Are abortion numbers rising in the US?

Episode Summary

Executive Summary: The episode examines why U.S. abortion numbers rose after Dobbs even as many states banned the procedure. Drawing on Guttmacher and WeCount data, it argues that telehealth medication abortions, shield laws, and interstate travel have offset bans, making national counts rise while access remains deeply unequal across states.

Main Topics: Post-Dobbs abortion numbers defy expectations (Priority: 5/5): Despite abortion bans in many states after the Supreme Court overturned Roe v. Wade, the national number of abortions has increased rather than fallen. Limitations of official government data (Priority: 4/5): The CDC’s abortion reporting has stalled, leaving researchers to rely on advocacy/research groups with more current but politically involved datasets. Telehealth medication abortion (Priority: 5/5): Remote consultations and mailing abortion pills have expanded access, especially since the COVID era, and now make up a substantial share of abortions. Shield laws and cross-state care (Priority: 5/5): Laws protecting providers and patients are enabling abortions to be prescribed across state lines and prompting large-scale travel to legal states. State-level increases and cross-border effects (Priority: 4/5): States without bans, especially those bordering restrictive states, have seen big increases in abortions due to both out-of-state patients and more local residents accessing care. Persistent inequality in access (Priority: 5/5): Rising national totals do not mean abortion access is secure for people in banned states; many still cannot obtain care.

Key Arguments: National abortion totals rose after Dobbs because bans were partially offset by telehealth, shield laws, and interstate travel, not because bans had no effect. Government reporting is incomplete: the CDC has not published updated national abortion data since 2022, so researchers must use alternative sources. Telehealth has sharply expanded access and reduced barriers such as cost, travel distance, and privacy concerns. Provider shield laws allow clinicians in legal states to prescribe abortion pills to patients in banned states without facing prosecution from those states. State totals can be misleading because they often count abortions performed in-state, not residents who travel elsewhere for care. An increase in national abortion numbers does not mean abortion access problems are solved; many people in banned states remain unable to get abortions.

Data Points: US abortions in 2024: around 1,049,000 - Estimated abortions in states without total bans; first time since 2012 that national count exceeded one million Abortions in the 1980s: 1.2 million to 1.5 million - Historical annual U.S. abortion totals cited from earlier decades Abortion rate in the 1980s: about 28 per thousand - Historical rate referenced for comparison Abortion rate in the 2010s: 14 per thousand - Shows long-term decline before Dobbs Monthly abortions reported by WeCount: 84,000 to 96,000 - Represents a 14% rise in monthly abortions tracked by WeCount Telehealth share of all abortions: 4% to 25% - Increase since data collection began in summer 2022 Telehealth abortions in states with total bans: about 6,000 per month - Estimate for banned states Telehealth abortions in states with six-week bans: about 2,000 per month - Estimate for states with restrictive six-week bans Telehealth abortions in states where telehealth is banned but abortion is legal: about 1,600 per month - Estimate for states with telehealth restrictions Telehealth abortions in broadly legal states: about 10,000 per month - Estimate for remaining legal states Shield-law abortions: 12,330 per month - WeCount estimate of abortions administered using shield laws CDC abortion report update: last published in 2022 - Indicates lack of recent official federal abortion data Out-of-state travel for abortion care: around 170,000 people per year - Estimated number traveling across state lines for abortions Illinois abortion increase: 72% increase - Rise in abortions provided in Illinois after Dobbs Out-of-state patients in Illinois: 21% in 2020; 41% in 2023 - Shows increased travel into Illinois for abortion care Arkansas abortion count: 0 recorded - State public health reporting example showing limits of counting systems

Pivotal Quotes: "We were very surprised once we started to see the results." — Dr. Oshma Upaliyai: Commenting on the unexpected rise in abortion numbers after Dobbs "there are still many people living in states with abortion bans that are not are still not able to get abortions, even though on a national level, the numbers are increasing." — Dr. Oshma Abdayi: Warning against interpreting rising totals as proof that access problems are solved "it has really removed barriers, including costs, travel distance, privacy reasons." — Dr. Oshma Upaliyai: Describing the effect of telehealth abortion access

Implications: National abortion totals can rise while access becomes more unequal. For policymakers and listeners, the key issue is not just overall numbers but who can still obtain care, where, and by what method.