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US abortion rates rise post-Roe amid deep divide in state-by-state access

Map of the US with colored spikes on top of each state representing the change in number of abortions for each state.

The average number of abortions performed each month in the US rose in the year after the supreme court overturned Roe v Wade and allowed more than a dozen states to ban the procedure, according to data released on Tuesday from a research group backed by the Society of Family Planning.

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This stunning finding masks a deep divide in abortion access in the US. The number of abortions performed in states with near-total or six-week abortion bans plummeted, with providers in those states performing 114,590 fewer abortions than they would have if Roe had not been overturned, according to data collected by the research group, WeCount.

At the same time, abortions rose dramatically in the states that still permit the procedure. In total, those states performed 116,790 more abortions than expected.

“From a national picture, it could look like a kind of calm increase over time,” said Dr Alison Norris, a co-chair of WeCount and an associate professor at the Ohio State University’s College of Public Health. “And what actually is happening is a complete disruption in the healthcare system and in people’s lives.”

It is unclear how long these abortion clinics, now overwhelmed with patients, will be able to keep up with the wild increase in demand for the procedure. Norris warned: “The increased access that the clinics have created by extending hours and hiring more staff, in some cases, is not sustainable.”

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WeCount’s data includes all abortions provided by clinicians, including pill-induced abortions performed through telehealth. Those kinds of abortions are increasingly common: before Dobbs v Jackson Women’s Health Organization, the case that overturned Roe, they accounted for just under 5% of all abortions; in the year after Dobbs, they made up more than 8% of all abortions.

Two stacked bar charts showing the difference in states’ abortion counts from before Roe fell by their legal status.

This rise in telehealth services may partially explain why the number of abortions performed each month spiked after Roe’s downfall, the WeCount researchers hypothesized. The increase may also be due to blue states’ expanded efforts to protect abortion access as well as to the post-Roe outpouring of donations for abortion funds, which help people travel for abortions.

The WeCount report does not include any so-called “self-managed” abortions, which take place outside of the US healthcare system and are exceedingly difficult to track.

States such as Illinois, Florida, North Carolina, California and New Mexico all saw the greatest increase in post-Roe abortions, WeCount found. Most of those states border states with abortion bans, indicating that when abortion is outlawed, would-be patients try to head to the closest state that still permits the procedure.

While the WeCount group is continuing to collect data, its latest report ends in June 2023. Since then, North Carolina outlawed abortion past 12 weeks of pregnancy – a move that led abortions to fall by 31% in the region, according to data from the Guttmacher Institute, which tracks abortion restrictions.

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Florida is also on the verge of potentially banning abortion. The state’s supreme court is now weighing a case that would allow a six-week abortion ban to take effect in the state.

“My real fear, as a public health scientist, is that people will begin to feel complacent about the situation,” Norris said. “It becomes possible to forget about the folks who need abortion – especially possible for those people who have the privilege to have access to abortion. It’s easy to forget about those who don’t.”