Abortions Increase As Mail-Order Pills Undermine State Laws

The CLI report, titled “How Many Abortions Are Occurring in America Post-Dobbs? A September 2026 Update,” synthesized abortion estimates from two pro-abortion groups, the Guttmacher Institute’s Monthly Provision Study and the Society of Family Planning’s #WeCount reports.

According to CLI, most abortions occurring post-Dobbs are still occurring the same way they did pre-Dobbs, which is “in person, in states where abortion is still legal and obtained by residents of those states.” The report stated that 72 percent of abortions tracked in the formal U.S. health care system were still performed at traditional brick-and-mortar facilities in 2025, whether they were surgical or merely dispensing the abortion pill in person. However, this number decreased from 78 percent in 2024, while the number of women using telehealth and mail-order pills increased. CLI reported that 28 percent of abortions were performed via telehealth and mail-order pills in 2025, an increase from 22 percent in 2024.

Notably, 139,650 women traveled out of their state of residence for an abortion in 2025, a steady decrease from 152,830 in 2024 and 167,840 in 2023, the report stated. Commensurate with this decrease, online-only abortion organizations increased from 20 to 34 sending abortion drugs into all 50 states and Washington, D.C.

This data shows that the primary driver of these post-Dobbs annual abortion increases are women having chemical abortions via mail-order drugs. While the report states that the initial abortion surges post-Dobbs (2022-2023) were driven by out-of-state travel from pro-life states to pro-abortion states, the 2025 increases can be attributed to an increase in telehealth prescriptions from both traditional facilities and from online-only abortion organizations due to easier access, lower costs, as well as shield laws protecting abortion providers who send chemical abortion drugs into pro-life states where abortion is illegal.

After Dobbs, the Biden administration in January 2023 removed the FDA’s safeguards from the abortion pill mifepristone. Before 2023, the FDA’s Risk Evaluation and Mitigation Strategy (REMS) for mifepristone required an in-person visit to a doctor before the pill could be prescribed. This safety requirement ensured that a physician could ensure the pregnant woman was under the FDA’s 10-week gestational limit for prescribing the drug and that the woman did not have an ectopic pregnancy, which could result in death if not properly diagnosed and treated.

Recently, the U.S. Fifth Circuit Court of Appeals heard oral arguments in Louisiana v. FDA, a case that challenges the FDA’s removal of these safeguards and seeks their reinstatement. Despite having a near-total abortion ban after conception and a law that classifies abortion pills as “controlled substances,” Louisiana officials estimate from abortion industry statistics that roughly 1,000 illegal mail-order abortions occur monthly in the state due to mifepristone being mailed in from out-of-state entities.

Louisiana Attorney General Liz Murrill told the Fifth Circuit that federal deregulation of mifepristone has created a “superhighway of mail-order drugs” that directly frustrates state-level abortion bans. Murrill also noted that the drug’s deregulation directly affects pro-life states through taxpayer-funded medical costs.

“[W]e are bearing [the cost of] Medicaid programs dealing with women who show up in the emergency room and need care after taking these pills illegally,” said AG Murrill. “We see these situations arising all the time now, and we can show a direct correlation to the Biden administration’s policy because it is facilitating the flood of these pills into our state. And then the shield laws in some other states are contributing to our inability to hold people accountable and through other means.”

Liberty Counsel filed an amicus brief in the case arguing that widespread abortion access is exposing unmonitored women to dangerous complications and reinstating the REMS restrictions would correct the FDA’s failure to ensure drug safety.

Meanwhile, as litigation attempts to once again restrict abortion pills, CLI confirms that 17 pro-life states saw overall abortion increases from 2024 to 2025 due to telehealth prescriptions mailed from eight different shield law states.

“[T]here is no lack of access to abortion in America,” reads the CLI report. “Even today, state health departments mistakenly claim these pro-life states with life-at-conception laws are abortion-free because the number of in-person abortions has decreased to almost zero in most of these states. However, the latest data shows that these states are anything but abortion-free.”

Liberty Counsel Founder and Chairman Mat Staver said, “Reinstating the in-person requirements for chemical abortion drugs would significantly change the current abortion landscape in America. It would effectively close the mail-order ‘superhighway’ of abortion drugs, eliminate online-only providers, and nullify shield-law mail distribution into pro-life states. Chemical abortions harm women physically and emotionally and cruelly kill defenseless children. The FDA must no longer ignore mifepristone’s safety dangers that destroy innocent lives and harm women.