The number of abortions in the United States has increased since the Supreme Court overturned federal abortion protections under Roe v. Wade in June 2022, largely due to increased access to telemedicine prescriptions of the abortion pill mifepristone.
Nationwide, the average number of abortions per month was nearly 100,000 in the first quarter of 2024, according to the WeCount initiative from the Society of Family Planning. Approximately 20% of these abortions each month were facilitated by telehealth.
Ushma Upadhyay, WeCount co-chairwoman and public health professor at the University of California, San Francisco, said in a press release that telehealth access to abortion “eases the surges and cuts down on wait times at abortion clinics providing in-person abortion care,” contributing to the nationwide increase.
“Telehealth abortion is making a critical difference for people seeking abortion care in this increasingly restrictive environment,” said Upadhyay, referencing the 21 states that have successfully implemented gestational age limits for abortion.
As of March, nearly two-thirds of all abortions in the United States were chemical abortions, using the combination of mifepristone and misoprostol, regardless if they were prescribed in person or online.
Mifepristone works by blocking progesterone receptors essential for fetal development. Within 24 to 48 hours of taking mifepristone for a chemical abortion, a patient is instructed to take misoprostol to induce contractions to expel the pregnancy tissue.
Anti-abortion advocates highlight that although the abortion regimen has been approved by the Food and Drug Administration since 2000, mifepristone has the highest classification of safety warnings. According to the agency’s warning, 1 in 25 women will experience a severe complication, such as sepsis or hemorrhaging, and will require emergency care.
The FDA removed the in-person screening requirements for mifepristone during the coronavirus pandemic, which enabled the dispensing of mifepristone via telehealth.
Anti-abortion groups argue that removing in-person screening requirements can allow for more complications that could have otherwise been prevented, such as ectopic pregnancy or mistaken gestational age.
Telehealth access to mifepristone has also opened the door for doctors in states that have liberal abortion laws to prescribe the pill in states that have prohibited elective abortions.
In the wake of the Dobbs v. Jackson Women’s Health Organization decision that overturned Roe, five states, New York, Massachusetts, Washington, Vermont, and Colorado, have enacted shield laws that prevent doctors from being prosecuted for prescribing abortion pills for patients in states with abortion bans. The laws also protect doctors from malpractice litigation following complications.
Telehealth abortions under shield laws averaged approximately 9,200 per month from January to March.
According to WeCount’s data from July 2023 to March 2024, over 65,000 women in states with total or six-week abortion restrictions have accessed abortion pills from providers protected by shield laws.
Angel Foster, co-founder of the Massachusetts Medication Abortion Access Project, said telemedicine providers working under shield law protections “are a lifeline” for women “whose next best option may be to travel hundreds of miles to reach an abortion clinic.”
Of all the states, Illinois has had the greatest monthly increase in abortions, with more than 2,600 being performed monthly compared to pre-Dobbs levels. This is likely due to women traveling from other states in the Midwest that have prohibited elective abortions.
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Although the number of abortions in the U.S. across the board has increased, strengthening abortion access has been a key plank of Vice President Kamala Harris ’s run for the White House, with Democrats down the ticket highlighting the need for national abortion access legislation.
Republicans in national races, including former President Donald Trump and his running mate, Sen. J.D. Vance (R-OH), have cemented their position ahead of the November election as supportive of state gestational age limits and restrictions on abortion without national restrictions.
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