10 Things to Know About Abortion Access Since the Dobbs Decision

Ivette Gomez, Karen Diep, Mabel Felix, and Alina Salganicoff
Published: Jun 20, 2024

June 24, 2024 marks the second anniversary of the Dobbs decision which overturned Roe v. Wade, the case that for almost 50 years protected the constitutional right to abortion in the United States. States can now set their own policies protecting or banning abortion without any federal standard protecting access to abortion and this has led to drastic changes in the landscape of abortion access across the U.S. This policy watch presents 10 key facts to know about abortion access two years after the Dobbs decision.

Since June 24, 2022, 14 states have banned abortion across the United States, largely concentrated in the South. An additional 6 states have early gestational limits between 6 and 15 weeks LMP (last menstrual period). To access abortion services, people living in states where abortion is banned or severely restricted either have to travel out of state—often incurring additional costs related to travel and loss of wages—or obtain medication abortion drugs from companies who ship the pills without requiring a clinician visit or from providers in states with shield-laws.
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While all 20 states with abortion bans or early gestational limits have exceptions for when the pregnant person’s life is in danger, six states do not have exceptions for when the pregnant person’s health is at risk, 10 states have no rape/incest exceptions, and 13 states have no fatal fetal anomaly exceptions. In practice, health exceptions to bans have often proven to be unworkable, except in the most extreme circumstances, and have sometimes prevented physicians from practicing evidence-based medicine. The federal government has sued the state of Idaho over its abortion ban, which includes an exception to save the life – but not the health – of the pregnant person, contending that the ban was in violation of the Emergency Medical Treatment and Active Labor Act (EMTALA), a law that requires that hospitals provide stabilizing treatment, including abortion, to patients who present in the emergency room with an emergency medical condition. The Supreme Court is set to rule on this case in June 2024.
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Paradoxically, the total number of abortions in the U.S. appears to have increased slightly following Dobbs. This rise could be due to increased interstate travel for abortion access, expanded in-person and virtual/telehealth capacity to see patients, increased measures to protect and cover abortion care for residents and out-of-state patients, and the broader availability of low-cost abortion medication. However, these aggregated trends mask the sharp decline in abortions provided in states with total bans or severe restrictions as well as the hardships that many pregnant people experience in accessing abortion care.
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One in five (19%) abortions were provided via telehealth in December 2023 according to Society for Family Planning’s #WeCount Project. These telehealth abortions were provided by virtual clinicians (48%), brick-and-mortar clinics (5%), and providers that prescribe medication abortion pills in states with shield laws to patients in other states with bans (36%) or telehealth restrictions (12%). States with shield laws aim to protect clinicians and minimize the legal risks associated with providing abortion care in states where abortion or telehealth abortion are banned or restricted. In a unanimous decision, the Supreme Court of the United States rejected a legal challenge to the abortion pill, mifepristone, allowing the pill to remain available for medication abortion in both clinical and telehealth settings where state law permits.
Six in ten Black (60%) and American Indian or Alaska Native (59%) women ages 18-49 live in states with abortion bans or gestational restrictions. Over half (53%) of White women ages 18-49 live in states with bans or restrictions, while less than half of Hispanic (45%) and about three in ten Asian (28%) and Native Hawaiian or Pacific Islander (29%) women ages 18-49 live in these states. People of color residing in states where abortion is banned or severely restricted may face disproportionately greater challenges accessing abortions due to longstanding underlying social and economic inequities, which could exacerbate existing disparities in maternal and infant health.
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Since the Dobbs decision, abortion providers and advocates in 23 states have challenged the legality of state abortion bans and limits, and their exceptions, contending that these laws violate the state constitution or state law. Since June 2022, the Supreme Courts of 5 states – Florida, Idaho, Indiana, Oklahoma, and South Carolina – have ruled that the state constitution does not protect the right to abortion, allowing their respective state’s abortion bans or limits to stand. Challenges to abortion bans and limits, or their exceptions, are ongoing in 15 states.
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National polls have consistently found that the majority of the public did not want to see Roe v. Wade overturned and that most people feel that abortion is a personal medical decision. Most of the public now supports access to abortions for patients who are experiencing pregnancy-related emergencies (86%), a patient’s right to travel for abortion care (79%) and protecting doctors who perform abortions from legal penalties (67%). About one third (32%) support laws banning the use of mifepristone, also known as medication abortion.
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Voters in six states have weighed in on constitutional amendments regarding abortion, and in each state since the Dobbs decision the side favoring abortion access has prevailed. This November, up to 11 states could have abortion measures on their ballots, seeking either to affirm that their state constitution protects the right to abortion or that nothing in the state constitution provides that right. As of June 20, 2024, 4 states—Colorado, Florida, Maryland and South Dakota—have confirmed they will have measures on their ballots for the November 2024 election. Over half (53%) of Democratic women voters living in states with confirmed or potential abortion-related ballot initiatives say that they are more motivated to vote during this year’s election compared to 43% of Democratic women in states without abortion-related ballot initiatives.
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1 in 7 (14%) women of reproductive age (18 to 49) report that they or someone they know has had difficulty accessing abortion services since Roe was overturned due to restrictions in their state, according to KFF polling. This includes 1 in 5 (21%) women ages 18-49 living in states where abortion is banned, and about one in ten women of reproductive age living in states where abortion is limited (9%) or legal (12%).
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The Dobbs decision brought increased attention at the state and federal levels to protect the legal right to contraception, in part due to Justice Thomas’ concurring opinion that, in future cases, the Court should overturn Griswold v. Connecticut, the Court’s 1965 landmark decision recognizing the right to obtain contraceptives. Soon after, the Right to Contraception Act was introduced in Congress, and while it quickly passed in the then Democrat-led House, it did not garner enough support to end the filibuster in the Senate. The bill was reintroduced in the current congressional session but has yet to garner enough support to pass in either chamber of Congress. At the state level, 6 states and D.C. have passed laws or constitutional amendments to secure the right to contraception for their residents since Dobbs, bringing the total number of states that protect this right to 14.
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10 Things to Know About Abortion Access Since the Dobbs Decision

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