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December 29, 2024
Two and a half years after the Supreme Court overturned Roe v. Wade, abortion in the United States has not become less common. Instead, new dynamics have emerged, reflecting a nation divided over reproductive rights. Despite bans and restrictions in many Republican-controlled states, abortions are slightly more common now than before the landmark Dobbs v. Jackson Women’s Health Organization decision.
A Changing Abortion Landscape
The number of monthly abortions nationwide has risen slightly, even as access has plummeted in states with strict bans. Many women have turned to abortion pills or traveled across state lines to seek care, highlighting how access disparities disproportionately affect low-income, minority, and immigrant women.
“Abortion bans don’t actually prevent abortions from happening,” says Ushma Upadhyay, a public health social scientist at the University of California, San Francisco. “But they do change care.”
The Role of Abortion Pills
Abortion pills now account for about two-thirds of abortions, up from half before Dobbs. Telehealth prescriptions, especially in states where abortion is banned, have made these pills a critical option. By mid-2024, about 10% of abortions were conducted via telemedicine in such states.
However, legal battles over abortion pills are intensifying. Texas recently sued a New York doctor for prescribing pills via telemedicine, while states like Idaho, Kansas, and Missouri are pushing to classify these drugs as “controlled dangerous substances.” There are also federal efforts to enforce a 19th-century law to prohibit mailing the pills.
Increased Travel for Abortions
With clinics closing in states with bans, abortion-related travel has surged. Texas residents, for example, often travel to New Mexico or Kansas, where abortion remains legal. According to the Guttmacher Institute, more Texans received abortions in New Mexico in 2023 than New Mexico residents themselves.
Abortion funds, bolstered by donations after the Dobbs decision, have helped many women cover travel expenses, though some organizations have had to limit assistance due to overwhelming demand.
Impact of Florida’s Six-Week Ban
Florida, once a refuge for Southern women seeking abortions, has seen a sharp decline in procedures since implementing a six-week ban in May 2024. Abortions dropped by 30% in May and 35% in June.
This has had a ripple effect across the Southeast, with patients facing longer travel times to states like North Carolina, where abortion is legal for the first 12 weeks of pregnancy.
Shifts in Abortion Provider Networks
The number of publicly identifiable abortion providers has remained relatively steady, dropping slightly from 799 in May 2022 to 792 in November 2024. However, some hospitals that previously performed abortions without advertising now openly offer the service. States like Illinois, Kansas, and New Mexico have seen new clinics open to meet demand.
Emergencies and Risk to Lives
Restrictions have also complicated emergency care for pregnancy complications. Hospitals in states with bans have faced criticism for delaying or denying care in life-threatening situations.
An Associated Press investigation found over 100 cases since 2022 where women were turned away or left unstable, leading to severe outcomes. In one instance, a Texas woman miscarried in a hospital restroom after being denied care, while another gave birth in her car outside a North Carolina hospital, only for the baby to die.
“It is increasingly less safe to be pregnant and seeking emergency care,” said Dr. Dara Kass, a former U.S. Health and Human Services official.
Abortion Rights and Public Opinion
Despite the legal battles, abortion rights remain popular. Of 18 reproductive rights-related ballot measures since 2022, abortion rights advocates have won 14. In 2024, five states added abortion protections to their constitutions.
Polls show growing public support for abortion rights, with over 60% of voters in 2024 favoring legal abortion in most or all cases, according to AP VoteCast.
The Fight Continues
As states and courts continue to shape the abortion landscape, the debate over reproductive rights remains far from settled. For millions of women, the post-Roe era is defined by a mix of resilience and struggle, with pills, travel, and legal uncertainty forming the new reality of abortion access in America.
