Today, June 24, 2026, marks the fourth anniversary of the Supreme Court’s landmark Dobbs v. Jackson Women’s Health Organization decision, which devastated abortion access nationwide by overturning Roe v. Wade and stripping away nearly 50 years of federal constitutional protections for reproductive rights.
January 22, 2026, marked 53 years since the Roe v. Wade decision recognized the constitutional right to privacy and guaranteed the right to abortion in the United States, which was ripped away when Trump’s appointees overturned it with the Dobbs v. Jackson Women’s Health Organization ruling on June 24, 2022.
Ironically, the total number of abortions has increased significantly since June 24, 2022, despite near-total bans in several states. Overall abortion volume across the U.S. has risen dramatically, driven largely by shield laws and the rapid expansion of online abortion pill suppliers, as well as related cuts in sex education, which leaves young people more vulnerable to unwanted pregnancies.
Four years ago today, the Supreme Court overturned Roe v. Wade. The decision was supposed to end abortion in America. It did not. The opposite occurred.
On June 24, 2022, the court’s conservative majority, fortified by three appointees of former President Donald Trump, dismantled nearly five decades of constitutional protection for reproductive rights in Dobbs v. Jackson Women’s Health Organization.
The ruling returned the question of abortion to the states. Thirteen states responded with near-total bans. Some imposed criminal penalties on doctors. The intention was clear: to make abortion all but impossible.
Instead, the number of abortions has nearly doubled.
Data from the Society of Family Planning’s #WeCount project shows that 1.13 million abortions were provided within the formal U.S. healthcare system in 2025.
That is a sharp increase from the years before the Dobbs ruling, when the Centers for Disease Control and Prevention reported roughly 613,000 abortions in 2022.
The monthly average climbed from 77,560 in 2022 to 93,900 in 2025. By December of last year, nearly 30 percent of all abortions were provided via telehealth.
The mechanism of this transformation is simple: the abortion pill.
Mifepristone, followed by misoprostol, can now be prescribed online and mailed to a patient’s home. The Food and Drug Administration removed the in-person dispensing requirement during the pandemic.
When Roe fell, a proliferation of telehealth companies rushed to fill the gap. They now ship pills across state lines, often directly into states with bans.
“The way that people access abortion now has just fundamentally changed,” said Kate Wells, the Michigan correspondent for KFF Health News. “Even if you can’t mail Mifepristone, telehealth providers will use Misoprostol. If the telehealth providers in the U.S. get shut down, patients are already getting these medications from outside the U.S.”
Shield laws have accelerated the trend. Twenty-three states have passed legislation intended to reduce the legal risks for clinicians who provide abortion care to patients in restrictive states. By December 2025, nearly 15,000 abortions per month were being provided under these shield laws. In states with total abortion bans, telehealth accounted for 97 to 100 percent of all clinician-provided abortions.
The result is a reality that abortion opponents did not foresee and cannot control. They are frustrated. They are especially frustrated with the Trump administration, which they expected to crack down on the pills.
There are now an estimated 1.1 million abortions taking place annually across the U.S. healthcare system, which is nearly twice as many abortions as there were each year in the U.S. before the Dobbs case.
Kristi Hamrick, a married mother of four who leads federal policy for Students for Life of America, said she appreciates the administration’s decision to cut Medicaid payments to Planned Parenthood. But that, she said, does not go far enough.
“That doesn’t get to the fact that the No. 1 way in which babies die in the womb in America today is biochemical abortion pills,” Hamrick said.
The administration has responded with incremental moves. The FDA launched a safety study of mifepristone in June, a step that could eventually restrict its distribution. But the study is expected to take six months, and it has done nothing to halt the flow of pills. The Biden-era regulations that allow telehealth prescribing and mail delivery remain in place.
Abortion opponents are demanding more. They want the administration to enforce the Comstock Act, a 19th-century law that could bar the mailing of all abortion-related materials, including misoprostol. They want the Justice Department to prosecute providers. So far, the administration has not acted.
Fourteen state attorneys general, led by Missouri Attorney General Catherine Hanaway, have sent a letter to the Environmental Protection Agency urging the agency to classify the abortion pill mifepristone as a water contaminant.
The letter adds to a coalition built by Students for Life of America that is pushing the Trump administration to enforce the Comstock Act, which prohibits mailing abortifacients, and to hold the FDA accountable for policies they say have enabled abortion-related water pollution.
After meeting with the EPA, SFLA championed an effort to require monitoring of mifepristone under the Safe Drinking Water Act. The EPA recently closed a public comment period on its list of “contaminants of concern.” Trump administration officials must now evaluate the concerns raised.
The international context is telling. Since 1994, more than 60 countries have expanded legal grounds for abortion. The United States is one of only four countries to remove legal grounds during the same period. The others are El Salvador, Nicaragua, and Poland.
In the wake of Dobbs, progressive reforms swept across Europe. Finland and San Marino enacted laws allowing abortion on request. The Netherlands abolished its mandatory waiting period. England and Wales made medication abortion at home permanent. In Latin America, the Green Wave movement produced groundbreaking reforms in Argentina, Colombia, and Mexico. The Colombian Constitutional Court recognized the right to health as including sexual and reproductive rights.
The Supreme Court of Mexico struck down restrictive abortion laws, recognizing that the right to human dignity includes a woman’s right to make decisions about her body.
Here, the battle has moved online. The clinics are closing in some states, but the pills are arriving in mailboxes. The fight is no longer about access to a building. It is about access to a package. And the package is winning.
The data is clear. The abortion rate has not fallen. It has risen.
The bans have not stopped the procedure. They have only changed how it is done. And for those who fought for decades to overturn Roe, the victory has turned to ash.
They won the court case. They lost the war.
Four years ago, the Supreme Court struck down Roe. Today, there are more abortions than ever. The law has changed. The country has not.
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