The report provides the most granular data available, but it doesn’t show a complete picture on the use of abortion pills in the United States. It includes total abortion figures from brick-and-mortar clinics and telehealth-only services but doesn’t break down how many patients opted for the pills over a surgical procedure at clinics like Planned Parenthood, which offer both.

What it does show is the ebb and flow of telehealth abortions based on the particulars of state law. In California, a sanctuary state that shields people who have an abortion or help provide one, telehealth abortions rose from 690 in April 2022 to 1,210 in March 2023. Massachusetts, another protective state, saw telehealth abortions more than triple, from 70 to 230 over those months. In Illinois—one of the last safe havens for abortion in the midwest—telehealth services more than doubled over the same period, from 330 to 750.

Cristina Villarreal, chief external affairs officer for Planned Parenthood of Illinois, says the demand for medication abortion is now up 51 percent at its clinics from the same time last year, and that the organization is “providing more abortion care across the board,” including surgical procedures. Many brick-and-mortar clinics in protected states are having to do more surgical abortions—especially later in pregnancy.

“This is a predictable consequence of abortion bans, because there are fewer places for people to access care,” says Colleen McNicholas, the chief medical officer at Planned Parenthood of the St. Louis Region and Southwest Missouri.

In fact, Illinois is picking up some of that demand from neighboring Missouri, which prohibits most abortions. Before Dobbs, medication abortion accounted for 62 percent of all abortions at Planned Parenthood of the St. Louis Region and Southwest Missouri, which provides abortions across the state line in Illinois. Now, medication abortion accounts for around 55 percent of its abortions.

Out-of-state patients may opt for a surgical abortion because the procedure is almost always effective. Abortion pills are about 98 percent effective for pregnancies up to nine weeks but get less effective after that. A small number of patients may still require a surgical procedure if the medication doesn’t work or causes excessive bleeding—and patients traveling long distances for an abortion may not want to take the risk of pills not working.

Planned Parenthood of the North Central States—which covers Iowa, Minnesota, and Nebraska—has experienced just a 2 percent increase in medication abortion use, compared to a 22 percent increase in surgical abortions since Dobbs. “We are seeing more patients choose a surgical abortion, primarily among patients that must drive long distances to their appointments,” says Ruth Richardson, the region’s president and CEO. These patients are most often coming from Texas, Louisiana, and Missouri, she says.

With clinics in blue states shouldering most of the abortion care burden, Phifer says telehealth services are helping to offload demand on brick-and-mortar clinics. That scenario is playing out in Colorado, where monthly telehealth abortions rose from about 220 in April 2022 to 460 in March 2023, according to WeCount. Nancy Fang, an abortion provider at the Comprehensive Women’s Health Center in Denver, says requests for the pills are actually down at her clinic, but she thinks that’s because so many telehealth services now exist for patients in Colorado. Overall, she says, the center is also doing more procedural abortions and is seeing more out-of-state patients.