More than 63 million legal abortions have been recorded in the United States since Roe v. Wade was decided in January 1973, according to a widely cited cumulative estimate built from annual provider surveys. The yearly count climbed sharply through the 1970s and 1980s, peaked around 1990 at roughly 1.6 million, fell for three decades, and then reversed course after the Supreme Court overturned Roe in 2022. There is no single official running total, and the two organizations that track abortion nationally use different methods and produce different numbers.
The 1990 Peak and the Long Decline
Legal abortions rose quickly once Roe took effect. Both the CDC, which compiles voluntary reports from state health agencies, and the Guttmacher Institute, which surveys providers directly, recorded a peak in 1990. The CDC counted 1,429,580 abortions that year. Guttmacher, which covers all 50 states, put the figure at 1,608,600.1Pew Research Center. What the Data Says About Abortion in the US
From that peak, the numbers dropped for about 30 years, even as the population of women of reproductive age grew. Guttmacher estimates that abortions in 2020 were 40% lower than in 1991. The abortion rate, which controls for population, tells the same story: Guttmacher recorded 29.3 per 1,000 women aged 15–44 in 1981 and 14.4 per 1,000 in 2020. The CDC’s rate fell from 25 per 1,000 in 1980 to 11.2 per 1,000 in 2022.1Pew Research Center. What the Data Says About Abortion in the US
Researchers attribute most of the decline to falling pregnancy rates and broader contraceptive access, including the Affordable Care Act’s requirement that private insurers cover contraception. State restrictions were a factor in some places, but 57% of the drop between 2011 and 2017 happened in states that had not enacted new restrictions.2PBS NewsHour. Number of Abortions in US Falls to Lowest Since 1973
The Rebound After Dobbs
The Dobbs decision in June 2022 was expected to reduce the national count. It did not. Even with 13 states enforcing total bans, annual figures have risen. Guttmacher estimates about 1,126,000 clinician-provided abortions in 2025, a 21% increase over 2020.3Guttmacher Institute. Induced Abortion in the United States The Society of Family Planning’s #WeCount project tracked a similar climb, from a monthly average near 80,000 in late 2022 to 95,000 per month in 2024, with 1.14 million total abortions that year.4Society of Family Planning. WeCount December 2024 Data
The rebound has been driven largely by telehealth and by shield laws in states that permit clinicians to mail abortion medication into states where the procedure is banned. By December 2024, nearly 14,000 abortions per month were being provided under shield-law protections. In states with total bans, more than 99% of the abortions reaching residents were delivered via telehealth.4Society of Family Planning. WeCount December 2024 Data
Why There Is No Official Cumulative Total
No federal agency publishes a running total of legal abortions since 1973. The CDC’s numbers rely on voluntary aggregate reports from state health agencies and have been missing data from California and other states since the late 1990s, which keeps CDC figures consistently below Guttmacher’s. Guttmacher has conducted its provider census only 19 times since 1973 and does not publish an official cumulative sum.1Pew Research Center. What the Data Says About Abortion in the US
The National Right to Life Committee compiled the widely cited estimate of roughly 63.5 million by taking Guttmacher’s annual figures and adjusting upward for assumed undercounting.5Poynter. Fact Check: 63 Million Abortions That number spans nearly five decades. It is not an annual figure, a distinction that has been lost in some public commentary.
Official counts also miss self-managed abortions performed with pills ordered online, obtained through community networks, or supplied by organizations based outside the United States. A 2024 study in JAMA estimated that in the six months after Dobbs, about 26,000 more self-managed abortions occurred than would have under Roe. Suppliers provided nearly 40,000 pills during that window, a more than 300% increase over pre-Dobbs volumes.6The Guardian. Self-Managed Abortions Avoid Bans Because those abortions happen outside formal reporting systems, they sit almost entirely outside both the CDC and Guttmacher counts.
Who Has Been Getting Abortions
Age, income, race, and marital status all shape the patient population. In the CDC’s 2022 surveillance data, women in their twenties accounted for 56.5% of abortions, with the 20–24 and 25–29 groups posting the highest rates (18.1 and 18.7 per 1,000 women). Non-Hispanic Black women accounted for 39.5% of abortions in the 32 reporting areas that provided race and ethnicity data, with a rate 4.3 times that of non-Hispanic White women. Hispanic women accounted for 21.2%.7CDC. Abortion Surveillance — United States, 2022
Roughly 72% of abortion patients are low-income. The abortion rate among women living in poverty has been measured at 36.6 per 1,000, more than double the national rate.8Brookings Institution. Abortion in the US: What You Need to Know About 87.7% of patients in 2022 were unmarried, and more than half had already given birth to at least one child. Timing has stayed early: 78.6% of abortions in 2022 took place at or before nine weeks of gestation, 92.8% by 13 weeks, and 1.1% at 21 weeks or later.7CDC. Abortion Surveillance — United States, 2022
How Abortions Are Provided Now
The delivery of abortion care has shifted dramatically. In 2006, 88% of abortions were surgical; by 2023, 65% involved medication.3Guttmacher Institute. Induced Abortion in the United States The FDA approved mifepristone in September 2000 with restrictions requiring three in-person visits. In 2016 the agency extended approved use to ten weeks, allowed nurse practitioners to prescribe, and cut required in-person visits to one. In 2021 the FDA stopped enforcing the in-person dispensing requirement, and in January 2023 it finalized a rule allowing certified retail pharmacies to dispense the drug.9FDA. Questions and Answers on Mifepristone
Telehealth is the sharpest area of growth. Virtual-only clinics did not exist in 2020. By 2023 there were 226 of them, and by 2025 they accounted for 24% of all clinician-provided abortions.3Guttmacher Institute. Induced Abortion in the United States Price differences are large: the median cost for a medication abortion at a virtual clinic was $150 in 2023, compared with $600 at a brick-and-mortar facility.10KFF. Abortion Trends Before and After Dobbs
The Legal Arc: Roe, Casey, Dobbs
Roe v. Wade, decided January 22, 1973, struck down a Texas criminal abortion statute and held that the Due Process Clause of the Fourteenth Amendment protects a right to privacy broad enough to encompass a decision to terminate a pregnancy. The 7–2 majority, authored by Justice Harry Blackmun, set up a trimester framework: the first trimester belonged to the patient and her physician; the second allowed state regulation for maternal health; after viability, states could prohibit abortion with exceptions for the life or health of the mother.11Justia. Roe v. Wade, 410 U.S. 11312National Constitution Center. Roe v. Wade
Planned Parenthood of Southeastern Pennsylvania v. Casey (1992) kept Roe‘s core holding but replaced the trimester framework with the “undue burden” test. State rules were permissible so long as they did not place a “substantial obstacle” in the path of someone seeking a pre-viability abortion.13Justia. Planned Parenthood of Southeastern Pa. v. Casey, 505 U.S. 833 Casey upheld informed-consent requirements, a 24-hour waiting period, and parental consent for minors, and struck down a spousal-notification provision.14NPR. Roe Established Abortion Rights; 20 Years Later, Casey Paved the Way for Restrictions That standard governed for the next 30 years and opened the door to hundreds of state regulations.
On June 24, 2022, the Supreme Court overturned both Roe and Casey in Dobbs v. Jackson Women’s Health Organization. Writing for a 6–3 majority, Justice Samuel Alito held that the Constitution “does not confer a right to abortion” and that such a right is neither “deeply rooted in this Nation’s history and tradition” nor “implicit in the concept of ordered liberty.”15Supreme Court of the United States. Dobbs v. Jackson Women’s Health Organization, No. 19-1392 Authority to regulate or prohibit abortion returned to the states. Chief Justice Roberts concurred in the judgment, agreeing to uphold Mississippi’s 15-week ban but arguing the Court should not have fully overruled Roe. Justices Breyer, Sotomayor, and Kagan dissented, writing that the ruling “undermines the Constitution’s promise of freedom and equality for women.”16National Constitution Center. Dobbs v. Jackson Women’s Health Organization
Where Abortion Stands State by State
As of early 2026, 13 states enforce total bans: Alabama, Arkansas, Idaho, Indiana, Kentucky, Louisiana, Mississippi, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, and West Virginia. Seven more enforce gestational limits between six and twelve weeks, including Florida, Georgia, Iowa, and South Carolina. Nine states and the District of Columbia impose no gestational limit; 18 states set the cutoff at or near fetal viability.17KFF. Abortion in the U.S. Dashboard18Guttmacher Institute. State Policies on Abortion Bans
Twenty-two states and D.C. have enacted shield laws to protect clinicians who serve patients in states where abortion is banned. Eight of those states extend protection specifically to telehealth provision regardless of where the patient is.19Guttmacher Institute. Shield Laws for Sexual and Reproductive Health Care20KFF. Shield Laws
Interstate travel for care doubled from 81,000 patients in 2020 to about 170,000 in 2023, then eased to 155,000 in 2024. Illinois has been a leading destination, receiving more than 35,000 out-of-state patients in 2024. Florida’s move to a six-week ban in May 2024 pushed many Floridians to Virginia and North Carolina.21Guttmacher Institute. Data on State of Residence of US Abortion Patients Traveling As telehealth and shield-law provision have expanded, the share of patients physically traveling out of state has begun to slip, from 16% in 2023 to 13% in 2025.22Guttmacher Institute. Monthly Abortion Provision Study
The number of brick-and-mortar clinics in states without total bans slipped from 807 in 2020 to 753 by December 2025, with 51 facilities stopping abortion services between March 2024 and December 2025 while 39 new ones started. Missouri saw three clinics resume services after voters approved a constitutional amendment protecting reproductive rights in November 2024. Florida lost four clinics after its six-week ban took effect. At least 25 online-only clinics now operate in the 28 states and D.C. that lack total bans or restrictive telehealth policies.23Guttmacher Institute. Abortion Clinics in the United States, 2024–2025
Voters have shaped the map as well. Rights-protective measures passed in 2022 and 2023 in California, Kentucky (where voters rejected a restriction), Michigan, Ohio, and Vermont, and in 2024 in Arizona, Colorado, Maryland, Missouri, Montana, Nevada, and New York. Similar measures failed in Florida, Nebraska, and South Dakota, and Nebraska separately passed a first-trimester ban.24KFF. The Status of Abortion-Related State Ballot Initiatives Since Dobbs On January 6, 2026, the Wyoming Supreme Court struck down the state’s 2023 abortion bans in State v. Johnson, ruling 4–1 that a 2012 state constitutional amendment guaranteeing the right to make one’s own health care decisions covers abortion.25Wyoming Public Media. Wyoming Supreme Court Protects Abortion Access