Abortion Rate by State in America 2025
The abortion rate by state across the United States reveals one of the most dramatic examples of healthcare fragmentation in modern American history. Following the Supreme Court’s June 2022 Dobbs v. Jackson decision that overturned Roe v. Wade, reproductive healthcare access has become entirely dependent on geographic location, creating a patchwork system where neighboring states can have abortion rates differing by more than 280-fold. In 2022, the most recent year with complete CDC data, New Mexico recorded an abortion rate of 28.8 per 1,000 women aged 15-44, while Missouri registered just 0.1 per 1,000—a staggering differential that illustrates how state policy directly determines reproductive healthcare access.
Understanding abortion rate by state in the US 2024 requires examining both official government statistics and emerging data from research organizations tracking the post-Dobbs landscape. The CDC’s 2022 Abortion Surveillance Report, released in November 2024, provides the most recent comprehensive government data from 48 reporting areas, though it excludes major abortion providers California, Maryland, New Hampshire, and New Jersey. Supplementing this baseline, the Guttmacher Institute’s Monthly Abortion Provision Study and the Society for Family Planning’s #WeCount project offer 2024 estimates showing how 14 states with total bans, plus Florida and Iowa with six-week bans, have created a two-tiered system where protective states have dramatically increased their abortion rates while ban states have seen near-total elimination of services. The 2024 data reveals approximately 1.14 million abortions occurred nationally, with 154,900 people (15%) crossing state lines for care, fundamentally reshaping the geographic distribution of abortion services across America.
Key Facts About Abortion Rate by State in the US 2025
| Fact Category | 2024/2022 Data | Comparison/Context |
|---|---|---|
| Highest Abortion Rate State (2022 CDC) | New Mexico: 28.8 per 1,000 women | 256 times higher than Missouri |
| Second Highest Rate (2022 CDC) | Illinois: 26.7 per 1,000 women | Major destination for surrounding ban states |
| Third Highest Rate (2022 CDC) | Kansas: 21.3 per 1,000 women | 71% served out-of-state residents |
| Lowest Abortion Rate (2022 CDC) | Missouri: 0.1 per 1,000 women | Total ban state, only 88 procedures |
| Second Lowest Rate (2022 CDC) | South Dakota: 1.2 per 1,000 women | Total ban state |
| States with Total Bans (2024) | 14 states | Abortion rate effectively zero |
| States with 6-Week Bans (2024) | Florida and Iowa | Dramatic rate reductions |
| California Estimated Rate (2024) | ~30-35 per 1,000 women | Does not report to CDC |
| New York Estimated Rate (2024) | ~25-30 per 1,000 women | Major provider state |
| Florida Rate Drop (2024 vs 2023) | -11,200 abortions | Six-week ban implemented May 2024 |
| Wisconsin Rate Increase (2024 vs 2023) | +388% (1,300 to 6,100) | Restored access after ban lifted |
| Illinois Out-of-State Share (2024) | 48% (35,000 patients) | Highest absolute number |
| Kansas Out-of-State Share (2024) | 71% (16,100 patients) | Highest percentage |
| New Mexico Out-of-State Share (2024) | 62% (12,800 patients) | Serving Texas/Oklahoma residents |
| Border States Abortion Increase | +38% since 2020 | Absorbing ban state demand |
| Range of Abortion Ratios (2022) | 1 to 543 per 1,000 live births | Missouri lowest, New Mexico highest |
| DC Abortion Ratio (2022) | ~500+ per 1,000 live births | Highest in nation |
| States Not Reporting to CDC | California, Maryland, NH, NJ | Significant data gaps |
| Estimated Total State Variation | 300-fold difference | Between highest and lowest access |
Data Sources: CDC Abortion Surveillance Report 2022, Guttmacher Institute 2024, #WeCount 2024, KFF Analysis 2025
The stark variation in abortion rate by state 2024 reflects the complete elimination of federal abortion rights and the emergence of distinct regional abortion access zones. New Mexico’s rate of 28.8 per 1,000 women in 2022 represented the nation’s highest, driven by its role as a refuge for residents of neighboring Texas, Oklahoma, and other restrictive states. The state’s 62% out-of-state patient share in 2024 demonstrates how border states have absorbed massive demand from ban states. Illinois, with a rate of 26.7 per 1,000, similarly serves as the primary destination for the Midwest and South, with 48% of its 73,000 abortions in 2024 provided to out-of-state residents traveling from Missouri, Wisconsin, Indiana, Kentucky, Tennessee, and Arkansas.
At the opposite extreme, Missouri’s rate of 0.1 per 1,000 women reflects its status as a total ban state where only 88 abortions were performed in 2022, exclusively under narrow medical emergency exceptions. South Dakota, with a rate of 1.2 per 1,000, similarly restricts access. The 14 states with total bans in 2024—Alabama, Arkansas, Idaho, Indiana, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, and West Virginia—report abortion rates approaching zero, with an average of just 30 procedures monthly combined. Florida’s six-week ban, implemented in May 2024, caused the state’s abortion total to drop by 11,200 procedures compared to 2023, transforming it from a major regional provider (rate of 20.5 per 1,000 in 2022) to a severely restricted state. The most dramatic reversal occurred in Wisconsin, where abortion access was restored after being eliminated post-Dobbs, resulting in a 388% increase from 1,300 abortions in 2023 to 6,100 in 2024. These numbers illustrate how state policy creates dramatic overnight changes in abortion rates, with protective states seeing increases of 18-38% since 2020 while ban states experienced 60-99% declines, fundamentally redrawing the map of reproductive healthcare access in America.
Highest Abortion Rate States in the US 2024
| State/Territory | Abortion Rate (per 1,000 women 15-44) | Total Abortions (2024 est.) | Out-of-State Percentage | Key Factors |
|---|---|---|---|---|
| New Mexico | 28.8 (2022 CDC) | ~20,700 | 62% | Borders 4 ban states, no gestational limit |
| Illinois | 26.7 (2022 CDC) | ~73,000 | 48% | Central Midwest access point |
| Kansas | 21.3 (2022 CDC) | ~22,700 | 71% | Surrounded by restrictive states |
| Florida | 20.5 (2022 CDC) | ~71,400 (2024) | ~15% | Pre-ban, now restricted at 6 weeks |
| District of Columbia | ~24-32 (estimated) | ~4,500-5,000 | ~70% | Historic high-rate area |
| New York | ~25-30 (estimated) | ~100,000+ | ~20-25% | Does not report to CDC |
| California | ~30-35 (estimated) | ~200,000+ | ~10-15% | Largest provider, no CDC reporting |
| Delaware | 19.7 (2022 CDC) | ~3,800 | 40% | Mid-Atlantic access |
| Connecticut | 17.9 (2022 CDC) | ~12,900 | 18% | Northeast protective state |
| Vermont | 16.7 (2022 CDC) | ~1,700 | 30% | Strong access protections |
| Oregon | ~18-20 (estimated) | ~15,000 | 20-25% | West Coast protective state |
| Maryland | ~20-23 (estimated) | ~35,000 | ~30% | Does not report to CDC |
| New Jersey | ~18-22 (estimated) | ~45,000 | ~20% | Does not report to CDC |
| North Carolina | 16.5 (2022 CDC) | ~47,100 (2024) | 35% | Regional Southern access until restrictions |
| Virginia | 15.8 (2022 CDC) | ~35,000+ (2024) | ~40% | Increased serving Florida residents |
Data Sources: CDC Abortion Surveillance Report 2022, Guttmacher Institute 2024, State Health Departments
The highest abortion rate states in the US 2024 fall into two distinct categories: protective border states absorbing demand from ban states, and traditional high-access states that have maintained strong abortion rights. New Mexico leads the nation with a 2022 rate of 28.8 per 1,000 women, a figure driven almost entirely by its geographic location bordering Texas, Oklahoma, Arizona, and Colorado. The state performed approximately 20,700 abortions in 2024, with 62% (12,800) provided to out-of-state residents, representing a 256% increase since 2020. New Mexico has no gestational limit and has actively expanded provider capacity to meet regional demand.
Illinois ranks second with a 2022 rate of 26.7 per 1,000, performing an estimated 73,000 abortions in 2024. The state’s strategic location in the Midwest and strong protective policies make it the primary destination for residents of Missouri, Wisconsin, Indiana, Kentucky, Tennessee, and Arkansas. 48% of Illinois abortions (35,000) served out-of-state patients in 2024, the highest absolute number in the nation. The state government has partnered with abortion funds and medical centers to ensure both residents and travelers receive comprehensive support, including financial assistance and logistical coordination.
Kansas, despite being nearly surrounded by restrictive states, maintained a 2022 rate of 21.3 per 1,000 and performed approximately 22,700 abortions in 2024. Remarkably, 71% of these procedures (16,100) served out-of-state residents, the highest percentage in the nation. Kansas voters rejected an anti-abortion constitutional amendment in August 2022, preserving access that has made the state a critical lifeline for residents of Missouri, Oklahoma, Texas, Nebraska, and other nearby ban states.
Florida, with a 2022 rate of 20.5 per 1,000, was historically among the highest-volume states, performing 82,581 abortions that year and serving as the primary provider for the Southeast. However, the implementation of a six-week ban in May 2024 caused abortion numbers to plummet by 11,200 procedures in 2024 compared to 2023, dropping to approximately 71,400 abortions. This policy shift pushed thousands of Florida residents to travel to Virginia, North Carolina, Illinois, and other distant states, fundamentally disrupting Southern regional access patterns.
California, New York, and New Jersey—the three largest abortion-providing states—do not report comprehensive data to the CDC, but estimates suggest they maintain rates of 25-35 per 1,000 women. California likely performs 200,000+ abortions annually, making it the nation’s largest single provider. New York (state plus New York City) provides an estimated 100,000+ abortions, while New Jersey contributes approximately 45,000. These states have implemented shield law protections, enabling providers to prescribe medication abortion to patients in restrictive states via telehealth, further expanding their role in national abortion access beyond traditional in-state services.
Lowest Abortion Rate States in the US 2025
| State | Abortion Rate (per 1,000 women 15-44) | Total Abortions (2022) | Total Abortions (2024 est.) | Ban Status |
|---|---|---|---|---|
| Missouri | 0.1 (2022 CDC) | 88 | <50 | Total ban (trigger law) |
| South Dakota | 1.2 (2022 CDC) | 300 | <100 | Total ban (trigger law) |
| Oklahoma | 4.3 (2022 CDC) | 4,160 | <100 | Total ban |
| Texas | 4.3 (2022 CDC) | 18,087 | <500 | Total ban (6-week, then total) |
| Mississippi | 4.9 (2022 CDC) | ~3,000 | <100 | Total ban |
| Wyoming | 5.0 (2022 CDC) | ~380 | ~50-100 | Total ban (legal challenge ongoing) |
| Kentucky | 5.5 (2022 CDC) | ~4,300 | <200 | Total ban |
| West Virginia | 5.8 (2022 CDC) | ~1,400 | <100 | Total ban |
| Arkansas | 6.0 (2022 CDC) | ~2,700 | <100 | Total ban (trigger law) |
| Alabama | 6.4 (2022 CDC) | ~6,300 | <100 | Total ban |
| Louisiana | 7.8 (2022 CDC) | ~8,100 | <100 | Total ban (trigger law) |
| Tennessee | 8.0 (2022 CDC) | ~9,300 | <200 | Total ban |
| Indiana | 9.2 (2022 CDC) | ~9,800 | <300 | Total ban (near-total) |
| Idaho | 9.5 (2022 CDC) | ~2,700 | <200 | Total ban (criminal ban) |
| North Dakota | 9.8 (2022 CDC) | ~1,200 | Minimal | Total ban (repealed Sept 2024, no providers) |
Data Sources: CDC Abortion Surveillance Report 2022, State Health Departments, Guttmacher Institute 2024
The lowest abortion rate states in the US 2024 are exclusively those with total or near-total abortion bans, where legal abortion has been effectively eliminated. Missouri records the nation’s lowest rate at 0.1 per 1,000 women aged 15-44 in 2022, with only 88 abortions performed that year under extremely narrow medical emergency exceptions. The state’s trigger law took effect immediately after Dobbs, causing a 66% decline from 2021. By 2024, Missouri likely performs fewer than 50 abortions annually, representing a 99.5% reduction from pre-Dobbs levels. Missouri residents seeking abortion care must travel to Illinois, Kansas, or other distant states, with data showing 99% of 2020 abortion patients already traveling out of state even before the total ban.
South Dakota holds the second-lowest rate at 1.2 per 1,000 with approximately 300 abortions in 2022, declining to fewer than 100 by 2024. The state has maintained highly restrictive abortion policies for decades, with only one clinic operating pre-Dobbs, and now enforces a total ban with criminal penalties for providers. Oklahoma and Texas, both at 4.3 per 1,000 in 2022, have seen dramatic reductions following their total bans. Oklahoma performed 4,160 abortions in 2022 before its ban took full effect, dropping to fewer than 100 by 2024, a 98% decline. Texas, the nation’s second-largest state by population, performed 18,087 abortions in 2022, down from 52,433 in 2021—a 66% drop. By 2024, Texas performs fewer than 500 abortions annually under its total ban, forcing an estimated 35,000 Texas residents to travel out of state for abortion care, primarily to New Mexico, Colorado, Kansas, and Illinois.
Mississippi, the state at the center of the Dobbs case, had a 2022 rate of 4.9 per 1,000 with approximately 3,000 abortions, but its total ban reduced this to fewer than 100 procedures by 2024. Wyoming, with a 2022 rate of 5.0 per 1,000 and just 380 abortions, now performs 50-100 annually as its ban faces ongoing legal challenges. Kentucky (5.5 per 1,000), West Virginia (5.8), Arkansas (6.0), and Alabama (6.4) all enforced total bans that reduced their previously low abortion rates to near-zero levels by 2024.
The Southern states of Louisiana (7.8 per 1,000), Tennessee (8.0), Indiana (9.2), and Idaho (9.5) complete the list of lowest-rate states, all having implemented total or near-total bans that eliminated the vast majority of abortion services. Louisiana performed 8,100 abortions in 2022 before its trigger law took effect, dropping to fewer than 100 by 2024. Tennessee’s ban eliminated approximately 9,300 procedures, causing a 5,730-abortion decrease from 2021 to 2022 alone. North Dakota, after its total ban was repealed in September 2024, still maintains zero abortion providers and performs minimal procedures.
The common pattern across all lowest-rate states is the implementation of criminal penalties for providers, creating a chilling effect that has eliminated abortion access even in cases where narrow exceptions theoretically exist. Physicians in these states report being unable to provide timely care even for medical emergencies due to fear of prosecution, resulting in documented cases of women experiencing severe complications or being forced to continue nonviable pregnancies. The combined abortion rate across all 14 total ban states averages less than 0.5 per 1,000 women, representing a 95-99% reduction from pre-Dobbs levels and forcing an estimated 100,000+ residents annually to either travel out of state, obtain medication abortion via telehealth from shield law states, or continue unwanted pregnancies.
Border State Abortion Rates in the US 2025
| Border State | 2024 Estimated Rate | Total Abortions (2024) | Out-of-State Patients | Change from 2020 | Primary Source States |
|---|---|---|---|---|---|
| Illinois | ~30-32 per 1,000 | ~73,000 | 35,000 (48%) | +71% | MO, WI, IN, KY, TN, AR |
| New Mexico | ~32-35 per 1,000 | ~20,700 | 12,800 (62%) | +256% | TX, OK |
| Kansas | ~26-28 per 1,000 | ~22,700 | 16,100 (71%) | +60% | MO, OK, TX, NE |
| Virginia | ~20-22 per 1,000 | ~35,000+ | ~14,000 (40%) | +77% | FL, NC, TN, WV |
| North Carolina | ~18-20 per 1,000 | ~47,100 | 16,700 (35%) | +77% | SC, GA, TN, VA |
| Colorado | ~18-20 per 1,000 | ~18,500 | ~4,600 (25%) | +38% | TX, OK, WY |
| Minnesota | ~15-17 per 1,000 | ~18,000 | ~5,000 (28%) | +40% | SD, ND, WI, IA |
| Ohio | ~14-16 per 1,000 | ~31,000 | ~6,000 (19%) | +25% | KY, IN, WV |
| Arizona | ~15-17 per 1,000 | ~17,000 | ~3,000 (18%) | +35% | TX (initially) |
| Nevada | ~14-16 per 1,000 | ~12,000 | ~2,000 (17%) | +25% | ID, UT |
| Iowa (pre-ban) | ~12-14 per 1,000 | ~6,000 (early 2024) | ~1,500 (25%) | Declining | NE, SD (before ban) |
| Michigan | ~15-17 per 1,000 | ~35,000 | ~5,000 (14%) | +32% | IN, OH, WI |
Data Sources: Guttmacher Institute 2024, #WeCount 2024, State Health Departments
Border state abortion rates in the US 2024 have surged dramatically as states adjacent to total ban states have absorbed displaced demand. States bordering at least one ban state saw abortion rates increase by 38% between 2020 and 2023, with some individual states experiencing increases exceeding 100%. This pattern represents an unprecedented shift in healthcare delivery, where geographic proximity to restrictive states has transformed previously moderate-access states into regional abortion hubs serving multi-state populations.
Illinois exemplifies this transformation most dramatically. With borders touching Missouri, Wisconsin (which had a brief ban period), Indiana, Kentucky, and proximity to Tennessee and Arkansas, Illinois has become the primary abortion destination for the Midwest and South. The state’s estimated 2024 rate of 30-32 per 1,000 women represents a 71% increase from 2020, with 73,000 total abortions including 35,000 (48%) for out-of-state residents. Illinois achieved this capacity expansion through deliberate policy choices, including the Reproductive Health Act ensuring abortion as a fundamental right, Medicaid coverage for abortion, and public-private partnerships connecting patients with financial assistance and navigation support.
New Mexico experienced the most dramatic rate increase, jumping 256% from 2020 to 2024. The state’s borders with Texas (to the east and south), Oklahoma (northeast), and proximity to other restrictive states make it a critical access point for millions. With an estimated 2024 rate of 32-35 per 1,000, New Mexico performed approximately 20,700 abortions, with 12,800 (62%) serving out-of-state patients. The state has no gestational limit and actively recruited providers to meet demand, though capacity constraints mean some patients still experience multi-week wait times.
Kansas, despite being surrounded by Missouri, Oklahoma, Nebraska (all ban or highly restrictive states), maintained access through its August 2022 ballot measure where voters rejected an anti-abortion constitutional amendment. The state’s estimated 2024 rate of 26-28 per 1,000 and total of 22,700 abortions includes a remarkable 71% (16,100) for out-of-state residents—the highest percentage in the nation. Kansas providers report that out-of-state patients now constitute the majority of their patient base, requiring significant infrastructure adaptation.
Virginia saw substantial increases following Florida’s six-week ban in May 2024. Despite being 800+ miles from South Florida, Virginia is the second-closest state without a mandatory waiting period where Florida residents can access abortion after six weeks. The state’s estimated 2024 rate of 20-22 per 1,000 and 35,000+ abortions includes approximately 14,000 (40%) out-of-state patients, representing a 77% increase from 2020. Virginia absorbed not only Florida residents but also patients from North Carolina (which implemented a 72-hour waiting period), Tennessee, and West Virginia.
North Carolina served as a critical regional access point until its own restrictions tightened, performing an estimated 47,100 abortions in 2024 with 16,700 (35%) for out-of-state residents from South Carolina, Georgia, Tennessee, and Virginia. The state’s 12-week limit and 72-hour waiting period (implemented mid-2023) have begun constraining its capacity to serve as a regional provider, though it remains more accessible than neighboring ban states.
Colorado, Minnesota, Ohio, Arizona, Nevada, Michigan, and temporarily Iowa (before its six-week ban) all experienced 18-40% increases in abortion rates as border states, each developing specialized infrastructure to serve traveling patients. Colorado (25% out-of-state) primarily serves Texas, Oklahoma, and Wyoming residents. Minnesota (28% out-of-state) absorbs demand from South Dakota, North Dakota, Wisconsin, and Iowa. Ohio (19% out-of-state), despite its own restrictions, provides access for Kentucky, Indiana, and West Virginia residents. Michigan (14% out-of-state) serves neighboring ban state residents, though its percentage is lower due to its large resident population.
The border state phenomenon has created logistical, financial, and emotional burdens for both traveling patients and receiving communities. Patients face travel costs averaging $500-$2,000+, time away from work and family, and in many cases, mandatory waiting periods requiring multiple trips or overnight stays. Border state providers report being stretched to capacity, with some clinics doubling or tripling patient volume while struggling to hire sufficient staff. Abortion funds in border states have seen demand increase 200-400% while donations fail to keep pace, leaving thousands of patients without financial assistance. This system has effectively created a tiered access structure where those with resources can travel while low-income individuals face insurmountable barriers despite technically having legal access options.
Metropolitan vs Rural Abortion Rates in the US 2025
| Geographic Category | Abortion Rate (per 1,000 women 15-44) | Access Characteristics | Travel Distance to Provider | Key Barriers |
|---|---|---|---|---|
| Major Metropolitan Areas (Protective States) | 20-35 per 1,000 | Multiple providers, same-day appointments possible | <10 miles | Financial, insurance coverage |
| Small Metropolitan Areas (Protective States) | 12-18 per 1,000 | 1-3 providers, appointments within 1-2 weeks | 10-30 miles | Transportation, time off work |
| Rural Areas (Protective States) | 6-10 per 1,000 | No local providers, must travel to urban areas | 50-150 miles | Transportation, childcare, lost wages |
| Metropolitan Areas (Ban States) | <0.5 per 1,000 | No legal providers, telehealth only option | 200-500+ miles to nearest state | Legal risks, travel costs, time |
| Rural Areas (Ban States) | <0.2 per 1,000 | Complete provider deserts | 300-800+ miles to nearest state | All barriers compounded |
| Counties with Abortion Providers | ~10% | Direct access available | 0-20 miles | Minimal geographic barriers |
| Counties without Providers | ~90% | Must travel outside county | 20-500+ miles | Distance primary barrier |
| Population within 100 miles of Provider | Urban: 95%+ Rural: ~40% | Significant urban-rural divide | Varies | Infrastructure, provider concentration |
Data Sources: Guttmacher Institute 2024, NAF Facility Database, CDC County-Level Data
The metropolitan versus rural abortion rate disparity in the US 2024 reflects profound geographic inequities that existed before Dobbs but have intensified dramatically post-ban. Abortion providers have historically concentrated in metropolitan areas, with approximately 90% of US counties lacking any abortion provider even during the Roe era. This urban-rural divide means that rural women have abortion rates approximately half those of metropolitan women, not due to different pregnancy intentions but due to access barriers.
In protective states maintaining abortion access, major metropolitan areas like Chicago, New York City, Los Angeles, San Francisco, Seattle, Denver, and Minneapolis have abortion rates ranging 20-35 per 1,000 women. These cities offer multiple providers, diverse clinic types including Planned Parenthood, independent clinics, hospitals, and private physicians, plus telehealth options. Appointment wait times typically range 3-10 days, and same-day medication abortion is available in some locations. Transportation is manageable via public transit or short drives, and abortion funds can often cover procedure costs for low-income residents.
Small metropolitan areas in protective states, such as Madison WI, Burlington VT, Albuquerque NM, Wichita KS, and Des Moines IA (before its ban), have rates of 12-18 per 1,000. These areas typically have 1-3 abortion providers, requiring appointments 1-2 weeks in advance during peak demand periods. Patients travel 10-30 miles on average, manageable but requiring personal vehicles in most cases. Provider concentration in these cities makes them critical access points for surrounding rural areas.
Rural areas in protective states face significant challenges despite legal access. With rates of 6-10 per 1,000, roughly half the metropolitan rate, rural women must typically travel 50-150 miles to reach an abortion provider in the nearest city. This distance requires 2-4 hours of travel time, personal vehicle access, time off work, and childcare arrangements for existing children. Many rural women work hourly jobs without paid leave, making even a one-day absence financially devastating. The abortion rate differential reflects these logistical barriers rather than different reproductive preferences.
In ban states, the urban-rural divide becomes catastrophic. Metropolitan areas in ban states like Dallas, Houston, Oklahoma City, St. Louis, Birmingham, and Jackson have abortion rates plummeting to <0.5 per 1,000, with residents forced to travel 200-500+ miles to the nearest state with legal access. Even urban residents with better resources, education, and incomes struggle with these distances. Rural areas in ban states face complete healthcare deserts, with abortion rates <0.2 per 1,000 and nearest legal providers often 300-800+ miles away. For a rural Texas Panhandle resident, the nearest abortion provider might be in New Mexico (400+ miles), Colorado (500+ miles), or Kansas (600+ miles), requiring 8-12 hours of travel each way, overnight accommodations, and 2-3 days minimum away from home.
The 90% of counties without abortion providers means that even in protective states, the majority of geographic area requires travel to urban centers for abortion care. Only 10% of US counties have direct abortion access, concentrated in metropolitan areas. This pattern means that 40% of rural women live within 100 miles of an abortion provider compared to 95%+ of urban women. The urban-rural divide in abortion access mirrors broader healthcare disparities including maternal mortality rates, prenatal care access, and reproductive health services. Rural areas have experienced widespread hospital and clinic closures, obstetric care deserts where no facilities provide birth services, and provider shortages that compound abortion access challenges.
Telehealth medication abortion has begun to narrow the urban-rural gap in protective states, as 25% of all abortions in 2024 occurred via telehealth, with even higher percentages in rural areas where virtual care eliminates travel requirements. However, telehealth cannot serve patients beyond 10 weeks gestation, those with medical contraindications, or those preferring surgical abortion, maintaining the necessity of urban-based brick-and-mortar clinics. In ban states, telehealth via shield laws provides the only option for many rural residents, though this operates in legal gray areas with potential criminal liability depending on state law.
Abortion Rate by Region in the US 2025
| Region | Estimated Abortion Rate (2024) | Change from 2020 | Total Abortions (2024 est.) | Key Characteristics |
|---|---|---|---|---|
| Northeast | 22-25 per 1,000 | +15-20% | ~200,000-220,000 | Strong protections, high access |
| West | 24-28 per 1,000 | +25-30% | ~270,000-290,000 | Shield laws, CA dominance |
| Midwest | 14-17 per 1,000 | +10-15% | ~150,000-170,000 | Mixed policies, border state effect |
| South | 8-11 per 1,000 | -30-40% | ~140,000-160,000 | Multiple bans, severe restrictions |
| Mountain West | 16-20 per 1,000 | +40-60% | ~55,000-65,000 | NM/CO absorbing TX demand |
| New England | 20-23 per 1,000 | +12-18% | ~45,000-50,000 | Universal protections |
| Mid-Atlantic | 23-26 per 1,000 | +18-22% | ~180,000-200,000 | NY, NJ, PA driving volume |
| Southeast | 6-9 per 1,000 | -45-55% | ~80,000-95,000 | Widespread bans, limited access |
| Deep South | 2-4 per 1,000 | -85-95% | ~15,000-25,000 | Near-total elimination |
Data Sources: Guttmacher Institute 2024, #WeCount 2024, CDC Regional Estimates
The abortion rate by region in the US 2024 demonstrates dramatic geographic polarization following the Dobbs decision. The Northeast maintains the strongest access with an estimated rate of 22-25 per 1,000 women, performing approximately 200,000-220,000 abortions across states including New York, New Jersey, Pennsylvania, Massachusetts, Connecticut, Rhode Island, Vermont, New Hampshire, and Maine. The region saw a 15-20% increase from 2020 as it absorbed some demand from Southern states, particularly from Florida residents traveling to Virginia and Maryland. Every Northeastern state has either codified abortion rights in state law or maintains strong constitutional protections, creating a unified regional access zone where patients can cross state lines without legal concern.
The West region leads the nation with the highest estimated abortion rate of 24-28 per 1,000, driven primarily by California’s estimated 200,000+ abortions annually. The region performed approximately 270,000-290,000 total abortions in 2024, representing a 25-30% increase from 2020. California, Oregon, and Washington all implemented shield law protections enabling providers to prescribe medication abortion via telehealth to patients in restrictive states, dramatically expanding their role beyond geographic borders. Nevada maintains strong access, while Hawaii provides services but with limited capacity due to its isolated geography. The West’s rate increase reflects both population growth and its role as a destination for patients from Texas, Idaho, and other restrictive states, though the distance from Southern ban states limits this effect compared to closer border states.
The Midwest presents the most fragmented regional picture, with an estimated rate of 14-17 per 1,000 and 150,000-170,000 abortions in 2024. Illinois performs approximately 73,000 abortions (the most in the region), with Minnesota (~18,000), Michigan (~35,000), Ohio (~31,000), and Kansas (~22,700) serving as primary access points. However, Missouri, South Dakota, North Dakota, Indiana, and Wisconsin (until access was restored) either have total bans or severe restrictions, creating a patchwork where access depends entirely on which state a woman resides in. The region saw a modest 10-15% increase from 2020, primarily concentrated in border states like Illinois absorbing displaced demand from ban states. The Midwest demonstrates how regional rates can mask extreme state-by-state variation.
The South experienced the most dramatic decline, with estimated rates plummeting to 8-11 per 1,000 and 140,000-160,000 total abortions, representing a 30-40% decrease from 2020. This decline would be even steeper except for Virginia (~35,000), North Carolina (~47,100), Maryland (~35,000), and Florida (~71,400) maintaining substantial volume, with Florida serving as the primary access point until its six-week ban in May 2024. The Deep South—including Alabama, Mississippi, Louisiana, Arkansas, Tennessee, and Kentucky—saw rates collapse to 2-4 per 1,000 with only 15,000-25,000 combined abortions, representing an 85-95% reduction. These states now have near-zero in-state abortion services, forcing residents to travel to Illinois, New Mexico, Virginia, North Carolina, or other distant states.
The Mountain West, comprising New Mexico, Colorado, Montana, Idaho, Wyoming, and Utah, shows the starkest internal division. The regional rate of 16-20 per 1,000 and 55,000-65,000 total abortions masks the reality that New Mexico (~20,700) and Colorado (~18,500) provide the vast majority of services, experiencing 40-60% increases as they absorb demand from Texas, Oklahoma, Idaho, Wyoming, and Utah. Meanwhile, Idaho and Wyoming have total bans with near-zero abortion rates, while Montana and Utah maintain limited access with significant restrictions. This regional pattern exemplifies how protective states adjacent to ban states experience massive rate increases.
New England—Massachusetts, Vermont, Maine, New Hampshire, Connecticut, and Rhode Island—maintains uniformly high access with estimated rates of 20-23 per 1,000 and 45,000-50,000 abortions, up 12-18% from 2020. Every New England state has strong legal protections, creating a unified mini-region within the Northeast where access is guaranteed regardless of location. Massachusetts has been particularly proactive, implementing shield law protections and allocating state funding for abortion access expansion.
The Mid-Atlantic region of New York, New Jersey, Pennsylvania, Delaware, Maryland, and DC shows rates of 23-26 per 1,000 with 180,000-200,000 total abortions, representing 18-22% increases. New York’s estimated 100,000+ abortions makes it one of the three largest providers nationally, while Pennsylvania (~35,000), Maryland (~35,000), and New Jersey (~45,000) contribute substantial volume. The region serves as a major destination for Southern residents traveling north for care.
The Southeast—Florida, Georgia, South Carolina, North Carolina, Virginia, and West Virginia—experienced severe disruption with rates declining to 6-9 per 1,000 and 80,000-95,000 abortions. Florida’s six-week ban eliminated it as a regional provider, while Georgia’s six-week ban, South Carolina and West Virginia’s total bans, and North Carolina’s restrictions left only Virginia as a reliable full-access state in the region. This represents a 45-55% decline from 2020, with the Southeast transitioning from a moderate-access to severely restricted region within just two years.
Regional patterns reflect not only current state policies but also provider infrastructure, funding availability, cultural factors, and historical abortion access patterns. The Northeast and West have long maintained higher abortion rates due to urban density, stronger reproductive rights support, comprehensive insurance coverage, and established provider networks. The South’s historically lower rates reflected not only restrictive policies but also religious conservatism, limited provider networks, and socioeconomic factors. Post-Dobbs, these baseline regional differences have been dramatically amplified, with protective regions seeing modest increases while restrictive regions experienced near-total collapse, creating a regional access divide unseen in American healthcare history.
Abortion Rate Changes Over Time by State in the US 2025
| State | 2021 Rate | 2022 Rate | 2024 Est. Rate | Percentage Change (2021-2024) | Key Policy Changes |
|---|---|---|---|---|---|
| Wisconsin | 6.1 | 1.8 | ~8.5 | +39% | Ban briefly enforced, then restored access |
| New Mexico | 9.8 | 28.8 | ~32-35 | +227-257% | Expanded to meet regional demand |
| Kansas | 13.8 | 21.3 | ~26-28 | +88-103% | Voters rejected anti-abortion amendment |
| Illinois | 18.2 | 26.7 | ~30-32 | +65-76% | Border state absorbing Midwest demand |
| Colorado | 13.1 | ~16-18 | ~18-20 | +37-53% | Serving TX, OK, WY residents |
| Virginia | 11.8 | 15.8 | ~20-22 | +69-86% | Absorbing FL, NC, TN demand |
| Minnesota | 10.2 | ~12-14 | ~15-17 | +47-67% | Protective policies, border state |
| North Carolina | 10.1 | 16.5 | ~18-20 | +78-98% | Served as Southeast hub until restrictions |
| Texas | 10.2 | 4.3 | <0.5 | -95% | Total ban implemented |
| Oklahoma | 10.6 | 4.3 | <0.5 | -95% | Total ban cascade of laws |
| Missouri | 2.4 | 0.1 | <0.1 | -96% | Total ban (trigger law) |
| Tennessee | 9.2 | 8.0 | <0.5 | -95% | Total ban mid-2022 |
| Louisiana | 11.0 | 7.8 | <0.5 | -95% | Total ban (trigger law) |
| Alabama | 9.5 | 6.4 | <0.5 | -95% | Total ban implemented |
| Florida | 20.5 | 20.5 | ~15-16 | -22-27% | Six-week ban May 2024 |
Data Sources: CDC 2021-2022, Guttmacher Institute 2024, #WeCount 2024
Abortion rate changes over time by state reveal the most rapid healthcare access transformation in modern American history, with some states seeing rates increase by 200%+ while others declined by 95%+ within just three years. Wisconsin experienced the most dramatic reversal, with its abortion rate dropping from 6.1 per 1,000 in 2021 to 1.8 in 2022 after an 1849 ban was briefly enforced post-Dobbs. However, when courts clarified that the old law didn’t apply and access was restored, the rate rebounded to an estimated 8.5 in 2024, representing a 39% increase from 2021 and a 372% increase from its 2022 low point. Wisconsin’s experience demonstrates how legal uncertainty can cause immediate access collapse followed by recovery once clarity is established.
New Mexico recorded the nation’s most substantial rate increase, surging from 9.8 per 1,000 in 2021 to 28.8 in 2022 and an estimated 32-35 in 2024—a staggering 227-257% increase in three years. This transformation reflects deliberate policy choices to expand provider capacity, eliminate gestational limits, and position the state as a safe haven for residents of neighboring Texas, Oklahoma, and Arizona. New Mexico’s abortion volume increased from 7,735 in 2021 to 13,900 in 2022 and approximately 20,700 in 2024, nearly tripling in three years. The state now performs 62% of its abortions for out-of-state residents, fundamentally changing the character of its reproductive healthcare system.
Kansas provides another success story, with rates climbing from 13.8 in 2021 to 21.3 in 2022 and 26-28 in 2024, representing an 88-103% increase. The state’s August 2022 ballot measure where 59% of voters rejected an anti-abortion constitutional amendment ensured continued access that made Kansas a critical lifeline for the central United States. The state’s abortion total grew from 8,047 in 2021 to 14,690 in 2022 and 22,700 in 2024, with the vast majority of growth coming from 71% out-of-state patients in 2024.
Illinois followed a similar trajectory, with rates rising from 18.2 in 2021 to 26.7 in 2022 and 30-32 in 2024, a 65-76% increase. The state’s abortion total climbed from 46,243 in 2021 to 67,770 in 2022 and approximately 73,000 in 2024. Illinois strategically expanded capacity through public-private partnerships, Medicaid coverage, and abortion fund support, enabling it to absorb demand from Missouri, Wisconsin, Indiana, Kentucky, Tennessee, and Arkansas while maintaining timely access for residents.
Colorado, Virginia, Minnesota, and North Carolina all experienced 37-98% rate increases between 2021 and 2024, transforming from moderate-access states to regional hubs. These increases required massive infrastructure expansion, provider recruitment, and funding increases to meet demand that doubled or tripled within two years.
At the opposite extreme, Texas experienced catastrophic access elimination, with rates plummeting from 10.2 per 1,000 in 2021 to 4.3 in 2022 (after its six-week ban took effect in September 2021) and <0.5 in 2024 after its total ban was implemented. This 95% decline represents 52,000+ abortions disappearing from Texas’s healthcare system, forcing residents to travel out of state or continue unwanted pregnancies. Oklahoma, Missouri, Tennessee, Louisiana, Alabama, Mississippi, Arkansas, Kentucky, Indiana, Idaho, South Dakota, and West Virginia all experienced similar 90-96% declines as total bans eliminated nearly all in-state abortion services.
Florida’s rate trajectory differed from other ban states due to its delayed implementation of severe restrictions. The state maintained its 2021-2022 rate of 20.5 per 1,000 with approximately 82,581 abortions, serving as the primary Southeast provider while surrounding states implemented bans. However, Florida’s 15-week ban (implemented mid-2022) and subsequent six-week ban (May 2024) caused its rate to decline to approximately 15-16 per 1,000 by late 2024, representing a 22-27% decrease and approximately 11,200 fewer abortions. Florida’s delayed restriction transformed the Southeast regional access pattern, eliminating what had been the last major provider south of Virginia.
The speed of these changes—occurring primarily between June 2022 and mid-2024—demonstrates how abortion access can be eliminated or expanded virtually overnight through policy changes. States that maintained access saw rates increase 37-257% within two years, while ban states experienced 90-96% declines in similar timeframes. These changes created a healthcare system where a woman’s ability to access abortion changed fundamentally by crossing a state border, often just a few miles away. The temporal pattern also reveals adaptation strategies, with telehealth medication abortion growing from 4% in April 2022 to 25% by late 2024, partially offsetting geographic barriers but unable to fully compensate for clinic closures in ban states.
Abortion Rate by Demographics and State in the US 2025
| Demographic Factor | High-Access States | Ban States | Impact of State Restrictions |
|---|---|---|---|
| Age 20-29 (highest rate group) | 18-22 per 1,000 | <0.5 per 1,000 | Young women most impacted by travel barriers |
| Black Women | 24-30 per 1,000 in access states | <1 per 1,000 in ban states | Disproportionate burden in South |
| Hispanic Women | 10-14 per 1,000 in access states | <0.5 per 1,000 in ban states | Texas ban eliminates majority access |
| White Women | 5-8 per 1,000 in access states | <0.2 per 1,000 in ban states | Lower baseline but still severely restricted |
| Low-Income (<100% FPL) | 15-25 per 1,000 with Medicaid | <0.5 per 1,000 in ban states | Economic barriers compound geographic ones |
| Already Parents | 60-65% of patients in all states | Near-zero access in ban states | Existing children create childcare barriers |
| Unmarried Women | 88-90% of patients in all states | <0.5 per 1,000 in ban states | Relationship status doesn’t predict access |
| Rural Residents | 6-10 per 1,000 even in access states | <0.2 per 1,000 in ban states | Compounding geographic disadvantage |
Data Sources: CDC Demographic Data 2022, Guttmacher Institute Analysis 2024
The intersection of abortion rate by demographics and state reveals how state-level bans disproportionately harm specific populations. Black women, who experience an abortion rate of 24.4 per 1,000 nationally, face particularly severe impacts in ban states where many reside. Approximately 58% of Black women of reproductive age live in states that have banned or severely restricted abortion. In protective states like Illinois, New York, and California, Black women maintain abortion access with rates of 24-30 per 1,000, similar to national pre-Dobbs patterns. However, in ban states across the South—where 38% of Black women nationally reside—access has been virtually eliminated with rates dropping to <1 per 1,000.
The Southern concentration of Black women combined with that region’s widespread bans creates a devastating intersection of racial and geographic injustice. States like Alabama (26.3% Black population), Mississippi (37.6%), Louisiana (32.2%), Georgia (32.0%), and South Carolina (26.6%) all have either total bans or severe six-week restrictions, directly eliminating abortion access for millions of Black women. These same states have the highest maternal mortality rates nationally, with Black women facing maternal death rates 3-4 times higher than White women. The elimination of abortion access in states with the worst maternal health outcomes and largest Black populations represents a compounding crisis.
Hispanic women, with a national abortion rate of 10.5 per 1,000, are similarly impacted by geographic restrictions. Texas, home to 5.4 million Hispanic women of reproductive age (more than any other state), has a total ban that has eliminated access for this population. In 2021, before restrictions, Hispanic women accounted for 21.2% of all abortions nationally, but Texas alone performed approximately 10,000 abortions for Hispanic women annually. The state’s ban has forced thousands of Hispanic women to either travel to New Mexico, Colorado, or Kansas (often 400-600 miles) or continue unwanted pregnancies. Florida’s Hispanic population of 2.9 million women similarly lost access with the state’s six-week ban in 2024.
Young women aged 20-29, who have the highest abortion rates at 18-19 per 1,000 nationally, face particular barriers in ban states. This age group, which accounts for 56.5% of all abortions, often has the least financial resources, least job security, and most precarious living situations. In protective states, young women maintain rates of 18-22 per 1,000, but in ban states, rates have collapsed to <0.5 per 1,000. Young women are less likely to have credit cards, personal vehicles, or ability to take multi-day trips necessary to travel for abortion care, making them disproportionately likely to be forced to continue unwanted pregnancies.
Low-income women experience the most severe impacts of state-level bans. In protective states with Medicaid coverage for abortion (17 states), low-income women maintain abortion access with rates of 15-25 per 1,000, similar to or higher than middle-class women. However, in ban states, even those low-income women who theoretically could travel face insurmountable financial barriers. The average cost of obtaining an abortion with travel—$1,500-$2,500—represents one month’s rent, two months of food budgets, or other prohibitive expense for women living at or below the poverty line. Abortion funds that provide financial assistance report being unable to meet even 50% of requests in ban states, leaving thousands of low-income women without options.
Rural women face compounding disadvantages in both protective and ban states. Even in access states, rural women have abortion rates of 6-10 per 1,000—approximately half the urban rate of 12-20 per 1,000—due to distance to providers, transportation barriers, and time off work requirements. In ban states, rural women experience near-zero abortion rates of <0.2 per 1,000 as they must travel 300-800+ miles to reach the nearest legal provider, often crossing multiple states. A rural Texas woman might live 400 miles from the nearest New Mexico clinic, requiring 16+ hours of travel round-trip plus overnight accommodation, creating an insurmountable barrier for those without resources.
Women who are already parents—who comprise 59-65% of abortion patients nationally—face unique barriers in ban states including arranging childcare for existing children during multi-day trips, explaining absences to children, and managing the logistics of travel with dependents. Many abortion patients seek abortion specifically because they cannot afford to have additional children while caring for existing ones, yet must find childcare funding to access care—a cruel paradox that forces some to continue pregnancies they explicitly sought to terminate.
The demographic analysis reveals that state-level bans do not affect all women equally. Instead, they create a system where Black women, Hispanic women, low-income women, young women, rural women, and those with existing children face the highest barriers, while White women, higher-income women, urban women, and those with greater resources maintain better access even in restrictive states through travel or telehealth options. This stratification by race, class, and geography represents a fundamental injustice where constitutional rights exist for some but not others based on demographic characteristics and zip code.
The abortion rate by state landscape will continue evolving rapidly through 2025 and beyond, shaped by ongoing legal battles, technological developments, and political changes. Several states are likely to implement additional restrictions or bans, while others may expand protections through ballot initiatives or legislation. The 2024 elections will prove decisive, as they determine whether federal legislation codifying abortion access or implementing national restrictions becomes possible. Arizona voters approved a constitutional amendment protecting abortion rights in November 2024, potentially reversing the state’s restrictive policies and demonstrating continued public support for access. Similar ballot measures may appear in Missouri, Florida, Nebraska, and other states, offering pathways to restore access through direct democracy even in conservative-leaning states.
Telehealth medication abortion will remain the critical battleground for access, potentially expanding to 30-35% of all abortions by 2026 if current legal frameworks hold. However, this pathway faces existential threats including potential Comstock Act enforcement by future administrations to ban mailing abortion pills, state-level criminalization of receiving abortion medication, and legal challenges to shield law protections that enable interstate prescription. If these threats materialize, tens of thousands of patients currently accessing abortion via telehealth would lose their only option, forcing dramatic increases in cross-state travel or unsafe self-managed abortion. Conversely, if protective frameworks strengthen, telehealth could further reduce geographic barriers for early pregnancies, though it cannot serve patients needing second-trimester care or those preferring surgical methods.
The public health consequences of state-level bans will become increasingly measurable and documented over the next several years. States with total bans are projected to see maternal mortality increases of 21-33% according to multiple research studies, with the highest impacts on Black women who already face maternal death rates 3-4 times higher than White women. Mental health outcomes including depression, anxiety, and PTSD from forced pregnancy will be quantified through longitudinal studies. Economic analyses will document increased poverty rates, reduced educational attainment, and worse financial outcomes for those denied wanted abortions compared to those who received care. These empirical findings will inform future policy debates, legal challenges, and public opinion, potentially shifting state-level politics as consequences become undeniable.
Geographic polarization will likely intensify, with protective states strengthening access guarantees while restrictive states pursue additional enforcement mechanisms including travel bans, criminal penalties for out-of-state abortion, and restrictions on information about abortion services. Border states maintaining access will continue experiencing elevated abortion rates as they serve multi-state populations, requiring sustained capacity expansion and funding to meet demand. The two-tiered system where abortion rates vary by 200-300-fold between neighboring states will persist as the defining characteristic of American reproductive healthcare, with long-term implications for population migration patterns, state economies, healthcare infrastructure, and social equity. Ultimately, abortion rates by state will continue serving as the most visible measure of how state policy directly determines healthcare access, reproductive autonomy, and fundamental rights for millions of Americans based solely on their geographic location.
Disclaimer: This research report is compiled from publicly available sources. While reasonable efforts have been made to ensure accuracy, no representation or warranty, express or implied, is given as to the completeness or reliability of the information. We accept no liability for any errors, omissions, losses, or damages of any kind arising from the use of this report.