Abortions rose to decade-old levels in 2023, the first full year after the Supreme Court overturned Roe vs. Wade in 2022. Despite stricter legislation in many states, there were a total of 1,026,690 abortions. That is 15.7 per 1,000 women of reproductive age. 63% of the cases were performed with medication. The Supreme Court will hear arguments on March 26 regarding whether this method should continue to be allowed.
Abortions have increased by 10% compared to 2020, the last year when comprehensive estimates were available, according to the Guttmacher Institute, which published the study. The report indicates that, compared to the notable drop in abortions in the 14 states that passed bans with limited exceptions and the seven that established stricter limitations on abortion based on the number of weeks of gestation, the rest of the states have experienced a notable increase in cases. Furthermore, the authors insist that the data only took into consideration numbers from the official health system, so they are convinced that the real number is much higher.
Medication was used in 63% of cases
The number of abortions has not exceeded one million since 2012. The highest number of cases dates back to 1990 with 1.6 million. Since then, the number of abortions began to gradually decrease. In 2017, there were 885,000 abortions. In 2019, abortions started to rise again. There were a total of 930,160 in 2020. The most used method (63%) was medication abortion which increased by 53% compared to 2020.
With the exception of Arizona, Georgia, Wisconsin and Indiana, where the fewest cases were recorded, abortions increased considerably in the rest of the states where the laws were not tightened. According to the authors, states without total bans experienced an average increase of 25% compared to 2020. The states that border others with strict laws are the ones that had the most considerable increase (37% on average). New Mexico's cases were up 257% compared to 2020.
States bordering ban states had particularly large increases. In total, abortions in these states increased by 37% between 2020 and 2023, with particularly sharp increases in Illinois (38,010 more abortions than in 2020, or an increase of 72%), New Mexico (15,090 more abortions, an increase of 257%), Virginia (14,190, an increase of 76%) and North Carolina (12,970, or 41%). Much of the increase in these states was due to increased travel across state lines. Illinois, for example, provided abortion care to an estimated 25,660 more patients from out of state, accounting for 68% of its overall increase.
Three factors that contribute to the increase in abortions
According to the authors, three factors contribute to this increase:
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- Broader availability of telehealth for medication abortion. The use of telehealth to provide medication abortion via mail increased considerably after the U.S. Food and Drug Administration lifted in-person dispensing requirements of mifepristone—one of the drugs most commonly used in medication abortion—during the pandemic.
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- Increased financial support. Cost has always been an obstacle for people seeking care. The average cost of an abortion was $550 in 2017, and in states where abortion is not covered by Medicaid, the vast majority of patients pay out of pocket. Increased financial support post-Dobbs—particularly from abortion funds—was a critical source of funding for people in ban states and may have increased access for many people living in states without bans as well.
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- State policies improving protections and access to care. Twenty-two states and Washington, DC have “shield laws” that protect health care providers—and, in some instances, volunteers and patients—from legal or professional consequences enforced by states banning abortion.
