Steady US Abortion Rate Amid Legal Restrictions
The abortion rate in the United States remains steady despite total and partial bans in some states, primarily due to cross-state travel and a notable rise in telehealth appointments, according to a recent report.
US regulatory authorities are currently reviewing potential changes to the dispensing methods for mifepristone, an abortion medication. However, this review has reportedly been postponed until after the midterm elections, reflecting the widespread debate over abortion access across the country.
According to data from the Guttmacher Institute, the number of abortions in the US increased slightly from 1.124 million in 2024 to 1.126 million in 2025. The report also highlights a shift away from traveling to states with legal abortion towards telehealth services, where providers prescribe abortion pills via mail.
Telehealth Expands Access Amid State Bans
A significant development noted in the report is the provision of telehealth services for patients residing in states with total abortion bans. Clinicians based in states such as New York and Massachusetts, which have enacted shield laws to protect providers, are remotely consulting and prescribing medication to patients living in restrictive states like Texas and Alabama.
"Shield laws have been ‘extremely important’ for protecting providers and increasing access," said Joanne Rosen, professor at the Johns Hopkins School of Public Health and co-director of its Center for Law and the Public’s Health.
"Essentially, these shield laws allow people to get around the effect of their own state’s abortion ban. It makes medication abortion more affordable and accessible while giving providers legal coverage."
Cross-State Travel Trends
Nationally, 142,000 individuals traveled across state lines for abortion care in 2025, a decrease from 154,000 in 2024 and 170,000 in 2023. Nearly half of those traveling were residents of states with total abortion bans.
The decline in travel is almost entirely among residents of states with total bans, with 12,000 fewer people traveling for abortion care in 2025 compared to 2024. Despite this decrease, the total number of people traveling from states with bans last year, 62,000, remains more than double the pre-Dobbs decision figures. Additionally, 47,000 people traveled from states enforcing six- or 12-week abortion bans in 2025.
The 2025 estimates are based on clinician data and do not account for fully self-managed abortions, suggesting the actual number may be higher.
Rising Telehealth Utilization
Telehealth visits have seen considerable growth in states with abortion bans, eliminating the need for travel for many patients. Isaac Maddow-Zimet, a data scientist at the Guttmacher Institute and co-author of the report, noted this trend:
"So it’s not surprising, but it is the first time that we’ve been able to put out specific numbers showing this shift almost in real time."
Maddow-Zimet described two concurrent trends: increasing difficulty and expense associated with travel, including costs of transportation and childcare, and the enactment of partial or total bans requiring patients to travel longer distances for care.
"People, of course, are traveling much farther than they have ever in the past. They need to travel hundreds of miles and across many state lines," Maddow-Zimet said.
Simultaneously, telehealth availability is expanding and is often more affordable.
"As long as abortion is banned or restricted in many states, there are always going to be people who need or prefer to travel for in-person care – for example, people later in pregnancy, or those who need or prefer procedural care," Maddow-Zimet said. "But for those who can access or prefer telehealth care, it can relieve a huge burden, and can really be a critical mode of access."
Some patients in states without bans but with in-person dispensing requirements also use telehealth for convenience, according to Rosen. The US Food and Drug Administration (FDA) has approved abortion medication for use up to 10 weeks of pregnancy, though evidence supports its effectiveness off-label up to and beyond 12 weeks.
Legal Challenges and Regulatory Reviews
While shield laws have provided legal protection to providers, they are currently being challenged in court. Texas has initiated civil actions against doctors practicing in New York and California.
"We don’t yet know what the courts will find," Rosen said.
The FDA is considering imposing restrictions on telehealth prescriptions of mifepristone, despite the medication’s high effectiveness and safety profile, which is reportedly better than Tylenol. Several states have filed lawsuits against the federal government challenging these potential rules.
"They’re arguing many things – in part that it’s not safe and in part that it undermines state sovereignty," Rosen said.
Complex Legal Landscape and Access Navigation
Before the Dobbs decision and subsequent state bans, many people were unaware of their state’s abortion laws until they required care. Maddow-Zimet emphasized that the current patchwork of laws across the US has increased complexity, necessitating navigational support for patients seeking reproductive healthcare.
"We’re in a policy environment where abortion access is incredibly restricted in many states, and because of that, it’s really critical that people have multiple routes of access, whether that’s telehealth or travel, because people’s individual situations are so specific," Maddow-Zimet said.
