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Are abortion numbers rising in the US?
00:08:58
Looking at the data behind abortion in a post Dobbs America.
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Hello and thank you for downloading the More Or Less podcast. We're the programme that looks at the numbers in the news and in life. And I'm Lizzie McNeill. Good evening. In a landmark ruling, the Supreme Court today legalized abortions. The United States. 1973, two women successfully took on laws that criminalized abortion.
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In effect, the Court makes abortion subject
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only to the decision of the pregnant woman's doctor.
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The subsequent law, case and ruling, Roe v. Wade, enshrined in the American Constitution a woman's legal right to access abortion. But then, Almost 50 years later, the Supreme Court passed the Dobbs decision, overruling Roe v. Wade. The right was no longer protected. Currently, 12 states ban abortion under almost any circumstances, and four states have highly prohibitive rules. People administering or receiving abortions in these states face heavy penalties. So in big areas of the usa, abortion is now banned, which you would imagine would lead to a big drop in the number of abortions. But actually the number of abortions carried out in the US has increased. So what is going on? One confused listener, Ben Crichton, asked us to look into the data behind the headlines.
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After Roe vs Wade in the early 70s, unsurprisingly, the number of abortions went up in the US. My name is Isaac Matto Zimit and I'm a data scientist at the Guttmacher Institute.
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The Guttmacher Institute is a research and policy organization whose aim is the advancement of sexual and reproductive health and rights worldwide. That is to say, yes, they are partisan, but they currently have much more reliable data than the government. More on that in a bit. After Roe vs Wade, the rate of abort was not linear.
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It peaked in the late 80s or early 90s, and then for almost 30 years, it was declining pretty steadily, with potentially a little bit of an uptick. Right before the Dobbs decision in the
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1980s, the number of abortions in the US was between 1.2 and 1.5 million. Depending on whose data you look at, that's a rate of around 28 per thousand. In the 2010s, this declined to a rate of 14 per thousand. And you'd think that this decline would have accelerated after abortion was banned in 12 states. But that is not what happened.
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In 2024, we estimate that there were around 1,049,000 abortions in states without total bans. Just to put this in a historical context, it's actually the first time since 2012 that there were even over a million abortions counted in the us. That's surprising in the context of the Dobbs decision. And it's also kind of a notable increase, even just historically.
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It does seem counterintuitive that the number of abortions has risen. Even the experts were baffled.
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We were very surprised once we started to see the results. I am Dr. Ushma Upadhyay. I am a professor and a public health scientist based at University of California, San Francisco, and I'm also co chair of We Count, which is a national effort to monitor the number of abortions by state in the US We Count,
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which by the way, is pro abortion rights, looks at the amount of abortions per month, and they've seen a 14% rise in monthly abortions from 84,000 to 96,000. Unsurprisingly, the vast majority of these abortions happen in states where it is still legal to have abortions. But what about the states we can't count? Well, to figure these out, we need to look at two different things. Telehealth abortions and people who travel out of state. Let's start with telehealth.
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Telehealth abortions is a way that people can access medication abortion by reaching out to a provider online, having a consultation through a video call or through secure messaging, and then if the patient qualifies, they can be sent medication abortion pills in the mail. This started during the COVID pandemic, and we think that this has really contributed to the slow increase over time.
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So what does the data tell us about how telehealth is affecting the numbers both in states where abortion is banned and the states where it's legal?
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In states where abortion is completely banned, There are about 6,000 telehealth abortions per month. There's three states with six week abortion bans. There are about 2,000 telehealth abortions in states where abortion is permitted, but telehealth is banned, there's about 1600. And then in the remaining states where abortion is broadly legal, there are about 10,000 monthly abortions. When we first began collecting data in the summer of 2022, 4% of all abortions were telehealth, and now it is up to 25%. We're finding that it has really removed barriers, including costs, travel distance, privacy reasons.
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Telehealth means that health care providers working in states where abortion is legal can prescribe pills to people in states where abortions are banned. And they do this by utilizing shield laws. These are the laws that protect those providers from being prosecuted by states where abortion is illegal. And we count estimates that 12,330 abortions per month are administered using shield laws. Now, the government does not currently count these numbers. In fact, the most recent edition of the abortion surveillance report was published by the CDC in 2022. Since then, nothing. Now, this means that some states are claiming some really unrealistic numbers. For example, officials in Arkansas claimed that the number of abortions recorded by their public health service was zero. It's probably true that they recorded zero. I mean, you can't record something if you're not counting it. But it doesn't really tell us much about how many people are getting abortions in the places where it's banned.
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We know that people in Arkansas are getting access via telehealth to medication, abortion. The other thing that's always really important to keep in mind when you're looking at reports from Department of Health in states is they're counting or they're attempting to count abortions that are occurring in that state. And even pre Dobbs, we know that enormous amount of people living in states, particularly with a lot of restrictions, were traveling out of state for care, and those aren't captured in those reporting systems.
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The data shows that people are increasingly crossing state lines to access abortions. Around 170,000 people per year make this journey.
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Many states that border ban states have seen really big increases in the number of abortions occurring in those states. So Illinois, for example, saw a 72% increase in the number of abortions that were provided in Illinois. A big piece of that is a big increase in travel from out of state. In 2020, around 21% of patients in Illinois were traveling from out of state. And in 2023, around 41% were.
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But the rise in numbers in the states that do not have abortion bans is not just to do with people from out of state coming in.
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We also see an increase in the number of abortions among residents of Illinois. And that's something that we're seeing in a lot of states without total bans. And we think that in a large part, that reflects the ways in which abortion access has been really difficult even prior to Dobbs. And a lot of the things that states have done to try to increase access to care and better support people traveling from out of state have also tremendously increased access to care for residents of their own states.
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The rise in the number of abortions might make people think that the banning of abortion has backfired and that the campaign is fighting against abortion bans have won.
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My biggest fear is that people will look at these numbers and think, oh, there isn't really a problem. People in banned states must be getting their abortions. There are still many people living in states with abortion bans that are still not able to get abortions even though on a national level the numbers are
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increasing thanks to Ujma Abdai and to Isaac Mado Zimit. And that is all we have time for this week. If you spot any interesting numbers in the news, please let us know at More or less at BBC Co uk. Until next week. Goodbye.