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Have we been Roe-ing backwards?

An analysis of available data since the overturn of Roe v. Wade

Two years ago today, the United States Supreme Court caused international uproar by overturning Roe v. Wade. This historic decision did not ban abortion in America - as many people believed it would - but instead allowed democracy to thrive. For the first time in almost 50 years, the voters in each state could elect lawmakers and politicians who would represent their views and legislate accordingly.

There is a lot of conflicting information and media spin surrounding the outcome of the Dobbs decision (the case that overturned Roe), so how can we find out what has actually happened and more importantly, why that might be?

What does this mean for the pro-choice/pro-life debate, have any babies been saved? And crucially, how should we respond?

What does the latest data show?

In March of this year The pro-abortion Guttmacher Institute, published a report detailing abortion statistics in the US for 2023. This data represents the first full year of abortion figures since the overturning of Roe in June 2022, and sadly it indicates a rise in abortion numbers, despite the restrictions that have been put in place in 21 out of 50 states. About a 10% uplift since 2020 (which is the last full year Guttmacher has data for, probably due to Covid). 

I don’t know about you but this rise has shocked me! Especially given where we were a year ago. 

I remember studying a leading report that looked at abortion numbers in the 6 months following the overturn. Pro-life advocates everywhere rejoiced to see a reduction of approximately 32 thousand abortions at the half year mark. We were confident that not only would that equate to 64 or 65 thousand babies saved in the first full year, but very likely more. In fact the outcome looked so positive, I wrote a piece detailing all the reasons to rejoice and debunking some of the flawed media coverage at the time.

After all, the pro-life states were just getting started, and a good number had not managed to pass restrictions yet due to legal challenges. Referencing this report, a leading American pro-life organisation told reporters at a press conference in May of 2023, that if legislation were to go into full effect in all 26 states who were aiming to pass it, roughly 200 thousand abortions would be stopped per year.

However, only one year on and with 14 states having passed abortion bans and another 7 having implemented restrictions, those triumphant hopes seem to have been dashed. But why, what has changed?

Too many variables

90% of statistics are made up” (hang on, that’s a statistic)! 

If you torture the data long enough, it will confess to anything” 

I don’t believe in statistics anyway

Any of these phrases sound familiar? 

I suspect that we are all a little bit bored of stats being thrown at us right left and centre, to supposedly prove whatever point it is that someone wants to make. And that goes for both sides of the abortion debate; I cannot claim neutrality or guarantee my biases will be completely eliminated (although I will try). But this doesn’t mean that data is never reliable, nor that we cannot derive truth from it.

Perhaps you expect me to contest Guttmacher’s data, claim it’s artificially inflated and fall back on the comforting half year picture from 2022. But we are in the pursuit of truth here, and unfortunately, I believe Guttmacher’s latest numbers to be correct and representative of a real increase since 2020. 

But the Guttmacher data doesn’t show us the whole truth, not by a long shot. We have to look at several other numbers and factors to understand this picture properly. 

Albert Einstein famously said that “not everything that can be counted counts, and not everything that counts can be counted”. Anyone who routinely analyses data, knows that you must control your variables carefully, and that multi-variant analysis is key. We all remember being taught that correlation doesn’t equal causation in science class at school; maybe it’s time we took heed of that, and look carefully at the “WHY” and not just the “WHAT”. 

Summary for skimmers

It probably won’t surprise you to learn that I believe these numbers do not truly reflect the effectiveness of legislating against abortion, and that we should not be discouraged in the long run. In this essay I will attempt to detail why I believe this, and present you with a compelling case to believe the same. However, this is a nuanced topic and requires a deep dive on the data to do it justice, so for those of you short on time (or just a little impatient), here’s a summary of the points I’m going to cover: 


Yes, abortion numbers have gone up in the US since 2020. But what else does the data show?  

  • Birth rates have gone up in pro-life states and what's more, abortions being delivered within those states have dropped dramatically
  • Historically, we have ample evidence from within the US and around the world, that pro-life legislation DOES reduce abortion numbers
  • We have seen a steep rise in abortions across both the US and the UK in the last 5 - 7 years, however the percentage rise in the US since 2020, is only around half that of the UK


  • Pro-abortion states in the US are perpetrating an aggressive campaign to nullify the overturning of Roe, by facilitating abortions within pro-life states.This is being accomplished by posting abortion pills into those states, as well as enacting laws to protect them from prosecution for doing so. These pills by post services, are provided at a fraction of the cost of the pre-Dobbs era
  • Pro-choice advocates in the US are supporting large funds which pay for women to travel across state lines to have abortions. Many employers are now funding abortions, and abortion travel too
  • The Biden administration is actively undermining pro-life states and facilitating access to abortion in direct opposition to state legislation
  • This is an election year in the US and abortion access is one of the pillars of the Democratic campaign
  • The culture war (among other things) is precipitating an ever rising demand for abortion

Births have gone up in states with abortion bans

Yes, you read that correctly. Births have increased in states with abortion bans, relative to those where abortion remains freely available. In fact, this report from the Institute of Labor Economics from November 2023, states that: 

in the first six months of 2023, births rose by an average of 2.3 percent in states enforcing total abortion bans compared to a control group of states where abortion rights remained protected, amounting to approximately 32,000 additional annual births resulting from abortion bans.

The report goes on to say that by their calculations:  “roughly one-fifth to one-fourth of people seeking abortions did not receive them due to bans.” Indeed even the New York Times reported as such.

Pro-life legislation DOES reduce abortion numbers

We also know that the bans are working well within state lines. The Arkansas Health Department figures for 2023  and Oklahoma State Department of Health,  show the number of abortions performed in these states in 2023 was zero! 

Likewise Kentucky has reported a drop to almost zero. West Virginia and Indiana have both seen abortions drop by 98%, and a recent WeCount report shows that protective legislation has brought the abortion industry in Louisiana, Texas, Alabama, Mississippi, Tennessee and more, to its knees. As is evidenced by their graph below.


What’s more, this correlates with years worth of data from both within the United States and around the world, which shows that when you make abortion illegal, abortion numbers drop. 

Secular Pro-Life has some fantastic studies available on this topic which cover decades worth of data. Consistently, these studies show that when abortion is restricted - such as with limitations on taxpayer funding, increased waiting periods, greater distance to clinics etc - abortion rates drop. What’s more, this holds when we account for illegal or off book abortions where “the research finds that greater abortion restrictions are associated with more births and more lax restrictions are associated with fewer births”. 

We have to look no further than Northern Ireland in 2017 to corroborate this. The Advertising Standards Authority upheld a pro-life campaign, which claimed that 100 thousand people are alive in Northern Ireland today because of the country’s restrictive abortion laws. And we see this borne out by the increases in Northern Irish Abortion numbers since then (including those previously done on English or Scottish soil). 

So HOW did we get here?

If all this is true, why on earth have we seen a RISE in overall US abortion numbers in 2023? 

This is indeed the million dollar question, because the data seems to be contradicting itself. So let’s try and understand why this might be? 

Some context: abortion have increased in the UK too

Unfortunately, we cannot do a direct comparison between the US and the UK, because our 2023 abortion statistics have not been released yet. In fact we have only just had the 2022 figures published within the last couple of months. However, even looking at those figures is illuminating. 

As you can see from the graph below (which comes from the UK government report), there were 251 377 abortions in England and Wales in 2022. In 2020, that figure was 209 917 abortions. That’s a 20% increase over 2 years! Remember, the Guttmacher figures show approximately a 10% increase over 3 years in the US. 

We can see from this graph that there has been a dramatic shift upwards in abortion numbers in the UK since 2016/2017. So what’s happened in the US across the same period. Well, it turns out we can see a very similar pattern, abortions have increased dramatically on both sides of the pond over the last 5 to 7 years. 

This rise in abortion numbers in the US since 2017, marks an about turn in the trend displayed in the previous 35 years, which observed a steady decline in abortion numbers since 1981.

However, given that the trends in our two nations have been mirroring each other so closely in recent times, it’s interesting that the rise in the US over the last three years has been significantly lower than the rise in the UK over the first two years in the same period. 

Is it unreasonable to speculate that without the overturning of Roe, the unfortunate increase in abortion numbers that Guttmacher has reported, may have been even MORE pronounced? 

In fact, we’re not the only ones to speculate about this. The producers of the WeCount survey (The Society of Family Planning), had this to say in their most recent report which covers up to December 2023: 

We estimate that overall, if abortion had not been banned in these 14 states [with total abortion bans], approximately 144,690 abortions would have occurred in person in these states in the 18 months since Dobbs. This represents a national monthly average of nearly 8,000 abortions that would have occurred in these 14 states. Of note, abortion access in these states was severely restricted before Dobbs, and so these numbers represent an underestimate of the actual need for abortion in these states.” 

Follow the money!

It’s important to remember a key difference in abortion between the UK and the US. In the UK, the NHS funds 98% of abortions. The American healthcare system is very different and like most medical treatments, abortions are expensive. 

According to Planned Parenthood (the largest abortion provider in the US), abortion pills cost up to $800 (average at PP is $580), while in clinic abortions range from $600 early in the first trimester, to $2000 later in the second trimester. Unsurprisingly, they don’t mention third trimester abortions on their website, however they do perform them in some states.  

US medical insurance plans vary widely in terms of what they will and won’t cover when it comes to abortion, and they are subject to state laws and federal funding restrictions in many cases. In 2014 the Guttmacher Institute reported that 53% of women paid for abortions themselves out of their own pockets. 

Funding for abortion in the US has always been a contentious issue. Laws like the Hyde Amendment are always hotly debated. This is because access to funding affects abortion numbers: the less funding available, the fewer abortions take place.

Abortion funds

There have always been activist groups in the US, who fund abortions. The National Network of Abortion Funds, brings together 100 organisations that offer financial support to those seeking abortions across the United States. Their website gives some interesting insights as to what has happened since the overturn of Roe. They report in January of 2024, that funding budgets grew by 88% in the year following the Dobbs decision, and abortion funds dispersed, increased by 178% to more than 10 million dollars!

However, they also report that following an initial “large increase” in donations after the Roe overturn, they then experienced a “staggering drop off”.

Employee benefits

In addition to these funds, many companies have offered to pay for out-of state abortions and cover the travel expenses to get there. Among them are big household names such as: Apple, Netflix, Disney, Amazon, Goldman Sachs, Ikea, Paramount, Starbucks, Uber, Warner Brothers…and many more.

Pills by post

However, perhaps the most concerning development in 2023, is the posting of abortion pills (often free of charge or at a highly subsidised rate), into the 21 states with abortion restrictions…by 6 of the most liberal states in the nation. 

As in the UK, the US went down the pills by post route (or Telehealth as they call it) because of Covid. Only 4 short years ago, the idea of obtaining abortion pills in the mail was unheard of, yet here we are. 

In April of 2022, only 4% of abortions in the US were Telehealth abortions of any kind. By the end of 2023, that figure was 19%, almost 1 in 5 abortions nationally. This is backed up by Guttmacher data showing that medical abortions (both prescribed in person and Telehealth) have gone up dramatically. With 63% of abortions being the result of pills in 2023 as opposed to 53% in 2020 and 39% in 2017.

But here’s the rub…these Telehealth abortions are counted in the states they are posted from, not the states they are posted to! 

We know that many liberal states were posting abortion pills into states with abortion restrictions, as early as January 2023. But they have only been officially counting them since about July of 2023, when 6 states enacted what they call shield laws

These laws make individuals and companies immune from prosecution, if they send pills into states with pro-life laws on the books. Those states are: Massachusetts, Washington, Colorado, Vermont, New York and California. These shield laws even go so far as to stipulate that agencies and officials within these states will not cooperate with another state’s efforts to investigate or penalise such abortion providers. This is a stark departure from typical practice between states, which would see them honour subpoenas and extradite culprits who flout another state's laws. 

John Seago, the President of Texas Right to Life said to The New York Times: “You have states not just picking their own strategy but really trying to completely sabotage the governing efforts of their neighbouring states”. He added “It can’t stand, and we can’t be content with this new development”. 

According to Dr. Abigail Aiken, an associate professor at the University of Texas (in The New York Times earlier this year); these providers are now using shield laws to serve about 7,000 patients per month, nearly 90% of them in states with bans or severe restrictions. 

To put that in perspective, the net reductions we saw reported by WeCount in the 6 months following the Roe overturn, amounted to just over 5,000 per month across the country! 

So MORE women are now accessing abortions (in pro-choice and pro-life states), than were accessing them before the Dobbs decision. As Dr Linda Prine, a New York shield law provider put it (again to The New York Times): “some people who might not have gotten an abortion if they had to take off work and go to a clinic, or wait three weeks and all of that, are doing it now

Not only that, but at a fraction of the cost! There are three main providers in these shield law states, and they claim to charge $150 or $250. That being said, all three services provide pills for reduced prices or even at no cost, based solely on what patients say they can manage to pay.

Dr. Rebecca Gomperts, the physician who founded Aid Access (one of the providers), said over half of its shield-law patients cannot pay full price. About a third of another provider’s (MAP) patients can afford only the service’s $5 minimum, said Dr. Angel M. Foster, the services’s Director.

This graph is from the WeCount report released on the 14th of May 2024. It only counts Telehealth abortions from July of 2023, as that’s when the shield laws came into effect, making these abortions legal. Still, it paints a stark picture of their impact.

Politics and media spin

You have to give me credit for getting more than 3,000 words into this before bringing up the US election! However, the fact remains that the abortion debate is more political now than it has ever been in the United States. 

Regardless of what you think about the personalities or character flaws on either side, we cannot deny their skin in the game when it comes to abortion. The Republican party runs on a pro-life platform, and the Democratic party runs on a pro-choice platform. Not only that, but the current Democratic administration is among the most aggressively pro-abortion in US political history. Kamala Harris is the first ever US vice president to visit an abortion clinic for example. She has visited 20 states and met with 250 state legislators, health care providers and advocates. She has even launched a “Fight for Reproductive Freedoms” tour!

Biden has made no secret of his wish (as a devout catholic no less) to codify Roe into the US constitution. To that end, Biden has issued 3 executive orders and one presidential memorandum since the court overturned Roe v. Wade. This administration has been instrumental in the FDA being able to approve that abortion pills can be dispensed directly by pharmacies, and for the Telehealth debacle I reference above. There is even a detailed 9 page fact sheet available on the White House website, laying out all that they are doing for “the fight for reproductive freedom”.

Media matters

Unfortunately, the media does matter and more than 90% of the mainstream media in the United States are pro-abortion and pro-Democrat. They have been running an endless smear campaign. Even as I write this (in mid June) I saw a segment on MSNBC today where host Joy Reed compared Missouri (one of the states with a total ban) to a “slave state” because the state legislature and Governor refused to sign off on giving tax payer money to Planned Parenthood for contraception. 

She said that because “it’s illegal for a pregnant woman to get an abortion, so they have also gone after no fault divorce. So if you’re pregnant and you’re in a marriage with an abusive spouse, you can’t even get a divorce once you become pregnant, you become the property of both your husband and the state, they have joint ownership of you in the state of Missouri. That is a slave state as far as being a woman is concerned, as far as I’m concerned” 

Er…what’s that Joy? A slave state…because you need to declare a reason for a divorce and you cannot kill your unborn child (unless your life is in danger)...yup...break out the thumb screws and slave ships! 

In all seriousness though, you would have to have been living under a rock for the last two years, to not have noticed the media backlash against the overturning of Roe. It’s been everywhere and a lot of it has been completely false. 

No state that has pro-life laws on the books has criminalised miscarriage care, even if it does require a D&C. No state has laws that would prohibit a Dr from saving a woman’s life, even if it would mean the tragic death of the baby. However these arguments are ones I hear continually on social media. Within the last 24 hours I have had to explain the difference between a D&C procedure for an induced abortion, and for an incomplete miscarriage, to someone online who was completely enraged and adamant that I was lying. Why so adamant, could it be because the media is spouting this same line over and over again on a loop? 

We have gone from the sage old slogan of the 90’s: “safe, legal and rare” to “shout your abortion”. The argument is less about “it’s a clump of cells” and much more about “I don’t care if it’s a baby, it can’t use my body without my consent”. So why has this shift occurred?

The culture war

It was suggested on a recent Christian podcast that nobody is asking the question: why is the demand for abortion going up so much? The hosts were keen to understand this given the almost universal access to sex education and contraception on both sides of the pond. 

They theorised that it might be because women are more reluctant to bring children into such a troubled world, or perhaps they’re more hesitant to take hormonal birth control, given the recent rise in available data regarding its side effects? They even questioned whether or not abortions were going down in the younger cohorts, due to the fact that these groups are now more likely to stay home and play Call of Duty whilst watching porn, than go out and meet members of the opposite sex in real life. 

Well, I’m no expert but I agree with the question. Why has the demand for abortion gone up so much since 2016/2017? 

Yes, there probably is an element of birth control reticence (although surveys in the US have consistently shown that only about half of women seeking abortions were on any form of contraception at all); and there is probably a lot of weariness regarding the state of the world. That said, half of all gen Z pregnancies now end in abortion…so perhaps we have to look at other causes too. 

So what else has happened since 2016/17 that may have had a hand in this seismic trend shift? 

Well among other things, Donald Trump was elected and inaugurated and the polarisation of the US political landscape was forever altered. The BLM riots happened, Covid happened, the shift in sexual ethics has been more pronounced than we have seen since the 60’s. 

We seem to have shifted very much into a society that’s based on the ultimate rights of some groups, and the erosion of the rights of others. Well what’s new under the sun you may say, and of course that’s true to an extent. But the pendulum rarely re-sets to centre, and as Carl Trueman so wonderfully outlines in his book, we seem to be seeing an unprecedented Rise and Triumph of the Modern Self

Is it so “out there” to speculate that “self” is where this atrocity nearly always begins and ends? Yes I know there are truly hard cases, for which we must have compassion and try our utmost to help wherever possible, but they are the exception, not the rule. 

Roughly 97% of abortions are elective, they are performed on healthy consenting mothers and healthy babies. When did it become ok to kill our very small, dependent children because they interfere with me, myself and I? Perhaps this is where we should truly begin our search for an answer.

There is still reason to rejoice!

Firstly, if you have read to the end of this piece, thank you for your patience. I realise brevity is not my strong point at the best of times but I think I have outdone myself on this occasion. 

What can we conclude from all of this? Is there any point in continuing to pursue pro-life legislation given the rise in abortions in the post Roe world? Can we still find encouragement in this troubling landscape?

Yes and yes! 

We can clearly see that pro-life legislation works in the states in which it has been passed. How can we not rejoice upon seeing abortion numbers fall to near zero in these states and hear of all the babies who have been saved? The rise in abortion numbers in the US is significantly lower than the rise in the UK since the overturn of Roe. 

Unfortunately, we have also seen the catastrophic effects of making abortion cheaper and easier to obtain across the US. 

The shield laws that have been put in place, pills by post and the huge funds which have risen up in the wake of the Roe overturn, have effectively rendered many pro-life states impotent when it comes to the lawful enforcement of their own legislation. Legislation which has been democratically enacted by the people in those states. 

However, do not lose hope. The shield laws have not yet been tested by the courts, and as they flout the US constitution (in terms of state sovereignty) so blatantly, it’s unlikely they will survive such challenges as they inevitably come.  

Only this month the Supreme Court has unfortunately dismissed a case relating to whether the FDA’s guidelines allowing abortion pills to be prescribed via Telehealth and accessed through the mail, should remain in effect. But the court has only dismissed this case based on how it was brought (a technicality really), they have not yet ruled on its substance and you can bet this issue will be back before the court in the near future. 

By their own admission, the National Network of Abortion Funds - set up to financially support those seeking abortions in the US - have experienced a “staggering drop off” in donations. 

If the tide turns against pro-choice states facilitating abortions by flouting local legislation in pro-life states, we can expect to see the trend turn in terms of abortion numbers. 

The current polls are showing the Republicans ahead of the Democrats with regards to the November general election. I think it’s safe to say that if the red wave actually arrives this time around, government support for abortion will fall off a cliff.

It's the right thing to do

We should support pro-life laws because they are on the side of truth and love. 

A recent peer reviewed study has found that 60% of women feel pressured to abort, and that this has a statistically significant impact on their mental health. 

We know of the harm abortion can do to women first hand and we want to protect them from that. But mostly, we want to protect the 1 million babies aborted annually in the United States, and the 73 million babies who lose their lives to abortion each year across the globe. 

The US constitution enshrines the rights to life, liberty and the pursuit of happiness. Life is the human right on which all others depend. Without it, none of our other rights matter, and it should be protected in law around the world. 

Join us in this fight and let’s make abortion unthinkable.