Data After Dobbs

What the numbers teach us

Over the last two years, Abortion, Every Day has told you about many, many studies, reports and polls—data that’s painted a rapidly-changing picture of post-Roe America. But we know the sheer volume of numbers we’ve thrown at you since Dobbs can feel confusing. So in the interest of taking a step back and giving you data that you can understand—and hopefully share—I’ve identified four main themes that come up again and again in these reports: 

• How abortion access is adapting and constricting to the changing landscape; 

• The immense harm done by abortion bans; 

• The worsening care crisis in our healthcare system; 

• And the overwhelming public support for abortion as we approach the 2024 elections. 

Abortion Landscape

Despite bans across the country, the number of abortions actually increased in 2023. In fact, for the first time since 2012, there were more than 1 million abortions in the U.S. 

What’s more, Guttmacher researchers point out that their estimate is “almost certainly an undercount,” because they only account for abortions obtained in healthcare facilities like clinics and via telehealth. (In other words, the report doesn’t contain information about abortions obtained outside of the formal healthcare system, like abortion medication that’s been mailed to anti-choice states.) 

We also know that abortion remains constant—new research affirmed this year that at least 1 in 4 women are expected to end a pregnancy in their lifetime. Report after report has also shown how important the expansion of telehealth, broader Medicaid coverage, well-supported abortion funds and abortion activism have been for preserving access for millions of patients.

The short version? Despite bans, many patients are still getting the abortion care they need. That doesn’t mean people aren’t being denied care; of course they are. But not nearly at the rate that the anti-abortion movement hoped.

While abortion rates haven’t changed significantly, what has shifted is the importance of abortion medication in post-Roe America. In fact, medication abortions now make up about 63% of abortions. #WeCount reports that telehealth now accounts for nearly 1 in 5 abortions in the U.S., and that in the second half of 2023, over 40,000 people in anti-choice states were able to access abortion medication through providers practicing in states with shield laws. (That’s about 8,000 people a month!)

As expected, anti-abortion groups are furious that so many people have been able to obtain care in spite of laws—that’s why Republicans and anti-abortion groups have spent so much time, energy and money attacking abortion medication. If they’re successful, 40 million patients would lose abortion access. We expect to see even worse attacks on medication abortion in the coming year now that the anti-abortion movement has a blueprint from the Supreme Court.

But again: in spite of the heroic efforts of abortion funds, activists, pro-choice lawmakers and others, people are still being denied care every day, and those who are able to access abortions have to clear cruel and serious hurdles. 

Harm Done

One number we cannot let become normalized: Nearly 1 in 5 patients are traveling out of state for abortion care, and Guttmacher reports that 171,000 patients traveled out-of-state for abortions last year. (Over 35,000 people traveled out of Texas alone!) From Isaac Maddow-Zimet, data-scientist behind the project, described just how striking it is:

“Despite the amazing resiliency of abortion patients and providers, we can’t lose sight of the fact that this is neither normal nor acceptable: A person should not have to travel hundreds or thousands of miles to receive basic health care.”

We’re also starting to see numbers that show just how many people are being forced into unwanted childbirth: Research from the Institute of Labor Economics found that birthrates have increased in every single state with an abortion ban since Dobbs, and that abortion bans have blocked at least 1 in 4 women in anti-choice states who wanted an abortion from getting one. 

Unsurprisingly, researchers found that Black women, Hispanic women, and women in their 20s disproportionately had increased birth rates—and that increase was especially large in states where patients would have to travel the furthest to find their nearest legal abortion appointment. Caitlin Myers, one of the paper’s authors and a professor of economics at Middlebury College, called this new trend “an inequality story.”

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One of the most disturbing numbers we saw over the past year? 65,000.That’s the estimated number of rape-related pregnancies in anti-choice states since they passed abortion bans. The research, published in JAMA Internal Medicine, was a stark reminder of what the anti-abortion movement really wants: forced childbirth, no matter what the circumstances. (This is a good time to remind you that AED uncovered that Students for Life president Kristan Hawkins claimed that “sexual assault actually helps prevent a lot of pregnancies itself because of your body’s natural response.”)

The connections between violence against women and abortion bans don’t end there. A report from the National Domestic Violence Hotline found that 1 in 4 respondents reported that their current or former partner pressured them into pregnancy, 13% were threatened with violence while pregnant, and 10% were threatened with violence if they expressed a desire to end the pregnancy. (Despite anti-abortion myths to the contrary, abused women are far more likely to be pressured into pregnancy rather than pressured to end one.)

Another study, this one from the Journal of the American College of Surgeons (JACS), found that pregnant women living in anti-choice states are more likely to experience domestic violence and that anti-choice states had a 75% higher rate of peripartum homicide. Once again, the risks were higher for more marginalized women: younger women, Black women, and women with lower levels of education. 

Another disturbing abortion ban harm: maternal and infant mortality. Research published in the American Journal of Preventive Medicine found that states with abortion restrictions had a 16% increased infant mortality rate, and that abortion restrictions made more of an impact on infant mortality than socioeconomic factors. The mortality rate for Black infants was more than twice that of White infants.

Remember: these are just the harms that we can quantify. There isn’t data (yet) about how many women were forced to carry doomed pregnancies to term just to watch their newborns die. There are no reports about how many women have gone septic or damaged their reproductive capabilities because their abortion care was delayed or denied. And, unfortunately, there’s no number that can capture the emotional and mental torture women have suffered under abortion bans. 

Care Crisis

Since Dobbs, Abortion, Every Day has been following the post-Roe care crisis closely: from the OBGYN exodus out of anti-abortion states, to doctors being legally prohibited from giving their patients adequate—or even health- and life-saving—care. And as the crisis worsens across the country, doctors are warning that the system will collapse—especially when it comes to labor and delivery care in rural areas. Reports have shown doctors fleeing anti-abortion states because they are worried that they won’t be able to give their patients the standard of care, or that they’ll be arrested if they do. 

Perhaps nowhere has that been more evident than in Idaho, where reproductive health care providers are leaving en masse. The state has lost nearly a quarter of its OBGYNs and half of its maternal fetal medicine specialists; as a result, multiple maternity wards have shuttered and maternal health deserts have widened. We know what happens next: rising maternal and infant mortality. (Though we may never know just how bad those numbers get, because the state disbanded its maternal mortality review committee.)

What’s happening in states like Idaho is an omen for what’s to come elsewhere. We’ve seen similar trends in places like Tennessee, South Carolina and Alabama—where the widening maternal health care gap (which was already disastrous) is forcing some patients to travel hours to find a hospital to give birth.

Just as bad: these states are unable to replace these lost doctors. Hospitals and health centers in anti-abortion states are increasingly unable to recruit new OBGYNS.

A study from the Association of American Medical Colleges (AAMC) found that recent medical school graduates were less likely to apply for residencies in anti-abortion states—with the biggest drop-offs in OBGYN applications, specifically. Alabama saw a 21.2% drop in OBGYN residency applications, for example; Louisiana had a nearly-18% drop; and Kentucky saw a 25% drop over the last three years.

It’s affecting undergraduate students too. 71% of current and prospective college students report that a state’s abortion policy is an important deciding factor when looking at schools. Of the students who say abortion policies are important to their decision where to attend college, 80% of students say they would prefer to live in a state with greater access to reproductive health care.

Abortion bans are also creating a crisis within the workplace for practitioners in anti-choice states. Researchers from Harvard’s School of Public Health, Boston College, and University of North Carolina at Chapel Hill School of Medicine found “deep and pervasive impacts” not just on patient outcomes—but physicians’ own health, and on workforce sustainability in anti-abortion states.

OBGYNs told researchers about having to delay medical care until a patient was at risk of death or permanent impairment because a fetal heartbeat was still present. Some reported having to delay vital care in middle-of-the-night medical emergencies because hospital lawyers were asleep and not answering phone calls. Nearly 90% reported worrying about legal culpability while practicing. 

What world are we heading towards when doctors are unable to follow basic standards of care because of abortion laws? Healthcare practitioners are telling us again and again that this post-Dobbs world is unsustainable and it will only get worse. 

America Supports Abortion

We’ve gone over a host of dark numbers, but we have to hold on to the fact that America supports abortion. Since Dobbs, poll after poll shows that the overwhelming majority of this country supports access to abortion. (At any point, for any reason.)

As we’ve said many times since Dobbs, abortion isn’t an issue of Americans disagreeing—it’s not something that’s polarizing the country, it’s not ‘controversial’, it's not something to hide from. The reality is that a small group of extremist legislators are passing bans against the wishes of the vast majority of their constituents, forcing laws onto people who don’t want them.

A recent poll from Axios/Ipsos, for example, that shows that 81% of Americans believe abortion “should be managed between a woman and her doctor, not the government.” And this is huge: 4 in 5 Americans don’t want pregnancy to be legislated. That includes over half of Republicans! 

We've seen multiple polls showing the same thing: Americans want abortion to be legal. (Check out research from PerryUndem for more evidence of this massive and growing support.)

There’s also broad support for mifepristone and misoprostol access amid the political attacks seeking to ban the medication. Polls show 7 in 10 Americans support abortion medication (including one from Fox News), which underscores how much Americans support medication access, regardless of party affiliation.

That’s because Americans increasingly understand that pregnancy is too complicated to legislate. A poll commissioned by Planned Parenthood, for example, found that the messages resonating most with voters are those emphasizing that medical decisions should be made by patients and doctors, not politicians, and those highlighting how wholly unqualified politicians are to have a say.

This support translates to elections, too: Abortion rights have won every time they’ve been on the ballot since Dobbs. Polls also show that 2 in 3 Americans would vote to codify abortion rights into their state constitutions—including nearly half of Republicans. And voters overwhelmingly reject efforts to brand abortion restrictions as ‘middle-ground compromises’ (like their proposal for a national 15-week ban).

All of this terrifies Republicans. That’s why anti-abortion legislators in multiple states are trying to stall or stop abortion rights ballot measures—even if it means undoing democracy in the process. They’ve tried to raise ballot measure standards and written false or misleading language in ballot summaries; they’ve attempted to get the courts to reject abortion rights amendments and have their Attorney Generals to upend the iniative process. And they’re working with anti-abortion groups throughout that process.

All of which is to say, the anti-abortion movement relies on the myth that abortion is just a matter of disagreement, rather than the truth: public officials are upending democracy to bring a landscape of devastation throughout our healthcare system that harms the lives of millions across the country.

And that’s more than a matter of numbers.

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