Abortion Rates Rose in 2024 as Telehealth Expanded

Abortion Rates Rose in 2024 as Telehealth Expanded

Abortion provision in the United States increased in 2024, while telehealth became a larger part of how people accessed medication abortion. Data from the Society of Family Planning's #WeCount project estimated that about 1.14 million abortions were provided in the United States in 2024. The same report found that telehealth accounted for about one in four abortions by the end of the year.

The increase marked another significant change in abortion access following the 2022 Supreme Court decision in Dobbs v. Jackson Women's Health Organization, which overturned the federal constitutional right to abortion established under Roe v. Wade. Since then, access has increasingly varied by state, while telehealth and medication abortion have become important parts of the changing healthcare landscape.

What Happened to Abortion Access in 2024?

According to #WeCount, the number of abortions provided in the United States increased gradually during the period studied after Dobbs. The project estimated approximately 1.14 million abortions in 2024, compared with lower annual totals in 2022 and 2023. The monthly average increased from about 80,000 in 2022 to 88,000 in 2023 and 95,000 in 2024.

The 2022 figure should be interpreted carefully because #WeCount began collecting data in April of that year rather than January, and the first three months of 2022 were not included in its study period. The project also notes that its figures are an undercount because some abortions provided by hospitals and private-practice clinicians may not be reported.

The increase in abortion provision occurred alongside major changes in how abortion care was delivered.

Telehealth Became a Larger Part of Abortion Care

One of the clearest changes in the #WeCount data was the growth of telehealth.

Telehealth accounted for approximately 5% of abortions during April through June 2022. By December 2024, that share had reached 25%, meaning approximately one in four abortions was provided through telehealth at the end of the study period.

For medication abortion, telehealth can involve a healthcare professional evaluating a patient remotely and arranging for prescribed medication to be dispensed and shipped to the patient. The FDA currently states that mifepristone, when used with misoprostol, is approved for medical termination of an intrauterine pregnancy through 70 days of gestation, and that mifepristone may be dispensed by certified pharmacies by mail under the federal Risk Evaluation and Mitigation Strategy (REMS).

Importantly, telehealth did not replace in-person abortion care. #WeCount found that most abortions in the United States continued to be provided in person throughout 2024.

Abortion Pills by Mail and Shield Laws

The expansion of telehealth was particularly significant in states where abortion or telehealth access was restricted.

#WeCount began tracking abortions provided under shield laws in July 2023. These arrangements allowed participating providers in states with legal protections to provide medication abortion by telehealth to patients in states with telehealth restrictions or abortion bans. By December 2024, nearly 14,000 abortions in a single month were provided under shield-law arrangements. Across 2024, abortions provided under shield laws accounted for about 49% of all abortions provided via telehealth.

These developments show how abortion access changed after Dobbs. Instead of relying only on in-person care within their home states, some patients increasingly used telehealth services, traveled to other states, or received medication through providers operating under shield-law protections.

However, the data do not establish that increased access to abortion pills by mail was the sole or primary reason the overall number of abortions increased. The Society of Family Planning specifically notes that the drivers of the observed trends are unclear and that multiple changes in the abortion-care environment may have contributed.

What Changed After 2024?

The shift toward telehealth continued after the 2024 period covered by the #WeCount report.

Guttmacher's full-year 2025 estimates put clinician-provided abortions at approximately 1.126 million, compared with about 1.124 million in 2024 using Guttmacher's methodology. At the same time, telehealth provision continued to expand in states with total abortion bans. Guttmacher estimated that telehealth provision to residents of states with total bans increased from approximately 74,000 abortions in 2024 to 91,000 in 2025.

The shift was also reflected in how people in restrictive states accessed care. In 2025, an estimated 142,000 people living in states with total, six-week, or twelve-week abortion bans accessed abortion through telehealth, compared with 98,000 who traveled across state lines for care.

Texas provides one example of this change. More than 42,000 Texans accessed abortion through telehealth from shield-law providers in 2025, compared with about 12,400 in 2023. During the same period, the number of Texans traveling out of state for abortion care declined.

Mifepristone Access Remained a Major Legal Issue in 2026

Access to mifepristone through telehealth and by mail also remained the subject of federal litigation in 2026.

In May 2026, the U.S. Supreme Court allowed telehealth, mailing, and pharmacy dispensing of mifepristone to continue while litigation proceeded in lower courts. The decision followed a Fifth Circuit ruling that had threatened to reinstate the previous in-person dispensing requirement.

The FDA's current information states that certified pharmacies can dispense mifepristone by mail under the federal REMS and that the REMS does not itself require a patient to see a healthcare provider in person before receiving the medication. Clinical assessment and applicable state requirements still matter, and providers must follow the applicable federal and state rules.

A New Legal Challenge Emerged in September 2026

The legal debate over abortion pills by mail has continued into the fall of 2026.

On September 30, Alabama, Arkansas, and Louisiana filed a lawsuit in the U.S. Supreme Court challenging abortion shield laws in California, Massachusetts, and New York. The states argue that those laws interfere with their ability to enforce their own abortion restrictions against providers who prescribe and send abortion medication across state lines.

The lawsuit represents a new stage in the legal conflict over interstate telehealth abortion care. The case challenges the relationship between states that protect providers who offer abortion care remotely and states that restrict or prohibit abortion within their borders.

At this stage, the lawsuit is a legal challenge—not a final Supreme Court ruling invalidating the shield laws. The outcome could have implications for the future of interstate telehealth abortion care and the ability of providers to mail abortion medication to patients in states with restrictive laws.

What the 2024 Abortion Data Mean Today

The 2024 data marked an important point in the evolution of abortion access in the United States. Abortion provision increased, while telehealth became a substantially larger part of medication abortion care. The trend continued into 2025, particularly for people living in states with strict abortion restrictions.

The developments of 2026 show that the issue remains unsettled. Federal rules currently permit certified providers and pharmacies to use mail dispensing for mifepristone under the applicable REMS, while state restrictions, shield laws, and ongoing litigation continue to shape how telehealth abortion care operates across state lines.

The 2024 increase therefore should be understood as part of a broader change in abortion care rather than as evidence that one method of access caused the overall rise. Telehealth, medication abortion, interstate travel, state abortion laws, and shield-law protections have all contributed to a rapidly changing access landscape since Dobbs.

Sources

• Society of Family Planning — #WeCount Report, April 2022–December 2024
• U.S. Food and Drug Administration — Information About Mifepristone
• U.S. Food and Drug Administration — Questions and Answers on Mifepristone