Report: Out-of-state travel for abortion declined this year as pill use increases

Packages of Mifepristone tablets are displayed at a family planning clinic on April 13, 2023 in Rockville, Maryland. (Photo illustration by Anna Moneymaker/Getty Images)

Fewer people crossed state lines to obtain an abortion in the first six months of 2025 than the same period last year, marking the first reported decline in clinic visits since the Supreme Court overturned Roe v Wade in 2022. 

But data contained in a new report by the Guttmacher Institute, a policy organization that advocates for reproductive rights, makes clear that is only a partial picture of abortion in America this year.

While the data shows an 8% decline in patients traveling to clinics in states where abortion remains legal, it does not take into account the increasing reliance on telehealth to obtain abortion-inducing medication. 

That shift to telehealth for abortion services was borne out in Tennessee last year.

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In 2024, 10,020 Tennessee residents travelled out of state to obtain an abortion, according to data compiled by Guttmacher.

However, an additional 5,840 patients terminated pregnancies with medication obtained through telehealth appointments. The total number of Tennesseans obtaining abortions — both surgical and medication — in 2024 surpassed those obtained before the Supreme Court’s Dobbs decision triggered a Tennessee near-total abortion ban in 2022.

Tennessee women continue to seek abortions at organizations like the The Massachusetts Medication Abortion Access Project, a medical practice established two years ago to provide abortion care via telemedicine to patients in all 50 states.  

The organization serves between 50 and 75 Tennessee patients each month, Dr. Angel Foster, its co-founder, said this week.

“Our patients are largely the same as patients getting in-clinic services in their states prior to Dobbs,” she said. “Financial precarity is shaping their decisions. We also hear every day from women in unstable or abusive relationships and college students early in their careers.”

It operates under a so-called Massachusetts’ “shield law” that allows it to prescribe and mail FDA-approved abortion pills anywhere in the country. The law also protects the organization and its medical staff from out-of-state prosecution.

And many of the Tennessee patients already have one or more children, she said. 

Thus far 22 states and the District of Columbia have adopted so-called shield laws since the Supreme Court decision overturning Roe v. Wade, making telemedicine abortion appointments widely accessible to those living in states with abortion bans to obtain a prescription for the two-pill regimen generally prescribed up to 10 weeks of pregnancy.

The increasing availability of abortion pills has prompted a backlash from attorneys general in Republican-led states, including Tennessee, which has laws barring the mailing and prescribing of abortion-inducing drugs.

More than 10,000 Tennesseans travelled out of state for abortions last year, new study finds

Earlier this month, Health and Human Services Secretary Robert F. Kennedy Jr. announced the Food and Drug Administration, or FDA, was mounting a review of the safety of mifepristone, the commonly prescribed abortion inducing medication, raising alarms for medical providers and abortion rights advocates about looming federal action to limit its availability. 

“It’s unclear what studies they will review, whether they are peer reviewed or junk science reports recently released by anti-abortion groups,” said Dr. Ushma Upadhyay, a professor at University of California, San Francisco in the Department of Obstetrics, Gynecology, & Reproductive Sciences of the Trump administration review.

The Guttmacher report also notes decline in out-of-state travel for abortions was most pronounced in states that implemented six-week abortion bans. 

Before South Carolina’s six-week ban was allowed to take place in August of 2023, it was one of six states that served as a destination for about 100 Tennessee patients seeking an abortion that year.

After a federal court allowed South Carolina’s six-week abortion ban to take effect, Tennesseans ceased obtaining abortions in that state, Guttmacher data showed.