How did annual U.S. abortion totals change from 2019 through 2024 according to Guttmacher and other monitoring projects?
Executive summary
Guttmacher’s newest full-year estimates show clinician‑provided abortions in U.S. states without total bans were essentially flat from 2023 to 2024 (about a 1% rise), and materially higher than pre‑Dobbs baselines—roughly a 12% increase from 2020 to 2024 according to Guttmacher’s reporting [1] [2]. Other monitoring projects that try to count telehealth or shield‑law provision produce larger totals for the same period, producing apparent divergence driven by methodology and what is counted [3] [4].
1. How Guttmacher frames 2023 → 2024: stability, not a spike
Guttmacher’s Monthly Abortion Provision Study reports 1,038,100 clinician‑provided abortions in 2024 in states without total bans, an increase of less than 1% from 2023, and describes the total number in those states as “relatively stable” between 2023 and 2024 [1] [5]. The institute also notes the share of abortions provided by online‑only clinics in those states rose from 10% in 2023 to 14% in 2024, and that about 155,000 people crossed state lines for care in 2024—15% of abortions in states without total bans—illustrating shifts in where and how care is delivered even as headline totals held steady [1].
2. The longer trend Guttmacher emphasizes: higher than 2020
Guttmacher explicitly compares 2024 to 2020, reporting that the 2024 count in states without total bans is roughly 12% higher than the comparable 2020 estimate—an assertion the institute repeats in fact‑sheet language and in its Monthly Abortion Provision Study summaries [2]. That frames the post‑Dobbs era not as a collapse in nationwide abortions but as a redistribution of care, increased telehealth/online provision, and modest net growth in clinician‑provided abortions where data are collected [2] [5].
3. Other monitoring projects produce larger national totals
Independent efforts that attempt to capture telehealth‑mailed medication abortions and facility counts report higher totals for overlapping periods: the Society for Family Planning’s #WeCount and related analyses have produced multi‑month totals suggesting more than 1.1 million abortions in a July 2023–June 2024 window, and some secondary commentators cite totals above a million for 2024 when telehealth shipments into banned states are included [3] [4]. Guttmacher’s published 2024 figure is explicitly limited to clinician‑provided abortions in states without total bans and therefore omits shield‑law telehealth deliveries into banned states unless separately modeled with SFP data [1] [2].
4. Why sources disagree: coverage, methods and missing state reports
Differences between Guttmacher, CDC and other trackers stem from coverage and method: CDC surveillance historically reports lower totals and has gaps because several large reporting areas sometimes do not submit data to CDC, while Guttmacher surveys providers and models missing data but, since Dobbs, shifted to a monthly provider sample plus statistical imputation [6] [3]. Guttmacher and others also acknowledge their 2024 clinician counts undercount total abortions because they exclude pills mailed under shield laws to people in states with total bans unless synthesized with SFP data [1] [2].
5. Synthesis and limits of the record
The clearest, well‑sourced takeaway is this: by Guttmacher’s main 2024 accounting, abortions in states without total bans rose only slightly from 2023 to 2024 (about 1%), and those 2024 totals are materially higher than comparable 2020 counts (about +12%), but national totals vary substantially across projects because some trackers add telehealth pill shipments and out‑of‑state provision that Guttmacher’s clinician‑only series does not fully capture; the CDC’s public surveillance remains incomplete for recent years because of reporting gaps [1] [2] [6] [3]. Reporting organizations make different implicit choices about what “counts” as an abortion in a fragmented legal landscape—an agenda that shapes headline claims as much as the underlying trend lines [5] [4].