The most recent CDC surveillance report, covering 2022, recorded abortions from 48 reporting areas, but several large states including California, Maryland, New Hampshire, and New Jersey did not submit data. Because of these gaps, the CDC’s count is widely understood to be an undercount. The Guttmacher Institute, which surveys abortion providers directly, has historically produced higher and more complete national estimates. For 2023, Guttmacher found that the total number of abortions provided in the U.S. substantially exceeded the number provided in 2020, the last year with comprehensive estimates, when roughly 930,000 abortions were recorded.
Getting a single, precise number is harder than it sounds, because no single agency captures every abortion in the country. Here’s what the data does tell us, and why the numbers vary depending on the source.
Why There Is No Single Official Count
Two organizations track U.S. abortion numbers, and they use different methods. The CDC collects data voluntarily from state health agencies. States are not required to participate, and several consistently opt out. California alone accounts for roughly 15% of the U.S. population, so its absence from CDC reports creates a significant gap. Maryland, New Hampshire, and New Jersey were also missing from the 2022 report.
The Guttmacher Institute takes a different approach, surveying abortion-providing clinics and hospitals directly. This method captures procedures in states that don’t report to the CDC, producing a more complete picture. The CDC itself relies on Guttmacher’s figures when it needs a national denominator for calculating rates like abortion-related mortality.
Neither source captures self-managed abortions, meaning pills obtained outside the formal U.S. healthcare system. Guttmacher has been explicit that its counts reflect only abortions occurring within clinical settings, so the true total is likely higher than any published figure.
How the Dobbs Decision Reshaped the Numbers
The Supreme Court’s June 2022 decision in Dobbs v. Jackson Women’s Health Organization overturned the federal right to abortion and triggered bans or severe restrictions in more than a dozen states. Many observers expected the national count to drop. Instead, it went up.
Abortions increased among residents of nearly every state where the procedure remained legal, and cross-state travel surged. More than 171,000 women traveled out of their home state to obtain an abortion in 2023. Texas alone saw roughly 35,500 residents leave the state for the procedure. Illinois absorbed the largest influx, receiving about 37,300 out-of-state patients that year.
The net effect: states with bans saw their procedure counts plummet, while neighboring states that kept abortion legal experienced dramatic caseload increases. Nationally, the total number of abortions rose rather than fell.
The Rise of Telehealth and Medication Abortion
One of the biggest shifts in how abortions happen has been the growth of medication abortion, which uses pills rather than a surgical procedure. In 2022, 53.3% of all abortions tracked by the CDC were early medication abortions, performed at nine weeks of pregnancy or earlier. That marks the first time medication abortion accounted for the majority of all abortions in CDC data.
Telehealth has accelerated this trend dramatically. In mid-2022, only about 5% of abortions were provided through telehealth consultations. By December 2024, that figure had climbed to 25%, meaning one in four abortions involved a remote medical visit rather than an in-person clinic appointment.
A key driver is so-called “shield laws” in certain states, which allow clinicians to prescribe abortion medication via telehealth to patients located in states where the procedure is banned. These prescriptions are mailed to the patient. By the end of 2024, abortions provided under shield laws averaged roughly 10,000 per month, peaking at nearly 14,000 in December 2024 alone. Shield-law prescriptions accounted for about 49% of all telehealth abortions in 2024.
This growth in telehealth and mail-order medication means that even in states with near-total bans, some residents are obtaining abortions without traveling. It also means a growing share of abortions falls outside traditional state-level tracking systems, making precise national counts even more difficult.
What the Trend Lines Show
Abortion numbers in the U.S. peaked in the early 1980s, when the CDC recorded over 1.5 million per year. From that high point, the count declined steadily for three decades, driven by improved access to contraception, changing demographics, and shifts in unintended pregnancy rates. By 2017, the number had dropped below 900,000 for the first time since the mid-1970s.
That long decline appears to have reversed. Numbers ticked upward in the years just before Dobbs, and the post-Dobbs data from Guttmacher confirms that 2023 exceeded 2020 levels by a substantial margin. The combination of expanded telehealth access, shield-law prescriptions, and increased interstate travel has more than offset the reductions in states with bans. The national trajectory is now climbing, even as access has become far more uneven geographically.
Putting the Numbers in Perspective
There are roughly 3.6 million births in the U.S. each year, so even at a conservative estimate of around one million annual abortions, the procedure is common. About one in four women in the U.S. will have an abortion by age 45, according to previous Guttmacher analyses. The procedure is most common among women in their twenties, and the majority occur early in pregnancy, at nine weeks of gestation or less.
The data landscape is messier now than at any point in the last 50 years. State-level bans have pushed more abortions into informal channels, telehealth has blurred geographic boundaries, and the two main tracking systems each miss portions of the picture. What the available evidence consistently shows is that the annual number of abortions in the U.S. remains close to or above one million, with the total likely higher once self-managed abortions are factored in.