A new report says the number of abortions in the U.S. has climbed sharply since the Supreme Court overturned Roe v. Wade in 2022, citing expanded access to abortion pills prescribed through telehealth and delivered by mail as a primary driver of the increase.
The Restoration of America Foundation (ROAF), a conservative advocacy group, released the report Feb. 5. It estimates that more than 1.1 million abortions occurred nationwide in 2024 — the highest total in more than a decade. The group attributed much of the increase to federal policy changes under the Biden administration that eliminated in-person safeguards for dispensing the abortion drug mifepristone.
To produce its estimates, ROAF drew on data from the Guttmacher Institute and the Society of Family Planning’s #WeCount project, both of which support abortion.
The report highlighted the role of telehealth abortions, which jumped from accounting for only 5% of all total abortions in mid-2022 to 27% of abortions by mid-2025. About 244,590 abortions were facilitated remotely in 2024.
Chemical abortions, typically induced by using mifepristone followed by misoprostol, now account for a majority of abortion procedures, making up 63% of abortions in 2023, up from 39% in 2017.
Changes to abortion pill regulations
The Biden administration initiated an ostensibly temporary suspension of certain abortion pill restrictions in 2021, citing the outbreak of COVID-19. But the suspension was made permanent later that year. ROAF says the Biden administration’s justifications for the move relied on limited studies and an adverse-event reporting system that does not capture the full scope of complications associated with chemical abortion. The policy was a sharp break from previous federal safeguards.
When the abortion pill was approved in 2000 during the Clinton administration, federal rules typically required three in-person visits before abortion drugs could be administered: An initial screening, an in-clinic dispensing of the drug, and a follow-up appointment. A 2016 update under the Obama administration reduced those requirements by allowing certain steps to be combined for a total of two visits. The 2016 changes also permitted non-physicians to prescribe abortion drugs, but it still required in-person dispensing. Biden’s policy change removed the remaining in-person requirement.
Health concerns, policy implications
Citing an April 2025 analysis conducted by the group, ROAF says more than one in 10 women experience serious adverse events after taking abortion pills, including hemorrhage, infection, and hospitalization – risks that are amplified when chemical abortions are prescribed without an in-person examination or direct physician oversight.
The new report also raised concerns about coercion and undetected complications when abortions are carried out through telehealth, warning that the absence of face-to-face medical care can delay treatment for incomplete abortions and other emergencies.
ROAF further argued that federal rules allowing abortion drugs to be prescribed remotely and shipped across state lines have weakened the enforcement of state abortion laws intended to protect women and unborn children.
The report urges the Trump administration to reverse the Biden-era changes. It calls on President Trump, Health and Human Services Secretary Robert F. Kennedy Jr., and FDA Commissioner Marty Makary to reinstate in-person dispensing requirements and complete a full safety review of mifepristone.
In 2025, 22 Republican attorneys general requested such a review. Kennedy and Makary later confirmed one was underway, though no official timeline or findings had been released yet.
The Trump administration drew widespread criticism from pro-life leaders in January 2026 after it was revealed the Department of Justice (DOJ) had requested a judge delay or dismiss a pro-life lawsuit seeking the reinstatement of pre-Biden-administration restrictions on mifepristone. In a filing with the judge, the DOJ cited the promised review of the abortion pill’s safety, saying it could take more than a year.
As ZealeNews reported at the time, CatholicVote President Kelsey Reinhardt condemned the DOJ’s filing, calling it "a contradiction of the assurances" Vice President JD Vance had "made to pro-life Americans just days ago at the March for Life.”