Abortions continue to rise across the US due to better access to care via telehealth, even as states push new restrictions and total abortion bans in the wake of the supreme court decision overturning Roe v Wade, according to a new #WeCount report from the Society of Family Planning published on Wednesday.
Still, despite the increase in access for some patients, there are significant challenges for others who need reproductive healthcare.
There were more than 100,000 abortions in the US in January 2024, the highest monthly rate since the study began in April 2022. In the first three months of 2024, there was an average of 98,990 abortions a month.
“Increased access has addressed a lot of the pre-existing unmet need for abortion that was already there,” said Ushma Upadhyay, professor at University of California, San Francisco, and co-chair of #WeCount, a research project collecting monthly abortion volume data by state.
Reports like these were “critical, because if we don’t know how many abortions are occurring, then we are subject to misinformation”, said Amanda Jean Stevenson, assistant professor of sociology at University of Colorado Boulder, who is not affiliated with the study.
After the Dobbs decision, states radically reshaped reproductive healthcare access, with 14 states instituting total bans and many others setting extreme limitations. Only nine states and the District of Columbia have no gestational bans on abortion.
Providers and policymakers in states where the procedure is legal responded to the crackdown on access by expanding telehealth, where patients can be seen remotely by physicians who can prescribe abortion medications.
Before the decision in Dobbs v Jackson Women’s Health Organization, about 5% of abortions happened through telehealth. Now, it accounts for 20% of all abortions in the US.
Dobbs pushed abortion providers to be creative in offering care, Upadhyay said, and telehealth is also cheaper, especially given the costs associated with traveling for in-person abortion care – transportation, lodgings, childcare, time off work, and more.
Providers also feel a “moral imperative” to reach those people living under abortion bans who have no other choice, Upadhyay said.
Some states and districts have also passed laws to protect the rights of patients and providers – including shield laws, which protect clinicians offering telehealth care to people in other states.
More than 65,000 people living in states with abortion bans were able to access medication through telehealth visits between July 2023 and March 2024 because of shield laws.
Florida, which is geographically close to several states with restrictions, was one of five states with the most abortions each month from January to March this year. But the state enacted its own six-week ban on 1 May.
Researchers expect to see a decline in in-person abortions in Florida, but there will probably be an increase in telehealth abortions because of the new restrictions.
Notably, not all patients are comfortable with or able to use telehealth, and abortion restrictions are still impeding patients’ ability to access reproductive healthcare, Upadhyay said.
“We believe there’s still many people living in these states with abortion bans who are not getting the abortions that they desire because of all of the barriers,” she said.
Stevenson also pointed out: “Just because abortion is increasing doesn’t mean there aren’t still people who can’t get abortions who want them.”
