Abortions rise 10% as telehealth access expands

The number of abortions in the U.S. has risen for the first time in nearly a decade, climbing 10% between 2020 and 2023 despite a wave of state-level abortion bans and restrictions passed since the Supreme Court overturned Roe v. Wade.

The increase is driven partly by better reporting as telehealth providers expand access to abortion pills, which now account for more than 60% of all procedures. But a surprising factor is a drop in the use of birth control, particularly among younger women. A Guttmacher Institute report found that 44% of women aged 18 to 25 reported not using contraception in 2023, up from 33% in 2020. Experts attribute this to pandemic disruptions, rising costs, and shifting attitudes toward long-term birth control like IUDs or implants—choices that became harder to access during clinic closures and supply chain delays.

The trend is most visible in states with strict bans, like Texas and Alabama, where abortion rates climbed even as total pregnancies declined. That suggests more people are turning to abortion after unplanned pregnancies rather than preventing them. Clinics in states like Illinois and New York, which have become abortion havens, report longer wait times and higher demand for medication abortions, which can now be prescribed via mail-order pharmacies in some cases. But access remains uneven. Low-income women, particularly in rural areas, still face barriers like travel costs and lack of providers.

What happens next depends on policy and funding. If birth control access improves—through expanded insurance coverage or subsidized options—unplanned pregnancies could drop again. But if state bans continue to push care into a patchwork of telehealth and underground networks, the abortion rate may keep rising. The Supreme Court will soon rule on a case that could further restrict mifepristone, the key abortion pill, which could tighten access even in states where abortion is legal. The stakes are high: a 2024 study from the Society of Family Planning estimates that without abortion pills, the national abortion rate could fall back to pre-2020 levels—but only if all other methods fail.