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Latest Abortion Numbers: What the Changing Landscape Means for North Carolina

  • 7 days ago
  • 5 min read

For nearly fifty years, Roe v. Wade stood as a decisive barrier to meaningful pro-life protections across the country. That changed in 2022, when Dobbs v. Jackson Women’s Health Organization returned the question of abortion policy “to the people and their elected representatives.”

 

In the years since, the legal and practical landscape of abortion in the United States has shifted dramatically. States have moved in very different directions, creating a patchwork of laws that reflect deep moral and political divides. But as new data shows, while the landscape is changing, the continued pervasiveness of abortion remains tragic and deeply sobering.

 

A Changing Map, Not Yet a Declining Number

A recent report from the Guttmacher Institute estimates that the total number of clinician-provided abortions in the United States remained essentially unchanged between 2024 and 2025. After a 6% rise from 2023 to 2024 (1,059,610 to 1,123,600), there was a less than 1% rise in 2025 to 1,125,930. Nonetheless, this was the highest number of abortions nationwide since 2009. And, sadly, given that the data excludes “abortions that are not provided by US clinicians (including those provided through community health networks, international clinics, websites or other means),” if anything, “these findings represent an underestimate of the total number of abortions nationally.”

In other words, the end of Roe has not yet translated into a sustained national decline in abortion. Instead, it has reshaped where and how abortions occur.

 

A Varied Legal Landscape

Since Dobbs, states have been able to adopt their own abortion laws. As a result, different states have adopted substantially different policies limiting or allowing abortion, reflecting stark political contrasts on the pro-life issue. We now have a wide range of state policies:

  • Twelve states now have laws that provide full 9-month protections

  • Four states have heartbeat protections

  • North Carolina and Nebraska have set limits at twelve weeks

At the same time:

  • Nine states and Washington, D.C., have no gestational limits

  • Fifteen states allow abortion until fetal viability

  • Five additional states permit abortion at 20 weeks or later

This patchwork has created a new reality: access to abortion increasingly depends not just on whether it is legal, but where a person is willing—and able—to go. That reality is especially evident in North Carolina.

 

North Carolina: A Regional Destination

With the passage of SB 20—Care for Women, Children, and Families Act in 2023, our state took an important step by limiting most abortions after twelve weeks. At the same time, however, this policy has made North Carolina one of the least restrictive states in the Southeast, with only Virginia being less restrictive. The result is clear in the data: North Carolina, like the United States more broadly, saw minimal change in abortion numbers after passage.

Worse yet, because North Carolina’s laws are less restrictive than many of our neighboring states, we have become a regional destination for abortion. North Carolina is the second highest in the nation—behind only Illinois—in the number of abortions provided to patients traveling from out of state. Women are coming here from across the region, including Alabama, Florida, Georgia, South Carolina, Tennessee, and Texas. In fact, more than one-third of all abortions performed in North Carolina in recent years have been for out-of-state patients. And while Illinois has seen a decline in such travel, North Carolina has experienced an increase of more than ten percent between 2023 and 2025.

 

Put simply, policies matter—and ours are shaping not just what happens within our borders, but across the Southeast.

 

The Deeper Shift: Telehealth and Chemical Abortions

At the same time, another transformation is underway—one that is less visible, but just as significant. Nationally, interstate travel for abortion has begun to decline. But this is not primarily because fewer abortions are taking place. Instead, it reflects a growing reliance on chemical abortions, increasingly obtained through telehealth and online distribution.

 

By 2023, more than 60 percent of clinician-provided abortions were chemical. Telemedicine-only clinics accounted for roughly 10 percent. And according to data from #WeCount, telehealth abortions have surged from under 4 percent in April 2022 to more than 28 percent by June 2025. North Carolina has not been immune to this trend, with telehealth abortions exceeding 17 percent by mid-2025.

 

Just as concerning is the growing availability of abortion pills through online vendors that operate with little to no meaningful oversight. This shift makes enforcement more difficult, weakens existing safeguards, and raises serious concerns about both legality and safety.

 

A Policy Response: Addressing the New Reality

Recognizing these challenges, state lawmakers have introduced HB 553—Ensuring Patient Safety with Mail Order Meds.This legislation seeks to address the rise of mail-order abortion drugs by extending North Carolina law to out-of-state providers and holding individuals and organizations accountable even when operating beyond state lines. It also would establish criminal penalties for violations and help ensure that abortion-inducing drugs not approved by the Food and Drug Administration (FDA) could not be distributed.

 

Importantly, the bill would automatically align with federal safety determinations. If the FDA were to revoke or restrict approval of drugs like mifepristone based on their ongoing safety review, the distribution of those drugs in North Carolina would no longer be permitted. This stands in sharp contrast to efforts in some states to shield access to these drugs regardless of federal guidance.

 

Beyond legal questions, the rise of chemical abortion raises serious concerns about women’s health. Research from the Ethics and Public Policy Center highlights safety concerns associated with mifepristone: approximately one in seven women experience a serious adverse event or require additional medical intervention within 45 days of taking mifepristone.

 

This highlights a critical point: as abortion increasingly moves outside traditional clinical settings, the risks may become harder to track, regulate, and address.

 

Moving Forward: The Role of North Carolina

The latest data tells a complex story. Abortion in America has certainly not disappeared. Unfortunately, it may still be on the rise. While legislation has made abortion more geographically concentrated in some places, it has also become more decentralized through telehealth and mail-order access. Still, there is evidence that policy decisions matter.

 

North Carolina’s experience shows that even incremental changes—like those enacted through SB 20—can shape regional patterns and influence real outcomes. That should both encourage and challenge us: Encourage us, because progress is possible; Challenge us, because progress requires action, persistence, and perseverance.

 

If we hope to build on that foundation—to enact policies that protect both women and preborn children in an increasingly complex landscape—it will require informed, engaged citizens who are willing to speak clearly and compassionately on behalf of life.

 

The landscape is changing. The question now is whether we will continue to shape it. NC Family remains committed to advancing policies that protect life, and we are grateful for all of you who join us in advocating for the fundamental right to life.


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