Abortions continue to increase nationwide

According to a new report from the Society of Family Planning, abortion has continued to increase nationwide even amid new laws banning abortions in several states.

In the first six months of 2024, there was a monthly average of almost 98,000 abortions, higher than the national monthly averages for both 2023 (89,000) and 2022 (81,400). Between the second quarter of 2023 to the second quarter of 2024, the number of abortions nationwide increased by 11%, going from 260,730 to 289,270.

This increase in abortion was largely due to expanded access to abortion medications through telehealth. Between the second quarter of 2023 and the second quarter of 2024, the number of telehealth-provided abortions increased by 155%.

Abortions have also increased in states with bans. Currently, 13 states have near-total abortion bans, and the number of abortions increased in all but three: Texas, Idaho, and Oklahoma. Although some women traveled out of state for abortion care, others were able to access abortion medication from doctors online under shield laws.

Shield laws provide legal protections for clinicians who offer abortion care through telehealth to patients living in states with abortion bans. Currently, eight states have enacted shield laws. In the second quarter of 2024, the average monthly number of abortions provided under shield laws was 9,700, a 5% increase from the first quarter of the year.

In addition, a new study published in JAMA Pediatrics revealed that infant mortality rates were higher than expected for several months after Roe was overturned. Most of the increase in deaths was due to infants with birth defects.

When reviewing infant mortality trends for the 18 months after Roe was overturned, researchers found that there was an average of 247 more deaths in October 2022, March 2023, and April 2023, which was equal to a 7% absolute increase in infant mortality. There was also a 10% increase in infant mortality with birth defects, which includes heart abnormalities, spina bifida, and more.

"This is evidence of a national ripple effect," said Parvati Singh, the study's lead author. "Mortality is the ultimate outcome of any health condition. This is a very, very acute indicator. It could be representative of underlying morbidity and underlying hardship."

Where abortion is on the ballot in November

Currently, 10 states have abortion-related questions on their ballots for November:

• Arizona
• Colorado
• Florida
• Maryland
• Missouri
• Montana
• Nebraska
• Nevada
• New York
• South Dakota

Several other states, including Arkansas, Iowa, Pennsylvania, and Maine, had proposed measures related to abortion, but they ultimately did not make it to the ballot. This Daily Briefing article outlines abortion and other key healthcare-related ballot measures in several states.

Aside from abortion-related ballot measures, there have also been efforts to limit access to abortion medication, such as mifepristone. Last week, three states, Idaho, Kansas, and Missouri, asked courts to reinstate certain restrictions on the drug, even though the U.S. Supreme Court dismissed a similar case earlier this year due to lack of standing.

In addition, Louisiana recently passed a law, which went into effect Oct. 1, that classifies mifepristone and misoprostol, another drug used in abortions, as controlled substances.

According to Advisory Board's Ellie Wiles, "many abortion drugs are also used for the safe and effective management of miscarriage and postpartum hemorrhaging. Reclassifying these as controlled substances will pose roadblocks that can detrimentally complicate and delay the delivery of life-saving care."

"Like with many other pieces of anti-abortion legislation, the implications are much more far-reaching than the narrow goal they aim to achieve," Wiles added.

Advisory Board's women's health resources

For more insights into women's health issues, including maternity care, check out Advisory Board's library of resources, including:

We have several resources on the top drivers of change in the maternal and reproductive health market, as well as the outlook for the women's health service line.

To learn more about ways to improve women's health in the United States, this report outlines six key factors to take into consideration, including the roles of various healthcare stakeholders and the importance of cross-industry collaboration.

Advisory Board also has several resources on how to utilize technology in maternity care, including this cheat sheet on telehealth and maternity care and a case study on how digital solutions can improve access to maternity care.

For resources specifically related to abortion, we offer this infographic explaining the potential health outcomes for individuals denied abortions in their state, as well as an expert insight on the groups that are disproportionately impacted by abortion restrictions. This expert insight also explains how leaders can help their clinical workforce amid changing abortion laws. (Society of Family Planning report, 10/22; Society of Family Planning press release, 10/22; Miller/Sanger-Katz, New York Times, 10/22; Habeshian, Axios, 10/22 [1]; Bettelheim, Axios, 10/22; Zhang, The Atlantic, 10/18; Habeshian, Axios, 10/22 [2])