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US ABORTION RATE HOLDS STEADY LARGELY DUE TO TRAVEL AND TELEHEALTH
AVAILABILITY – REPORT  
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Melody Schreiber
March 29, 2026
The Guardian
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_ Shift seen away from from traveling to states with legal abortion
in favor of telehealth and mail-order pills _

A physician prepares boxes of abortion pills to be sent patients from
a Massachusetts clinic on 1 April 2025. , Sophie Park

 

The abortion [[link removed]] rate is
holding steady in the US despite total and partial bans in some states
– largely because of travel across state lines and a significant
increase in telehealth
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appointments, a new report says.

US regulatory officials are weighing changes to the ways mifepristone,
an abortion medication, may be dispensed, but they have reportedly
pushed their review until after the midterm elections, given the
widespread support
[[link removed]]
for abortion across the US.

The number of abortions in the US increased slightly last year, from
1.124m to 1.126m, according to a Guttmacher Institute report
[[link removed]].
There’s also a shift away from traveling and toward telehealth, in
which providers may prescribe mail-order pills.

One major change in this report is the provision of telehealth for
patients in states with total bans – with clinicians in states such
as New York or Massachusetts, which have shield laws to protect
providers, seeing and prescribing remotely to patients living in
states such as Texas or Alabama.

Shield laws have been “extremely important” for protecting
providers and increasing access, said Joanne Rosen, a professor at the
Johns Hopkins School of Public Health
[[link removed]] and co-director of its
Center for Law and the Public’s Health.

“Essentially, these shield laws allow people to get around the
effect of their own state’s abortion ban,” Rosen said. It makes
medication abortion more affordable and accessible while giving
providers legal coverage.

Nationally, 142,000 people traveled across state lines for abortion
care in 2025 – a decline from 154,000 in 2024 and from 170,000 in
2023. Nearly half of the people traveling for abortions were residents
of states with total bans.

The drop is almost entirely among residents of states with total bans,
where 12,000 fewer people traveled for abortion last year compared
with 2024.

But the total number of people who traveled for abortions from states
with bans last year, 62,000, was still more than double the number of
people who traveled from those states before the Dobbs decision.
Another 47,000 people in 2025 traveled from states with six- or
12-week bans.

The estimates for 2025 come from clinician data, and do not include
fully self-managed abortions, which means the true number is likely
higher.

Telehealth visits are also seeing major increases in states with bans.
That makes sense because people who access telehealth no longer need
to travel for care, said Isaac Maddow-Zimet, a data scientist at the
Guttmacher Institute and co-author of the report. “So it’s not
surprising, but it is the first time that we’ve been able to put out
specific numbers showing this shift almost in real time.”

There are two trends emerging at once, Maddow-Zimet said. It has
become more difficult to travel – more expensive to drive or fly and
to procure childcare; and with partial or total bans enacted across
swaths of the country, patients frequently have to travel longer
distances to access care.

“People, of course, are traveling much farther than they have ever
in the past,” Maddow-Zimet said. “They need to travel hundreds of
miles and across many state lines.”

At the same time, telehealth is becoming more broadly available, and
it’s often much cheaper.

“As long as abortion is banned or restricted in many states, there
are always going to be people who need or prefer to travel for
in-person care – for example, people later in pregnancy, or those
who need or prefer procedural care,” Maddow-Zimet said. “But for
those who can access or prefer telehealth care, it can relieve a huge
burden, and can really be a critical mode of access.”

Some patients are also using telehealth in states where abortion
isn’t banned but which have in-person dispensing requirements,
because they prefer remote appointments, Rosen said. Abortion
medication has been approved by the US Food and Drug Administration
(FDA) up to 10 weeks of pregnancy, though evidence shows
[[link removed]] it can be effective when
used off-label up to and after 12 weeks.

While shield laws have given legal protection to providers, they are
now being tested in court; Texas has brought
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civil actions against doctors in New York and California.

“We don’t yet know what the courts will find,” Rosen said.

The FDA is considering imposing restrictions on telehealth
prescriptions of mifepristone, even though the medication is highly
effective and safer
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than Tylenol. Several states have filed lawsuits against the federal
government to challenge these rules.

“They’re arguing many things – in part that it’s not safe and
in part that it undermines state sovereignty,” Rosen said.

Even before the Dobbs decision and subsequent bans, people often
didn’t have a good sense of their state’s abortion laws until they
needed the care, Maddow-Zimet said. Now “it is even more
complicated” with the patchwork of laws across the country, which
means patients also need “navigational support” to understand how
to access reproductive healthcare, he said.

“We’re in a policy environment where abortion access is incredibly
restricted in many states, and because of that, it’s really critical
that people have multiple routes of access, whether that’s
telehealth or travel, because people’s individual situations are so
specific,” Maddow-Zimet said.

_MELODY SCHREIBER is a freelance journalist whose articles and essays
have been published by The Atlantic, Catapult, NPR, The Washington
Post, The Guardian, Pacific Standard, Vice, Wired, PBS Newshour, and
others. She has appeared on CNN and Feature Story News. She lives in
Washington, D.C._

_GUARDIAN U.S. Covering American and international news for an online,
global audience._

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