Abortions provided by clinicians have declined for the first time since the Supreme Court’s Dobbs decision, according to data released Tuesday, as the impacts of new restrictions are being felt and it becomes increasing common to manage an abortion without the direct involvement of a physician.
Abortion access has become a patchwork of permissible and restricted in the years since the Supreme Court overturned Roe v. Wade and ended the constitutional right to the procedure.
In 2023 and 2024, the number of clinician-provided abortions increased nationwide and out-of-state travel more than doubled. But that trend seems to be reversing, according to new data from the Guttmacher Institute, a research and policy organization focused on advancing sexual and reproductive health and rights.
According to the analysis, there were 5 percent fewer clinician-provided abortions in the first half of this year than there were in the first half of last year.
Declines in clinician-provided abortions occurred in 22 of the states without total abortion bans, but they were largest in states that implemented six-week bans and in states that border those with total abortion bans.
The number of patients traveling to states where abortion remains legal declined by 8 percent in the first six months of the year compared to the same period last year. Still, that figure is still “significantly higher” than it was before Roe was overturned, researchers noted.
There are a few potential reasons for the decline, and Guttmacher researchers emphasized preliminary data do not yet provide a basis for full-year findings.
Researchers said the trends likely reflect the impact of recent abortion restrictions, the expanding availability of medication abortion prescribed by physicians protected by shield laws, as well as the increasing hardship posed by travel for abortion care.
“Given the number of states that have total abortion ban, we’ve seen in our data that travel is an absolutely critical mode of care for folks. That being said, travel is an extremely costly endeavor, from a financial perspective, from an emotional perspective, from a logistical perspective,” said Isabel DoCampo, a Guttmacher Institute senior research associate.
DoCampo noted that abortion funds, which help people cover the costs of travel, are struggling with money as the waves of donations that followed the end of Roe v. Wade have dried up.
But shield laws, which offer protections for providers who practice in places where abortion remains legal, are also likely contributing to the drop in clinician-provided abortions. Online clinics offering abortion care to individuals in states with bans are expanding.
Guttmacher didn’t include data on abortions provided through shield laws in its report, but the Society of Family Planning, which does track that data, found that abortions provided under shield laws have been increasing.
“While shield law provision may not be an appropriate or preferred option for some patients—those at later gestational durations, for example, or those who prefer procedural abortion to medication abortion—this critical innovation is likely a key factor in reducing travel for abortion care, particularly by residents of states with total bans,” Guttmacher researchers wrote.
Still, increasing numbers of abortion restrictions and bans mean there may not be any nearby states for people to travel.
Florida was a key abortion access point in the Southeast, but after a six-week ban passed in 2024, abortions plummeted.
In the first full year after the Dobbs decision, about 1 in 3 abortions in the South and about 1 in 12 nationwide happened in Florida, according to previous Guttmacher data.
But the latest figures showed there were more than 12,000 fewer abortions provided in the state compared to the same period last year, a drop of 27 percent. This change in abortion caseloads was the largest absolute change observed in any state and accounted for over 40 percent of the overall decline in states without total bans
“Shield laws and direct financial assistance for patients are necessary to help people living in restrictive states access the abortion care they need. As even more extreme threats to abortion loom, bold and decisive policy responses are more necessary than ever,” Kelly Baden, the Guttmacher Institute’s vice president of public policy, said in a statement.
