Pro-life activists fear a recent report that mail-order pills flowing into abortion-restricting states have stymied their efforts to restrict the procedure.
The pro-choice Guttmacher Institute reported this month that 142,000 women left restrictive states to terminate pregnancies elsewhere in 2025, down from 154,000 in 2024. At the same time, telehealth abortions surged from mail-order pills crossing state lines.
In states banning nearly all abortions, 62,000 women went elsewhere to terminate their pregnancies last year, down 16% from 74,000 in 2024.
Over the same period, the number of telehealth abortions in those states jumped 26% from 72,000 to 91,000, according to medical providers Guttmacher surveyed.
“We found a significant shift in how and where people were obtaining abortion care,” Isaac Maddow-Zimet, Guttmacher’s data scientist and lead author of the report, said in an email this week.
Overall, Guttmacher found that reported abortions nationwide inched up from 1,124,000 to 1,126,000 over the period.
The report adds to a growing rift between the White House and pro-lifers over abortion pills, which have driven a nationwide increase in abortions since the Supreme Court let states shutter clinics in 2022.
Conservative lawmakers have urged the Trump administration to rescind a Biden administration policy that lets patients in abortion-restricting areas order mifepristone, a key abortion drug, after virtual appointments with doctors in other states.
The Food and Drug Administration has insisted that an ongoing safety review of mifepristone will take a year or more, fueling speculation that the White House sees it as a losing issue for Republicans in November’s midterm elections.
Reinforcing this perception, the Justice Department has asked federal courts to pause or dismiss lawsuits filed by Texas, Florida and Louisiana to prevent the sale of mail-order pills in their states.
The White House did not respond to a request for comment on the Guttmacher report.
Several pro-life advocates told The Washington Times that the Trump administration could immediately restore in-person dispensing requirements that the Biden administration waived for mifepristone.
“Under President Trump’s strong leadership, the FDA has a critical opportunity to repair this broken system created by ’Abortion President’ Joe Biden and reestablish appropriate medical standards for this dangerous drug,” said Rep. Christopher Smith, a New Jersey Republican and leading pro-life lawmaker.
Susan B. Anthony Pro-Life America, which has allocated $80 million to support pro-life Republicans in the midterms, estimated that 1 in 3 of the party’s most engaged base voters will likely sit it out if nothing changes with the pills.
“The mystery is why, more than a year in, the Trump-Vance administration lets the horrible Biden policy stand, even as hundreds of Republican elected officials seek help and answers,” said Marjorie Dannenfelser, the group’s president.
“The hands-off, ’states-only’ approach they promoted has not worked.”
President Trump has repeatedly touted his appointment of the Supreme Court justices who voted in Dobbs v. Jackson Women’s Health to return jurisdiction over abortion to the states. His administration has also trumpeted efforts to cut off federal funding for the procedure.
Researchers on both sides of the issue said the Guttmacher report confirms that these policies have failed to stop women from getting abortions, as pro-lifers hoped.
“It shows us that the Trump administration is allowing the national abortion industry to undercut the state laws that were made possible by Dobbs, rather than taking steps to protect life and women’s health and safety,” said Julie Scott Emmons, a North Carolina-based official with the Human Coalition, a national network of pro-life women’s health clinics.
Jessie Hill, a reproductive rights legal scholar at Case Western Reserve University in Cleveland, said the report illustrates how telehealth abortions have become a “highly effective” workaround for women in restrictive states.
“Criminalizing abortion does not mean that people stop needing or getting abortions,” Ms. Hill said.
State trends
Guttmacher counted 13 states that have restricted all abortions with limited exceptions for cases such as rape and incest: Alabama, Arkansas, Idaho, Indiana, Kentucky, Louisiana, Mississippi, North Dakota, Oklahoma, South Dakota, Tennessee, Texas and West Virginia.
An additional 28 states, including Florida, Iowa and Missouri, ban abortions at stages ranging from six weeks of pregnancy to the viability of the fetus.
Tricia Bruce, a Catholic sociologist affiliated with multiple institutions, said the report shows that abortions have become invisible in these states rather than disappearing.
“Abortion access looks less like driving to a clinic, as Americans have long imagined the event, protesters and all, and more like checking the mail or going to the pharmacy alone,” Ms. Bruce said.
At the same time, she pointed to a March 9 survey from the Pew Research Center that found 47% of adults nationwide described abortion as “morally wrong.”
An additional 31% of those surveyed insisted abortion is not a moral issue, and 21% described it as “morally acceptable.”
Abortion experts said the shift to a quieter and more privatized experience has made it harder for pro-lifers to protest mail-order pills in restrictive states.
“The pro-life movement is in crisis because of the Trump administration’s failure to contend with shield laws in pro-abortion states, and unborn babies are literally paying the price,” said Terrisa Bukovinac, founder of the Progressive Anti-Abortion Uprising.
Mary Ziegler, a leading historian of the legal abortion debate, said the number of telehealth abortions is likely even higher than what Guttmacher reported.
She pointed to years of incomplete abortion reporting by pro-choice jurisdictions that withhold their numbers from the Centers for Disease Control and Prevention.
“The abortions in question are legally questionable, so a lot of women and providers may not want anyone to know about them,” said Ms. Ziegler, a law professor at the University of California, Davis.
Despite last year’s decline in out-of-state abortions to 62,000 women, the Guttmacher report also noted that the number remained higher than the 19,000 to 25,000 it counted each year from 2013 to 2020.
The report found that two-thirds of all abortions reported in Kansas and New Mexico occurred among patients traveling from other states. One-fifth of all Virginia abortions arose from the same source.
Roughly 32,000 abortions were provided to out-of-state residents in Illinois, nearly a quarter of the 142,000 out-of-state abortions nationwide.
Mark Lee Dickson, director of Right to Life Across Texas, noted that dozens of cities and counties bordering other states have passed laws forbidding such travel in recent years.
“While the fight against abortion-inducing drugs is a fight we must fight, we must also fight against abortion trafficking across state lines just as hard,” Mr. Dickson said in an email.
Michael New, a social research professor at D.C.’s Catholic University of America and affiliated scholar at the pro-life Charlotte Lozier Institute, said abortions could continue trending up if the FDA fails to act.
“It seems likely that the Trump administration thinks limits on telehealth abortions will hurt the Republicans politically during the 2026 midterm election,” Mr. New said.
Correction: A previous version of this story mischaracterized some out-of-state abortion numbers.
• Sean Salai can be reached at ssalai@washingtontimes.com.
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