The end of Roe v. Wade has created a steady stream of horror stories in conservative states: preteen rape survivors who have to flee across state lines; women with wanted but totally unviable pregnancies who have to do the same; people whose pregnancies threaten to kill them but can’t get care until they are on the brink of death. The list goes on and on.
If we examine surveys of Americans who do have abortions, about three-quarters of them cite an inability to afford another child as among their reasons.
It’s understandable that such nightmarish stories get a lot of media attention. But it also raises a question: What is happening to the number of abortions overall? And how much have things really changed since the Dobbs decision in June? The surprising answer appears to be “not much.”
Matt Bruenig, head of the People’s Policy Project think tank, compiled data gathered by the Society of Family Planning, which surveyed most abortion providers from April to August this year, thus allowing a measurement of what happened when Dobbs took effect.
It found that while abortions have dropped by 12,500 per month in states with new restrictions (or old ones that came into force), they have increased by 7,140 per month in states without them. In total, monthly abortions dropped from about 85,000 to about 79,600.
In other words, the anti-abortion movement got its major objective, what it had been frenziedly working toward for decades, and the result is a reduction in abortions of about … 6%.
The actual number is, in fact, less than that, because the Society of Family Planning figure doesn’t include nonprescription use of abortion pills, which can be obtained relatively easily from other states or Mexico (where pharmacies have seen a surge of American buyers). That type of abortion will surely grow as knowledge of how to get around the restrictions spreads.
This suggests that even if the anti-abortion movement gets a national ban enforced — a tall order given how similar measures have recently failed in deep-red Kansas, Kentucky and Montana — the effect on abortion numbers would likely be only temporary. If the anti-abortion movement actually cared to reduce abortions, it would be both more just and more effective to address the large and growing financial burdens of parenthood.
Now, one might quibble with Bruenig’s read of the data. It’s possible that the number of abortions would have gone up without the Dobbs decision, in which case the effect is understated.
The number had increased slightly from 2017 to 2020, though before that it had declined consistently for decades. And it should also be emphasized that even if the total number of abortions did not move very much, as noted above, it still created tremendous suffering where the newer restrictions did bite.
While abortion patients are disproportionately low-income, more than half are above the poverty line.
But even granting those caveats, it is all but undeniable that overturning Roe had only a small impact on total abortion numbers. The Society of Family Planning produces high-quality data, and its survey (by design) doesn’t even measure some kinds of abortions. And this result makes some sense — after all, many states with new restrictions had already made it very difficult to get a legal abortion with onerous regulations and legal harassment.
On the other hand, while abortion seekers are disproportionately low-income, more than half are above the poverty line. It’s often difficult for them to arrange transportation across state lines or acquire abortion pills, but it’s seldom impossible.
To be sure, a national abortion ban likely would seriously disrupt abortion access. And sure enough, anti-abortion activists are attempting to get a hack Trump-appointed judge to declare abortion pills unconstitutional. But even this would likely have only a temporary effect.
Perhaps the most convincing evidence on this question comes from an example from history. In 1966, Romania’s megalomaniac communist dictator Nicolae Ceaușescu banned all abortion and contraception in an attempt to increase the size of the population and labor force.
In the years immediately following, the birth rate did indeed shoot up. But soon, women figured out that they could bribe doctors to get abortions or contraception, or go to other countries to get them, or attempt grim amateur procedures.
Though there were a large absolute number of children born to parents who didn’t want them, creating a massive surge of orphans who ended up starving in horrific state-run orphanages, after a few years the birthrate resumed falling as before. By the mid-1980s, it was about back to where it was before the bans. (Ceaușescu was overthrown in 1989 and he and his wife were executed on Christmas Day that year.) Such a trajectory would be far faster in the United States, given how easy and simple it is to use abortion pills, which weren’t available in Ceaușescu’s Romania. Anti-abortion propaganda focuses on the microscopic number of late-term abortions for maximum shock value, but this is just not reflective of reality. In reality, about 43% of abortions happen before the sixth week of pregnancy, and 92% before the 13th week. Abortion pills, which are safe and highly effective throughout the first trimester, have grown quickly to account for over half of abortions now. Generic brands can be bought over the counter in Mexico for as little as $20; it would only be a matter of time before smuggling networks were set up. Fundamentally, if a repressive dictatorship — complete with a brutal secret police and dragnet surveillance — had only temporary success in preventing abortions, it stands to reason that similar measures will be dramatically less effective in a country as rich as America, where civil liberties abound and women have access to a much easier and cheaper form of abortion. Meanwhile, Republicans have no plans to deal with a problem that directly incentivizes abortion: the skyrocketing cost of raising children. The major categories of family spending — housing, child care, health insurance and secondary education — have been increasing faster than inflation for decades. Today, child care alone can easily eat up an entire full-time salary. If we examine surveys of Americans who do have abortions, about three-quarters of them cite an inability to afford another child among their reasons. It is consistently found that as countries become richer and expand their social services, abortion rates tend to fall. Given all this, if the anti-abortion movement cared about its stated goal of protecting every sacred life, the logical thing to do would be to team up with Sen. Bernie Sanders, I-Vt., to build up a world-class welfare state for families. But if what they really care about is viciously stomping on the worst-off people in society, as I suspect is the case, then they will do no such thing. I conclude that the post-Dobbs restrictions on reproductive rights — as usual for conservative policy — are largely failing to achieve their stated objectives and instead are cruelly hurting those most in need: child rape victims, the very poor, and pregnant people with severe medical problems stuck in red-state hospitals. That is going to remain true no matter what national policy they might pass. All the anti-abortion movement can offer is a world in which black market abortion becomes the contraceptive of first resort for millions.
Ryan Cooper
Ryan Cooper is managing editor of The American Prospect. His work has appeared in The Nation, The New Republic and The Washington Post. He is the author of the book "How Are You Going to Pay for That: Smart Answers to the Dumbest Question in Politics." 
