits for medication abortion.