Which states saw the largest increases or decreases in abortion procedures since the Dobbs decision?
Executive summary
State-by-state changes in abortion procedures since Dobbs have been highly uneven: Guttmacher and other researchers report sharp declines in some states with new six-week or total bans (Florida, South Carolina) and substantial increases in several permissive or destination states (Wisconsin, Arizona, California, Kansas, Ohio, Virginia) [1]. Nationally, Guttmacher found clinician‑provided abortions in states without total bans were roughly stable — up 1% from 2023 to 2024 — even as travel and telehealth patterns shifted; preliminary 2025 data show a subsequent 5% decline in the first half of 2025 compared with 2024 in those same states [2] [3].
1. Sharp losses where laws tightened: bans and six‑week limits reshaped caseloads
States that adopted six‑week bans or near‑total bans saw the largest drops in clinician‑provided abortions. Guttmacher singled out Florida and South Carolina as experiencing “particularly sharp declines,” and noted Florida’s 2024 six‑week ban drove a 27% drop in abortions in the first half of 2025 compared with the same period in 2024 — a single‑state change that accounted for more than two‑fifths of the overall decline across states without total bans [1] [4].
2. Big gains in permissive and destination states — some surprising outliers
Several states reported substantial increases in the number of abortions provided as patients traveled or as providers scaled up services: Guttmacher named Wisconsin, Arizona, California, Kansas, Ohio and Virginia among those with “substantial increases” in 2024 [1]. Researchers and hospital reports also documented increased utilization of hospital‑based abortion care in protective states such as Oregon after Dobbs [5]. These destination‑state increases reflect both inbound travel and expansions of telehealth or clinic capacity [2] [3].
3. The national picture masks wide local variation
Aggregate results are deceptively calm. Guttmacher’s full‑year 2024 estimates show abortions in states without total bans rose only 1% between 2023 and 2024, yet that stability “masks major shifts in access” and large state‑level swings — e.g., big declines where bans were enacted and big increases where care concentrated [2]. Likewise, while 2025 first‑half data show a 5% drop in clinician‑provided abortions in non‑ban states relative to 2024, that decline was driven unevenly by a few states such as Florida [3] [4].
4. Travel, telehealth and ‘shield laws’ changed where procedures occurred
Interstate travel for abortion rose sharply immediately after Dobbs, then shifted again as telemedicine and “shield law” protections allowed some clinicians to mail medication abortion across state lines. Guttmacher found about 155,000 people crossed state lines for care in 2024 (15% of abortions in states without total bans), down slightly from 2023; in 2025 first‑half data, out‑of‑state travel declined another 8% compared with 2024 [1] [3]. These patterns — more care moving into permissive states and more medication abortions via telehealth — help explain why totals can look stable while locations change [2] [1].
5. Data limitations: what the sources say they cannot (yet) show
All major datasets and studies warn that reporting differences, incomplete state submissions, and uncounted self‑managed abortions (pills obtained outside clinical settings) limit comparability. The CDC’s surveillance was already incomplete through 2022 and its future reporting is uncertain; Guttmacher’s Monthly Abortion Provision Study uses provider surveys and models to estimate changes and updates estimates as new data arrive [6] [7] [8]. Available sources do not provide a single, definitive ranked list of every state’s percentage increase or decrease that is directly comparable across years because of reporting gaps and differing methodologies [6] [2].
6. Competing interpretations: policy effect vs. adaptive responses
Some researchers and advocates frame state declines as direct results of bans and enforcement; others emphasize adaptive responses (travel, telehealth, provider shifts) that have blunted nationwide declines. Guttmacher and other analyses document both effects: bans reduced in‑state provision in many places while permissive states absorbed increased demand, and telehealth/shield‑law mechanisms partly substituted for travel [2] [1] [3]. Human Rights Watch, public‑health reviews and several peer‑reviewed studies emphasize harms and inequities from bans, including worse outcomes in banned states [9] [10].
7. What to watch next: data, litigation, and funding shocks
Trends will change as state courts, legislatures and Congress act, as funding for travel and abortion funds fluctuates, and as researchers refine methods. Guttmacher cautions updates throughout 2025 altered earlier estimates; preliminary 2025 figures already show a narrowing of out‑of‑state travel and an absolute decline in clinician‑provided abortions in non‑ban states for the first half of 2025 [4] [3]. Policymakers and reporters must follow state‑level reporting, telehealth access, and legal decisions to understand future shifts [2].
Sources cited: Guttmacher Institute reporting and full‑year data [1] [2] [3] [4], CDC surveillance context [6] [7], scholarly and policy analyses on Dobbs impacts [9] [5] [10].