More than 1.1 million unborn babies were killed in abortions in 2025, according to a new report from the Guttmacher Institute, with total procedures rising slightly to an estimated 1,126,000 from 1,124,000 the year prior.

The report notes its figures likely undercount the true total, as it does not include abortions obtained through international providers or underground networks distributing abortion pills outside the formal healthcare system.

A key driver of the increase was the continued rise in telehealth abortions. The number of mail-order procedures jumped from roughly 72,000 in 2024 to 91,000 in 2025, including significant growth in states that restrict abortion. Analysts say the expansion of remote access has allowed abortion providers to bypass geographic limitations.

At the same time, interstate travel for abortions declined, falling to about 142,000 cases in 2025 from 154,000 in 2024 and 170,000 in 2023. The shift reflects a growing reliance on telehealth services, which reduces the need for patients to cross state lines.

Medication abortions continue to make up a growing share of total procedures. Guttmacher previously estimated they accounted for 63 percent of abortions in 2023, a sharp rise from earlier years, with additional cases likely occurring through unregulated distribution channels.

The expansion of mail-order abortions traces back in part to a 2021 policy change under the Biden administration’s FDA, which removed the requirement for in-person dispensing of abortion drugs. That decision, combined with legal protections in Democrat-led states, has enabled providers to ship abortion pills into states with pro-life laws.

Republican lawmakers have urged the Trump administration to revisit the policy and tighten oversight of abortion drugs, particularly mifepristone, citing studies suggesting higher complication rates than previously reported.

Meanwhile, some states have enacted laws aimed at limiting abortion access across state lines, particularly for minors. Despite those efforts, states like Illinois and North Carolina continue to see large numbers of out-of-state abortion patients, underscoring the shifting landscape of abortion access in the post-Roe era.