Fueled by pills, the rate of abortions nationwide keeps rising after Supreme Court’s Dobbs decision

The number of abortions reported nationwide has grown steadily since the Supreme Court returned jurisdiction of the procedure to the states, driven by a surge in mail-order pills.

The pro-choice Society of Family Planning estimates that the U.S. averaged nearly 99,000 abortions per month during the first half of 2025, up roughly 4% from 2024.

The society found that 73% occurred at clinics, compared with 27% through telehealth prescriptions. That’s up from less than 10% of pregnancy terminations occurring remotely in the first six months of 2023.

Nearly half of all prescriptions mailed from April 2022 to June 2025 were issued by doctors in states with “shield laws” supporting pill access to women in states that restricted abortions after the high court’s ruling in Dobbs vs. Jackson Women’s Health Organization in June 2022.

“Banning abortion does not stop people from doing it,” said Jessie Hill, a reproductive rights legal scholar at Case Western Reserve University. “A huge factor in the post-Dobbs period has been the availability of abortion pills online and the ability for providers operating under shield laws to discreetly mail them into states where abortion is banned.”

However, Ms. Hill noted that “it’s hard to know how real the increase has been” due to decades of incomplete reporting from states and clinics.

The Centers for Disease Control and Prevention, which relies on voluntary reporting from states, estimates that abortions dropped by 5% from 2013 to 2022. But key jurisdictions such as California, the nation’s largest abortion-providing state, do not report their numbers.

Chaos from a lengthy federal government shutdown and layoffs delayed the CDC from releasing its annual abortion surveillance report at the end of last year.

That report is now expected this spring. It will offer the first federal snapshot of abortions through 2023, the first full year after the high court’s 2022 ruling.

Meanwhile, the Society of Family Planning’s “We Count” project has surveyed abortion providers and health departments directly since April 2022.

Michael New, a professor of social research at the Catholic University of America who studies the topic, said its numbers confirm that mail-order abortions have offset declines in states that have restricted the procedure.

At the same time, he noted that three separate studies of Texas data found that 1,000 more babies have been born each month since the state became the first to restrict abortions in September 2021.

“Telehealth abortions have weakened many of the strong pro-life laws that were enacted in the aftermath of the Dobbs decision,” said Mr. New, an affiliated scholar at the pro-life Charlotte Lozier Institute. “That said, there is a solid body of research that shows state birth rates are increasing faster in states with strong pro-life laws.”

The Dobbs ruling overturned Roe v. Wade, a 1973 landmark case that legalized abortion nationally. Thousands of pro-life activists will mark Roe’s anniversary in the 53rd annual March for Life at the Supreme Court on Friday, Jan. 23.

Rep. Chris Smith, a New Jersey Republican who has attended every March for Life, pointed to reports that 200,000 fewer abortions have occurred in the 20 states that restricted the procedure at various stages of pregnancy after Dobbs. That includes Idaho, Indiana, Florida and Alabama.

“The existential threats to life and human dignity continue, however,” Mr. Smith said in a statement. “There is important work to be done in this new year, especially in exposing the risks posed to women and children by the chemical abortion drug mifepristone, which is used to procure at least six out of ten abortions in the United States.”

Bitter pill

Medication abortions, also known as chemical abortions, commonly involve a two-drug regimen of mifepristone and misoprostol. The pro-choice Guttmacher Institute estimates that the regimen was used in 63% of abortions reported in the U.S. in 2023, up from 53% in 2020 and 24% in 2011.

Since President Trump returned to office a year ago, pro-lifers have urged Food and Drug Commissioner Marty Makary to publish a review of the side effects of mifepristone and restrict it based on those findings.

In November, 175 Republican lawmakers signed a letter urging the FDA to reinstate in-person dispensing requirements for mifepristone, which the Biden administration lifted during the pandemic.

“The primary action needs to take place at the agency level,” Kristi Hamrick, a vice president at Students for Life of America, said in an email.

Meanwhile, attorneys general in states such as Texas, Florida and Louisiana have sued to stop the flow of mail-order pills into their states.

“Trump could take action, or the Supreme Court could declare the shield laws unconstitutional,” said Josh Blackman, a constitutional law professor at South Texas College of Law in Houston. “What I would say is that the doomsday predictions in Dobbs have not come to pass, largely because of the mailing of pills.”

Experts on both sides say the Trump administration is unlikely to act before November’s midterm elections. That makes the federal courts the best chance pro-lifers have to stifle the flow of prescriptions between states.

“I think President Trump thinks that pro-life policies are a political loser that will hurt Republicans in the midterm elections,” said Mr. New of Catholic University. “The best short-term strategy for pro-lifers is to support litigation against out-of-state medical professionals who are mailing chemical abortion drugs into pro-life states.”

Mary Ziegler, a leading historian of the legal abortion debate, said federal courts have become the wild card as the Trump administration “postpones having a policy” on mifepristone.

“There’s been a lot of ’let’s do lunch’ coming from the Trump administration,” said Ms. Ziegler, a law professor at the University of California, Davis. “They’re not saying they won’t do it; they’re just taking their time and avoiding unpopular policies that could hurt Republicans in 2026.”

In a statement emailed to The Washington Times, the White House insisted that the FDA’s forthcoming “gold standard science” review of mifepristone requires time to complete.

“The White House maintains the utmost confidence in Commissioner Makary, whose leadership at the FDA has delivered and continues to deliver one landmark victory for the American people after another, from cracking down on artificial ingredients in our food supply to conducting the first safety review of baby formula in decades,” said Kush Desai, a White House spokesman.

More abortions

Abortions started increasing nationwide long before the Dobbs decision.

Researchers say the best estimates come from Guttmacher, which has periodically surveyed all known abortion providers since the procedure became legal in 1973.

According to the group’s data, abortions jumped after the FDA expanded access to abortion pills in 2016 and after it stopped requiring in-person medical visits in 2021.

Guttmacher found that 807 clinics conducted 930,160 abortions in 2020, up 8% from 863,320 in 2017 and reversing 37 years of decline.

Leading the way, the study found clinics and doctors’ offices reported pill abortions jumped by 45% from 339,650 in 2017 to 492,210 in 2020.

Guttmacher counted 1,038,000 abortions in states “without total bans” in 2024, up less than 1% from 2023 and 12% from 2020.

Kelsey Pritchard, communications director at Susan B. Anthony Pro-Life America, said abortion foes will not rest until the Trump administration restricts mifepristone.

“There is no justification for Biden’s COVID-era abortion policy remaining in place today,” Ms. Pritchard said. “Our administration has everything they need to end [former President Joseph R.] Biden’s reckless rule immediately.”