Post-Dobbs abortions on the rise in Texas
Texas has seen the country's highest number of medication abortions via telehealth under shield law protections, with an average 3,427 monthly in the final quarter of 2024, per a national report. The big picture: The number of abortions in the U.S. continued to rise in 2024 — totaling 1.14 million — despite bans and restrictions in more than half the states, including Texas. Expanded telehealth access to medication abortion has allowed patients to circumvent state bans.
The Role of Telemedicine and Medication Abortion
The majority of U.S. abortions are now induced with medication instead of done surgically, and telemedicine providers of these pills will play a crucial role in serving patients who live in states that sharply limit or ban abortions. It was only in December that the Food and Drug Administration made permanent a rule change allowing patients to receive abortion pills by mail instead of having to visit specially certified providers in person.
Texas, which has a near-total ban on abortions, saw more monthly abortions by the end of 2024 than in the months before Roe v. Wade was overturned, according to the #WeCount report from the Society of Family Planning, a nonprofit that advocates for abortion access. The following data highlights the state of play in 2024:
| Metric | Data Point |
|---|---|
| Total U.S. abortions (2024) | 1.14 million |
| Texas telehealth medication abortions (Q4 2024 average) | 3,427 per month |
| Access method | Telehealth and medication (pills by mail) |
Legal Protections and Judicial Conflict
Shield laws are meant to provide legal protections to clinicians who offer telehealth abortion care to patients in states with restrictions. However, these protections face significant legal challenges. In February, a Texas judge ordered a doctor to stop prescribing and sending abortion pills under New York's shield law to patients in Texas and to pay a penalty of more than $100,000.
“I’m fully aware that my days in certain places may be limited,” said Melissa Grant, chief operations officer of Carafem, which provides both telemedicine and in-person abortion. Now telemedicine abortion providers will have to grapple with how to serve patients across the country as more states are expected to restrict and criminalize abortions.
Future Outlook
"This is exactly the kind of case where it really involves a conflict between states and so it's inevitable that it will make it to the Supreme Court," Carmel Shachar, director of the Health Law and Policy Clinic at Harvard Law School, told Harvard Law Today in February regarding the clash between state bans and shield laws.