Challenges and Shifts in U.S. Abortion Access After the Overturning of Roe v. Wade

The Jackson Women’s Health Organization — otherwise known as the Pink House — was the center of the U.S. Supreme Court case that overturned the federal right to abortion in June. Today, the clinic, the only abortion clinic to serve Mississippi and the greater area for years, is shuttered. The Pink House is just one of dozens of clinics across the South that have closed or stopped offering abortion services in the face of trigger abortion bans that went into effect right after Dobbs v. Jackson Women’s Health Clinic overturned Roe v. Wade.

Legal Challenges to Medication Abortion

Remaining abortion clinics face more challenges if the abortion pill is limited by a Texas judge. Medication abortions account for over half of all abortions in the United States, according to the research group Guttmacher Institute. A federal judge in Texas decides on a lawsuit filed by anti-abortion groups that directs the U.S. Food and Drug Administration to withdraw its approval of mifepristone — a widely used drug used in medication abortion that’s been around for decades. A ruling in favor of the anti-abortion groups would not only make legal abortion more challenging, it would also erase some of the limited options left for people in states where there are strict abortion bans.

The typical regimen used in medication abortion involves the use of mifepristone and misoprostol, and has been prescribed by doctors since the 2000s. The likely immediate impact would be that manufacturers would not be allowed to ship mifepristone anywhere in the United States, and providers would no longer be able to prescribe it. It’s still unclear what could happen with misoprostol, a drug that’s used in medication abortion as well as to treat ulcers.

National Stability and Regional Shifts in Provision

New full-year estimates from Guttmacher Institute’s Monthly Abortion Provision Study show that the total number of abortions provided in all US states without total abortion bans remained relatively stable between 2023 and 2024, increasing by 1%. However, the share of abortions in states without total bans that were provided via online-only clinics rose to 15% in 2024 from 10% in 2023. This stability at the national level masked substantial variability across individual states.

State-Level Abortion Provision Data (2023–2024)

• Florida: Experienced a decline of 11,200 abortions provided in 2024 compared to 2023.
• South Carolina: Had 2,700 fewer abortions provided in 2024 than in 2023.
• Wisconsin: Large increase from 1,300 abortions provided in 2023 to 6,500 in 2024.
• Virginia: Substantial increase of approximately 6,600 abortions provided.
• Washington: The number of abortions provided rose 23% last year, with more than 20,000 performed in 2022.

Geographic Barriers and Legislative Access

Access does not simply rely on states’ abortion laws, but rather is a product of geographic access, legislative access, and health care professional availability. Research has found that 41.8% of U.S. women of reproductive age have to drive 30 minutes or more to reach an abortion care facility. Even within a state where abortion is not restricted (such as Washington state), the time it takes for a person to travel to an abortion facility can vary widely. Now, many people in the South are traveling out of state to seek an abortion — either in-clinic or via medication abortion.