Abortion Numbers Climb Four Years After Roe Was Overturned

More than four years after the Supreme Court dismantled Roe v. Wade, the American abortion rate is doing something almost no one on either side of the debate predicted: it is rising.Since the 2022 landmark decision in Dobbs v. Jackson Women’s Health Organization, 13 states now enforce total abortion bans. Six more restrict the procedure to six or 12 weeks. Yet, new estimates released this spring by the abortion-rights group Guttmacher Institute show an estimated 1,126,000 abortions were provided by clinicians in the United States in 2025, largely unchanged from the 1,124,000 provided the year before — the highest total since 2009.The Society of Family Planning tallies it differently. Its #WeCount project, which tracks both procedures and pills, counted 1.13 million abortions in 2025, a figure that has been climbing steadily, from 1.05 million in 2023 to 1.11 million the following year. Nonetheless, the numbers are climbing.The reason, according to a historian tracking the abortion debate and legal fallout of Dobbs, comes down to a shift in how the fight itself is being fought.“The right to abortion hasn’t increased, but actual abortions have, which is a strange place for the U.S. to be, where more people are having abortions, but no one has a legal right to,” a professor at University of California-Davis School of Law, Mary Ziegler, tells The New York Sun.The Pill Pipeline That Won’t StopBans have not stopped abortion — they have rerouted it, largely into the mail. The engine behind the rise is abortion medication prescribed by a doctor in a state the patient has never set foot in.Guttmacher’s 2025 data, for the first time, folded in estimates of telehealth prescriptions sent into states with total bans.The new numbers show: 91,000 abortions were provided last year via telehealth to patients in states with bans, up from 74,000 in 2024. Out-of-state travel, by contrast, is edging down, from 154,000 trips in 2024 to 142,000 in 2025, largely because residents of states with bans no longer need to cross lines for care.“The bans created the demand for workarounds, and the infrastructure to meet that demand scaled faster than the legal barriers,” explains a professor at the University of Texas School of Law, Rachel Rebouché.Networks like Aid Access and Plan C expanded significantly after Dobbs, Ms. Rebouché notes, and telehealth shield clinics in states such as New York, Massachusetts, and Colorado can now prescribe and ship across state lines.“The bans didn’t eliminate abortion, they rerouted” them, Ms. Rebouché tells the sun.Ms. Rebouché adds that the legal architecture protecting those clinics has held up so far mainly because enforcement requires interstate cooperation that states with bans have not been able to compel. No federal extradition or licensing mechanism forces a New York provider to answer to Texas law. The shields are being stress-tested under the Constitution’s Full Faith and Credit Clause, though none of those challenges have succeeded yet in court.The attempt to stop mailed pills sits beneath renewed calls to revive the Comstock Act. The 1873 vice law would make shipping or receiving anything related to procuring an abortion a federal crime. Policing the domestic mail at that scale, Ms. Rebouché notes, remains difficult, costly, and likely to provoke backlash.More than 15,000 abortion pill packets are mailed every month by providers in states with shield laws, most head to states with bans. That volume, defenders of the current system argue, is itself the clearest evidence the workaround economy has outpaced the legal one.“Because providers have been creative, resilient, and nimble, and patients have proven what history and international experience has shown us repeatedly, that when people are pregnant and don’t want to be, they find ways not to be,” a professor at Drexel University’s Kline School of Law, David Cohen, co-author of “After Dobbs: How the Supreme Court Ended Roe but Not Abortion,” tells the Sun.Mr. Cohen is skeptical that state crackdowns can still change that trajectory, pointing to a small number of legal challenges against individual providers that so far “have gone nowhere.”Abortion opponents, however, describe the same numbers as evidence of a system operating outside meaningful oversight.“Abortion pills make it easier than ever for activists to kill babies in the womb,” the director of media and communication at Texas Right to Life, Kimberlyn Schwartz, tells the Sun, tracing the increase to the Food and Drug Administration’s 2021 decision allowing the pills to be mailed. Ms. Schwartz notes that President Trump could reverse that policy.Ms. Schwartz says federal lawmakers have other options short of that, including treating abortion pill websites the way the government treats sites that sell illegal drugs, expanding attorney general enforcement powers, and stripping tax incentives from businesses that fund abortion travel or paid time off for the procedure.A recent report by the Restoration of America Foundation found that shield laws have enabled the shipping of more than 330,000 abortion drugs into states with bans since mid-2023. The president of Susan B. Anthony Pro-Life America, Marjorie Dannenfelser, argues that the uptick is part of a deliberate strategy in states with shield laws, notably that no in-person medical evaluation is required and anyone can buy them.Ms. Dannenfelser points to the case of Rosalie Markezich, who sued the FDA over the removal of in-person safeguards after she says a former boyfriend ordered pills online from California and coerced her into taking them. Ms Dannenfelser tells the Sun that her organization has urged the Trump administration to settle that case and pull abortion drugs from the mail while the litigation now before the Supreme Court on an emergency stay request plays out.States Sue and Mostly LoseAttorney General Ken Paxton of Texas has led the most aggressive legal campaign against out-of-state prescribers. So far, the results have not gone his way. He sued a New York physician in December 2024 for mailing pills to a woman near Dallas and won a default judgment exceeding $100,000.The clerk of Ulster County, New York, Taylor Bruck said no. Citing New York’s shield law, he refused to file the judgment against Dr. Carpenter, and Governor Kathy Hochul backed him, turning down a separate extradition request sent over by Louisiana to the same doctor. Mr. Paxton responded by suing Mr. Bruck personally. A judge threw that case out in October 2025.Mr. Paxton’s office then moved on to new targets: a Delaware nurse practitioner in January, then a California physician connected to Aid Access, the telemedicine group whose founder is a Dutch physician.Texas lawmakers have also tried a new legal weapon. A statute nicknamed the Woman and Child Protection Act took effect in early December, letting private citizens sue anyone involved in mailing abortion pills into the state, with damages starting at $100,000.“The Woman and Child Protection Act is the strongest measure passed so far,” Ms. Schwartz says. “The law took effect last December, but it has not been tested yet in court, so its impact is yet to be seen.”The organization defending the first physician sued under the new law perceives it differently. “This law enables people to sue anyone who manufactures, distributes, mails or provides medication abortion into Texas for at least $100,000,” the interim litigation director at the Center for Reproductive Rights, Autumn Katz, tells the Sun. “It goes against everything Texans value. It’s anti-freedom, anti-privacy, anti-family.”Ms. Katz points out that the one person who has filed suit under the statute so far has a documented history of domestic violence, and notes a related fight is heading to the full Fifth Circuit, which is set to rehear arguments next month in Louisiana v. FDA over whether to reinstate older restrictions on how patients access mifepristone, even in states with shield laws.So far, eight states with shield laws extend protections to doctors treating patients across state lines, insulating prescribers from the civil judgments piling up against them elsewhere.A professor at the University of Pittsburgh School of Law, Greer Donley, credits that legal architecture with keeping providers in business.“Yes, they are currently working,” Ms. Donley tells the Sun. “That doesn’t mean they will work forever, but they have held up well for years now.”Ms. Donley says the country has learned the same lesson twice: bans didn’t stop abortion before Roe, and they won’t work after Dobbs.Texas isn’t fighting this battle alone. Louisiana passed its own law in 2025, dubbed by sponsors the “Justice for Victims of Abortion Drug Dealers Act,” letting a woman who had an abortion sue any out-of-state provider she says helped arrange it. South Carolina went further still. Lawmakers there introduced a bill in January that would treat abortion as homicide under the law — not just for providers, but for the patients themselves.Missouri offers a case study in just how messy this fight has gotten within a single state’s borders. Voters enshrined abortion rights in the state constitution back in 2024. Then, in June 2026, a Jackson County judge handed down a permanent injunction against most of the restrictions still standing in its way. The fight, however, isn’t over. Voters will decide in November whether to repeal that amendment entirely.Mr. Cohen says the entire enforcement effort is a losing bet against a determined workaround economy. “No matter what states do, there will be counter moves, and those will be successful,” he says. “Just think about the war on illegal drugs. It hasn’t stopped drugs in any meaningful way. The same will be true for abortion pills. They’re unstoppable.”What’s at stake, for now, is a fight both sides are waging in courtrooms from Austin to Albany, with no resolution in sight for either side.“The bottom line is people will always need abortions,” Ms. Katz adds. “Bans won’t stop people from seeking abortion care.”

Abortion Numbers Climb Four Years After Roe Was Overturned

Abortion Numbers Climb Four Years After Roe Was Overturned

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