In 2024, more than 1 million abortions were provided across the United States, a slight increase from 2023. But marginally fewer traveled across state lines to access the procedure, a decrease of roughly 1% last year. A growing number of states have adopted restrictions on abortion, but experts say figures like these appear relatively stable.
That is according to a new report released this month by the Guttmacher Institute, a research group that studies reproductive health. Lead data scientist Isaac Maddow-Zimet spoke with reporter Jack Walker about the findings, and what they mean for states with near-total abortion bans like West Virginia.
This interview has been edited for length and clarity.
Walker: To begin, could you tell me about your organization and what this new study entailed?
Maddow-Zimet: Absolutely. So, the Guttmacher Institute has been tracking the number of abortions in the United States for over 50 years. Our first census of abortion providers was actually in 1974, just a year after the Roe v. Wade decision. In general, our statistics are considered the most comprehensive abortion statistics in the U.S. The monthly abortion provision study is a relatively newer effort, though it’s been going on now for two years, that really is aimed to provide data in close to real time on the number of abortions that are being provided in states without total bans, and also travel across state lines.
Walker: I know the information released so far is broad, but I was wondering if you could speak to general trends you’re seeing in states with near-total abortion bans, like West Virginia.
Maddow-Zimet: In 2023, we estimated that around 170,000 people traveled across state lines to access care. In 2024, that same number is 155,000. But even 155,000 is almost double the number of people who traveled in either 2019 or 2020. So, historically, it’s really a massive amount of people who are traveling across state lines to access abortion care.
That travel really only can often happen because of an enormous amount of support that people are getting — from abortion funds, from practical support organizations, from providers themselves — because there’s a lot of financial costs that are associated with that travel. There’s also logistical costs: finding childcare, finding accommodation, even just navigating the really complicated patchwork of laws that there are in the US about where to obtain abortion care. People often don’t even know what the legal status of abortion is in their state until they need an abortion, let alone the legal status in surrounding states. So broadly, what we’re seeing is that travel remains a major way that people are accessing care.
Walker: Speaking to last year’s report, I know a sizable number of West Virginia residents traveled to neighboring states like Maryland and Pennsylvania to receive abortions. So far, do figures for 2024 seem similar?
Maddow-Zimet: I mean, it’s certainly true that, [compared] to pre-Dobbs, many more West Virginia residents are traveling out of state. We know that that was true in 2023. It’s unlikely to have changed in 2024, because it really hasn’t gotten much easier to get an abortion in West Virginia.
Where people traveled to in 2023 was just really a handful of states, and they were really the states surrounding West Virginia, or the states without bans surrounding West Virginia. So people traveled to Virginia; they traveled to Maryland; they traveled to Pennsylvania; they traveled to Ohio. I’d expect that to be similar.
I think one of the things to kind of keep an eye on is the way in which some states are taking on more care as bans get passed. So certainly we know that when Florida’s ban went into effect, provision in Florida declined to a huge degree — 12,000 fewer abortions in 2024 than in 2023. And, at the same time, we saw increases in other states, most notably Virginia.
Walker: With the adoptions of bans in states like West Virginia and Florida, it seems like there’s been a lot more focus on online or remote abortion care — things like mifepristone, et cetera. Beyond traveling out of state, how are you seeing folks seeking abortions continue to access care?
Maddow-Zimet: We’re documenting in states without bans that there’s been a continued shift toward more provision from online-only clinics. That is a major mode of care that continues a shift that’s been happening for a long time, where people are increasingly opting to get care through telehealth. It’s still not the majority of the way that people get care, but it can be a really appealing option for folks who might not have otherwise been able to make it to a clinic, who prefer to have an abortion at home, or who maybe live in a rural area and might have trouble traveling to get to a clinic. So we’re seeing that certainly in states without bans.
We don’t publish data on telehealth into states with total bans. But other folks have — the WeCount project in particular has published data on this. We know that that has also become a major mode of access for people in states where abortion care is otherwise extremely restricted. So, what I’m talking about here are people accessing telehealth who are living in a state like West Virginia or Texas, where they are seeing a provider virtually or asynchronously who is living in a state with a shield law in place — so, a state like New York or Massachusetts or California — getting prescribed abortion medication, and then [receiving] that abortion medication via telehealth at their own home.
Walker: Did any other 2024 data stick out to you as particularly pertinent?
Maddow-Zimet: In general [what] we saw, in terms of the total number of abortions in states without total bans, was with stability. We saw a less than 1% increase from 2023 to 2024 that, of course, was masking a huge amount of change that was happening at the state level. You know, I’ve already highlighted Florida had a really big decrease, and Virginia had an increase. But there were other states that saw big changes, too. …
So what we’re seeing is a kind of stable pattern when we’re looking at the total numbers, but then a lot of change at the state level that often has to do with what is happening in terms of expanding clinic capacity at the state level, and what is happening in terms of policy bans going into effect.