Abortion rates in the U.S. at their highest in a decade, finds new report. Here's what to know.

The rate of abortions rose by 10% in 2023, compared to 2020, according to a new report from the reproductive health organization, Guttmacher Institute. The rise comes after the Supreme Court struck down federal legal protection for abortions when it overturned Roe v. Wade in the controversial Dobbs v. Jackson Women’s Health Organization case in 2022. Abortion opponents celebrated the decision, believing it would lead to fewer people terminating their pregnancies. But the new data shows that the opposite happened in the first year post-Roe. Abortion rates instead hit a 10-year high, with more than a million occurring for the first time since 2012. Here’s what to know.

?? The national abortion rate was rising before Roe fell

Last year, some 1,026,690 abortions were performed in hospitals and clinics or happened outside of clinical settings using the abortion medications mifepristone and misoprostol, according to that report. And that number is likely an undercount, as it only includes legal abortions.

That means that there were 15.7 abortions for every 1,000 women between ages 14 and 44 (the range classified as “reproductive age”). That figure had been steadily declining for nearly 30 years, until 2019, when it began to slowly tick back up, a trend that continued through 2020.

But it seemed the trend might be reversed after Roe was overturned in 2022 and abortion restrictions and bans were enacted in several states, leaving many women who wanted to get an abortion unable to do so and in some cases, unable to travel elsewhere to get a medication abortion or procedure.

???? Where abortion rates are rising — and why

Even though the national rate of abortions is rising, there are actually two different trends happening. Among states without total bans, there was a 25% increase in abortions provided in 2023, including steep increases in states that border those with abortion bans in place.

The number of abortions in New Mexico, for example, surged by 257% between 2020 and 2023, according to the new report. New Mexico borders both Oklahoma and Texas, states where abortion is banned with only rare exceptions. Similar jumps in abortions occurred in Virginia (76%), North Carolina (41%) and Illinois (72%) — all of which border states with strict abortion restrictions or bans.

It’s clear from the Guttmacher report that these increases are largely driven by people traveling across state lines to get abortion care. In Illinois, out-of-town patients accounted for more than two-thirds (68%) of the increase in abortions.

By contrast, the number of abortions has fallen precipitously in the 14 states with trigger laws that went into effect after the Dobbs decision, as well as in other states than have restricted abortion access since 2020. Wisconsin, which had a trigger law in the books, saw abortion numbers plummet by 87%, as rates in neighboring Illinois went up.

?? What an expert says: It's a story of 'two Americas'

The rising number of abortions is a continuation of a trend that began as early as 2018, Dr. Alison Norris, professor of epidemiology at the Ohio State University and co-chair of the #WeCount Project of the Society of Family Planning, tells Yahoo Life. But it may seem counterintuitive that this increase has continued despite abortion bans being enacted in 14 states.

“What we really see is a picture of two Americas: a context where abortion is banned and access to that form of reproductive care is eliminated” within the state, and “a stark increase in abortion where it’s permitted and particularly where access has improved.” She refers to the former as a “public health crisis” and the other as a “public health triumph,” bolstered by an increase in awareness and funding in states that still allow abortion.

Norris stresses that just because abortion numbers are going up doesn’t mean that there aren’t still people who need abortions and can’t get them, or who don’t bear considerable costs in crossing state lines to get an abortion. “It would be a misunderstanding to think that if the number of abortions is high, then everyone who needed to get an abortion was able to get one — that is definitely not true,” she says. “It’s kind of an invisible problem,” because the people who can’t access abortion care don't wind up in the clinics where researchers like her would count them, Norris explains.

However, rising abortion rates reflect better access to medication abortions. Previous Guttmacher research found that medication abortions accounted for nearly two-thirds of all abortions in the U.S. in 2023, up from 53% in 2020. This is thanks in part to rules about prescribing these drugs via telemedicine being relaxed during COVID, and in part to laws protecting medical providers who prescribe them in many states. And now, massive pharmacy chains CVS and Walgreens have begun selling one of those abortion medications (mifepristone), meaning it will be available in more places. These policy changes have, in turn, improved access and helped reduce costs for patients and providers alike. “Those are all really important things to help people have access to care — people who live in rural areas or don't have a car or can’t travel for an abortion,” Norris says.

But access to abortion care is an ever-shifting landscape. One of the two pills involved in a medication abortion, mifepristone, is at the center of one of many political battles over abortion. The Supreme Court will hear arguments on Tuesday, March 26, in a case challenging whether policies allowing the drug to be more widely prescribed are constitutional.

This story previously stated incorrectly that Dr. Alison Norris is co-chair of the Society of Family Planning. It has been updated to reflect that she is co-chair of the organization's #WeCount Project.