As originally published in the Thursday, October 25,2023 Wall Street Journal print edition as ‘Procedures on the Rise Since Court Voided Roe v. Wade’
More than a year after the Supreme Court overturned Roe v. Wade, one thing seems clear: New state bans have done little so far to deter women from obtaining abortions.
Data released Tuesday shows the number of abortions ticked up slightly in the year following the high court’s Dobbs v. Jackson Women’s Health Organization decision. That ruling, from June 2022, ended federal protections for the procedure, and paved the way for some 16 states to ban many or most abortions.
The data indicate that abortion providers, funders and others have adapted quickly to a legal landscape that has changed profoundly. Access has been cut off throughout much of the South, and demand has surged in states in which abortion is still legal. Many providers there have had to significantly increase capacity.
The findings also underscore the challenges facing antiabortion groups, as the ease of traveling to another state or obtaining abortion pills online seem to be largely undercutting laws intended to reduce abortions.
In the new study, WeCount, an abortion-data project sponsored by the Society of Family Planning, which supports abortion rights, found that nationwide there were 183 more monthly abortions on average in the 12-month period following the Dobbs decision compared with the monthly average prior to the decision. That trend mirrors similar findings by the Guttmacher Institute, a research group that also supports abortion rights, which showed the number of abortions rising in most states in the first half of this year compared with 2020, the most recent year for which data are available.
“I have been surprised to see the evidence that is mounting that abortions have had a slight increase,” said Caitlin Myers, an economics professor at Middlebury College who has studied abortion data.
While it has become much harder since the end of Roe to obtain an abortion in states with newly enacted bans, it actually appears to have become easier in many other states, thanks to increased attention and resources. Abortion funds, nonprofits that help finance abortions and logistics associated with them, have raised millions to help lower-income women pay for procedures and travel, while new clinics have opened in states such as Illinois and New Mexico that have become major destinations for women traveling from other states.
Nearly 115,000 fewer abortions were performed in the year after the Dobbs decision in states that banned abortions throughout pregnancy or after six weeks, according to the WeCount data. At the same time, states including Illinois, Florida and North Carolina—where the procedure remained largely legal —saw an increase of 117,000 abortions.
The data don’t include women who order pills online from overseas outside of the formal medical system, a practice that appears to have become more common.
Efforts focused on helping women travel seem to have also made it easier for some in-state residents to obtain abortions. For example, providing more telehealth appointments to accommodate increased demand can also make appointments more accessible for women in rural areas. In California, Planned Parenthood of Orange & San Bernardino Counties doubled the number of open appointments available for medication abortion at its nine locations in spring 2022 in anticipation of the high court’s decision, said Krista Hollinger, the Planned Parenthood branch’s chief operating officer.
Those centers have seen an increase in out-of-state patients, but more Californians are getting abortions as well. Planned Parenthood of Orange & San Bernardino Counties saw a 20% increase in its total abortion patient volume since June 2022, while only about a fifth of that increase came from out-of-state patients.
Abortion providers say that while the number of abortions may not have significantly declined, laws have nonetheless created obstacles. For instance, women forced to travel out-of-state for an abortion may have to take time off work and involve friends and family members in a private medical decision because they need help traveling or with child care. Bans are also pushing some abortions further back into pregnancy, when they become more complicated and expensive.
For antiabortion advocates, the policy options available to combat the ease of traveling and obtaining pills online present major challenges. Any efforts to prevent women from traveling out of state for abortions could run up against constitutional challenges. Restricting the use of abortion pills ordered online from overseas or out-of-state actors is difficult without punishing the women who take them—long something antiabortion groups have pledged to avoid.
Abortion opponents are fighting hard to garner support from Republican presidential candidates for a national abortion limit, but such a proposal has little hope of making it through the current Congress.
“We’re now forced to think about this as a national problem,” said Katie Daniel, state policy director for Susan B. Anthony Pro-Life America, an antiabortion group.
Daniel said the antiabortion movement could end up back in federal court challenging shield laws enacted in a number of blue states designed to provide legal protection for doctors who prescribe pills to women in states with bans.
While few states appear likely to pass new abortion bans in the coming months, the landscape of abortion access remains unsettled. In Florida, which has seen one of the largest upticks in abortions since the Dobbs decision, the state’s highest court is expected to release a decision soon that could allow a six-week ban to go into effect.
In the first month since North Carolina passed a 12-week limit, the number of abortions in the state declined by nearly one-third from the prior month, according to Guttmacher. The law increased requirements for in-person medical visits, which providers say has virtually eliminated visits from out-of-state patients.
A challenge to approval for a widely used abortion pill appears headed to the U.S. Supreme Court and could potentially upend access across the country in the next year if it succeeds.
Abortion-rights groups also acknowledge that they face internal risks, including staff burnout at clinics that remain open and a decrease in fundraising firepower if public attention fades.
The Chicago Abortion Fund has quadrupled its staff and tripled its budget since 2021. The fund has provided about $4.5 million to thousands of patients to assist with plane, train and bus tickets; hotel stays; child care; and other costs since Roe was struck down.
“This is not a long-term solution,” said Megan Jefyio, executive director of the Chicago Abortion Fund. “We are dealing with competing crises in this country and I don’t know how long we’re going to have this sustained support.”