In the years following the Supreme Court’s landmark 2022 Dobbs decision that overturned federal abortion rights, a striking and counterintuitive trend has emerged across the United States. While numerous states moved swiftly to enact severe restrictions or outright bans on the procedure, the total number of abortions has not decreased; instead, it has climbed steadily. This unexpected outcome directly challenges the central premise of anti-abortion legislation, revealing a profound shift in how essential healthcare is accessed. A powerful combination of medical technology, legal innovation, and resilient provider networks has fundamentally reshaped the landscape, moving abortion care out of traditional clinics and into a decentralized, remote model that circumvents state-level prohibitions and continues to meet a persistent, and potentially growing, demand.
The Statistical Reality Post-Dobbs
The narrative that legal bans effectively eliminate or reduce abortions is directly contradicted by comprehensive data tracking the procedure nationwide. According to the Society of Family Planning’s #WeCount report, the average number of abortions provided within the formal U.S. healthcare system has shown a consistent and significant increase. In the months following the Dobbs decision in 2022, the average was approximately 79,600 procedures per month. By 2023, that number had risen to 88,200, and it continued to climb through 2024 to 95,300. The trend has accelerated into the current year, with the first half of 2025 showing an average of 98,800 abortions per month. This clear statistical progression underscores a crucial point articulated by experts like Dr. Alison Norris, co-chair of the report, who stated that “abortion bans don’t stop people from needing and pursuing essential abortion care.” The data confirms that legal barriers are not eliminating the procedure but are instead altering the methods and pathways through which individuals access it.
This upward trend in abortion numbers represents a fundamental failure of state-level bans to achieve their stated objective of reducing the incidence of abortion. Instead of curtailing access, these restrictive laws appear to have catalyzed a powerful and adaptive response from both patients and providers. The data suggests that the demand for abortion care has remained robust, and in the face of significant legal obstacles, the healthcare system has evolved to meet it. This evolution highlights a disconnect between legislative intent and real-world outcomes, where technological advancements and interstate provider networks have created a resilient infrastructure for abortion access that operates beyond the effective reach of state-specific prohibitions. The persistent increase in procedures serves as a potent reminder that legal frameworks alone cannot erase a fundamental healthcare need, pushing the conflict into new arenas of technology, law, and interstate jurisdiction.
The Rise of Telehealth and Legal Safeguards
The primary driver behind this sustained and growing access to abortion care is the remarkable expansion of telehealth services for medication abortion. Before the Dobbs ruling, telehealth represented a small fraction of procedures, accounting for just 5% of all abortions. However, its role has since exploded, growing to 20% in 2023, 25% in 2024, and now constituting 27% of all abortions within the formal healthcare system as of mid-2025. This paradigm shift has transformed the patient experience, replacing the arduous process of long-distance travel, navigating protests at brick-and-mortar clinics, and incurring significant costs with a more private and accessible alternative. Patients can now engage in virtual consultations from the security of their homes, receive FDA-approved abortion pills discreetly by mail, and do so at a substantially lower cost, which often falls to $150 or less due to sliding-scale fees and financial assistance programs.
This flourishing telehealth model is legally enabled by a crucial innovation known as “shield laws,” which have been implemented in a handful of states. These laws create a legal safe harbor, protecting in-state clinicians who prescribe and mail abortion pills to patients located in states where the procedure is banned or heavily restricted. The impact of these protective measures has been profound and is growing rapidly. By June 2025, a majority (55%) of all telehealth abortions were provided by clinicians operating under the shield laws’ protection. The number of patients in restrictive states served by these providers has surged, increasing by 61% in a single year from 9,180 in June 2024 to 14,770 by June 2025. In states with total abortion bans, nearly all clinician-provided abortions are now facilitated via this remote model. The varied impact is notable; for instance, in South Carolina, 68% of abortions are supported by shield-law providers, while in North Carolina, which has a similar 12-week ban, the figure is 18%.
Beyond the Official Numbers and Underlying Demand
While the official statistics paint a clear picture of rising abortion numbers, they almost certainly represent a significant undercount of the total procedures occurring nationwide. The methodology of the #WeCount report is limited to abortions provided within the formal U.S. medical system, meaning it does not capture the substantial activity happening through alternative channels. These informal networks have become a critical lifeline for thousands of individuals, particularly in states with the most severe restrictions. International telehealth providers like Women on Web and Abortion Pills in Private serve nearly a thousand U.S. patients monthly, offering medication for $120 or less. Simultaneously, grassroots community networks affiliated with groups such as Red State Access and DASH operate on the ground, distributing free abortion pills to tens of thousands of women since the Dobbs decision. Furthermore, many individuals are sourcing pills directly from online vendors for as little as $50, a channel that is almost impossible to track accurately.
The data suggests not only that access has been maintained but that the underlying demand for abortion may itself be increasing, particularly in states with bans. This potential rise in demand is likely driven by a confluence of factors directly and indirectly related to restrictive policies. In many states that have banned abortion, access to contraception has also been simultaneously eroded, leading to a higher rate of unintended pregnancies. Moreover, the increasing medical dangers associated with carrying a pregnancy to term in states that lack health exceptions for emergency care may compel more individuals to seek an abortion. The growing criminalization of pregnancy outcomes and the deterioration of social safety net programs, which make it more difficult for women to afford to have and raise children, are also believed to be contributing factors that discourage people from continuing pregnancies in environments they perceive as hostile to their well-being and autonomy.
A New Front in an Old Conflict
The successful pivot to telehealth had solidified a new, resilient model for abortion access, but this very success marked it as the next major battleground. Anti-abortion advocates and politicians quickly identified remote care as a primary threat to their agenda and launched a series of concerted legal and legislative challenges. Experts like Dr. Ushma Upadhyay, another co-chair of the #WeCount report, warned of these “relentless attacks on mifepristone and telehealth,” recognizing them as a direct assault on the infrastructure that had preserved access post-Dobbs. This conflict created a stark contrast between the proven safety and efficacy of medication abortion, supported by over two decades of data, and the political motivations of those seeking to restrict it. The fight shifted from the doors of physical clinics to the digital and legal frameworks that enabled care across state lines, framing the future of abortion access as an ongoing contest between technological innovation and determined legal opposition.
