The landscape of abortion access in the United States has undergone significant changes since the Supreme Court overturned Roe v. Wade in June 2022. While numerous Republican-controlled states have implemented bans or stringent restrictions, data indicates that the overall number of abortions has slightly increased nationwide. This shift highlights the evolving strategies individuals are using to access care, including travel and the use of abortion pills.
The overturning of Roe v. Wade led to a dramatic change in how and where abortions are obtained. Although the number of abortions in states with bans has sharply declined, the national monthly average has slightly increased compared to pre-Dobbs levels. This is largely due to women seeking care in states where abortion remains legal, illustrating a redistribution of abortion services rather than an overall reduction in need.
Concurrently, the use of abortion pills, often involving a combination of two drugs, has become more prevalent. Before the Dobbs decision, pills accounted for about half of all abortions, a figure that has now climbed to approximately two-thirds. Telehealth prescriptions for abortion pills have also risen, providing an additional avenue for access, especially for individuals in states with bans. This increased reliance on medication abortion has, in turn, led to new legal challenges. Several states are attempting to restrict access to abortion pills by challenging their federal approval and invoking older federal laws to ban mailing them.
In response to state-level restrictions, travel for abortion services has surged. Clinics in states with bans have closed or halted services, resulting in women crossing state lines to access care in more permissive areas. Data reveals that individuals from restrictive states, such as Texas, now constitute a substantial proportion of patients in clinics in states such as New Mexico and Kansas. While abortion funds have provided financial support, they are also facing capacity limitations, highlighting the challenges in navigating this new reality.
The legal and political battles surrounding abortion continue to reshape the landscape. The implementation of a six-week ban in Florida has transformed the state from a regional refuge to a source of residents seeking out-of-state care. In contrast, some states with more permissive laws, such as Illinois, Kansas and New Mexico, have seen an expansion of clinic services. Notably, while the number of publicly identifiable abortion providers has remained relatively stable, some hospitals are now including abortion services in their advertised offerings.
Access to timely abortion care is particularly critical in emergency situations where a patient's life or health is in danger. Federal guidelines mandate that hospitals provide necessary abortions even in states with bans. Despite these guidelines, numerous women experiencing pregnancy complications have been denied care, underscoring the need for continued oversight.
Finally, public opinion on abortion access remains largely supportive, particularly in ballot initiatives. Since the overturning of Roe v. Wade, abortion rights advocates have succeeded in 14 of 18 statewide ballot measures. This indicates a strong voter preference for abortion access, even as political parties continue to debate its legality. The issue of abortion is expected to remain a significant factor in future elections and legal proceedings.
