The Impact of the Dobbs Decision on Self-Managed Abortions and Telehealth Access
Self-managed abortions rose by more than 26,000 in the six months after the U.S. Supreme Court overturned Roe v. Wade nearly two years ago, according to a peer-reviewed study published Monday in JAMA, the American Medical Association’s journal. The Dobbs v. Jackson Women’s Health Organization ruling in June 2022 overturned the federal right to abortion, returning the decision to the states and leading to 14 with near-total abortion bans.
Growth in Self-Managed Care and Medication Provision
Researchers determined that an increase of approximately 27,838 online orders of abortion pills between July and December 2022 corresponded to the findings of an additional 26,055 medication abortions reported outside the formal health care system. Post-Dobbs, there was an estimated monthly average of 5,931 provisions — orders — of abortion pills from those main sources. That’s a 322% increase from a pre-Dobbs average of 1,407 provisions per month, according to the study.
Researchers analyzed data provided by telemedicine organizations — such as Aid Access, an international abortion pill provider, community networks and online vendors. Community networks — organizations run by volunteers that sometimes work offline or through hotlines and provide pills at no-cost to recipients — accounted for more than half of all abortion pill orders.
Telehealth Trends and Statistics
Telehealth abortion has really had a huge impact. Abortions through telehealth increased post-Dobbs, according to a Society of Family Planning #WeCount report. They made up 16% of all reported abortions as of September 2023. Before Dobbs, just 4% of all abortions were telehealth abortions. By 2024, about 25% of abortions in the U.S. were provided through telehealth. Receiving abortion pills by mail has become an important option for expanding abortion access to people who want timely, medically supported care.
| Metric | Pre-Dobbs (2020-2022) | Post-Dobbs (2022-2024) |
|---|---|---|
| Monthly average pill provisions | 1,407 | 5,931 |
| Percentage of abortions via telehealth | 4% - 5% | 16% - 25% |
| Clinician-provided medication abortions | N/A | 63% (in 2023) |
The Status of Mifepristone and Legal Challenges
The U.S. Food and Drug Administration approved a key abortion pill mifepristone for use in 2000. Since the FDA approved mifepristone in 2000, 32 deaths have been associated with the drug’s use as of December 2022. The U.S. Supreme Court will take up a case challenging that approval. Alliance for Hippocratic Medicine, an anti-abortion group of physicians, is asking the court to rule that the U.S. Food and Drug Administration should revert to pre-2016 mifepristone regulations. The change would reduce mifepristone’s use from 10 weeks gestation to seven, alter the dosage, and require three in-person visits.
State Laws and Shield Protections
Nearly half of all states have abortion bans or restrictions prior to viability. Currently, 12 states are considered to have total abortion bans. As an unprecedented number of people travel out of state to receive care, they have to worry about shield laws, which protect patients and doctors from legal consequences. For example, 22 states and D.C. have protections against out-of-state investigations and prosecutions. Eight states now offer broad legal protections for telehealth abortion care, allowing providers to offer virtual abortion care and mail medication to clients living in states with total abortion bans.