The Math They Don’t Want You to See
The Rest of the World Report | September 2, 2026 — Special Report
Great Park in Irvine, California, August 29, 2026. Tens of thousands of people gathered on a day that felt like a desert afternoon. The orange hot air balloon bloomed overhead with the Daisy Chain Fields logo. The festival ran all day. Olivia Rodrigo closed the show. Before she played her first note, she made an announcement.
The festival had raised $10 million for 10 nonprofit organizations dedicated to women’s health and rights. Then philanthropist Melinda French Gates appeared on screen. She pledged another $10 million through Pivotal Ventures. The total was $20 million. The crowd’s response spilled into the music.
Rodrigo said she named the festival “Daisy Chain” because individual parts can come together to create something strong and unbreakable. She called it a response to the regression of women’s rights today.
The nonprofit partners included Planned Parenthood, the National Women’s Law Center, and Black Mamas Matter Alliance. A chalkboard installation by the Guerilla Girls invited attendees to write their grievances. One read “ABORTION RIGHTS 4 ALL.”
This was not just a music festival. It was a response to a political reality. In 2025 the federal government paused $27.5 million in family planning grants. While Rodrigo and French Gates stood on a California stage raising money for reproductive healthcare, that same government continued its effort to dismantle the infrastructure of contraception access and abortion care.
The pause came on March 31, 2025. Sixteen of 86 Title X grantees received notification that their funding would be temporarily withheld. That includes Planned Parenthood affiliates. HHS administratively restored the funds in December 2025, rendering pending litigation moot. The damage did not reverse when the money returned. Clinics were disrupted. Services were delayed. Patient trust was eroded.
What follows is not opinion. It is documentation. The question this report seeks to answer is simple and specific: Do restrictions on abortion and reproductive healthcare lead to fewer abortions? Or does the opposite happen? Does expanding access to contraception, education, and reproductive healthcare reduce unintended pregnancy and therefore reduce abortion incidence?
The answer is in the data. The data has been collected for decades. It comes from inside the United States and from every continent on earth. The answer does not change depending on who is asking.
The Numbers After Dobbs
On June 24, 2022, the Supreme Court issued its ruling in Dobbs v. Jackson Women’s Health Organization. The decision overturned Roe v. Wade. It ended nearly 50 years of constitutionally protected access to abortion care. Legal oversight transferred from the federal judiciary to individual states.
Twelve states enacted near-total abortion bans within days. Another six states imposed gestational limits between 6 and 12 weeks. Eighteen states comprising nearly one-third of the US population restricted or banned abortion entirely.
Experts predicted the abortion rate would drop. The logic was straightforward. Fewer legal options means fewer procedures. This prediction proved wrong.
An estimated 1,126,000 abortions were provided by US clinicians in 2025. That is largely unchanged from 1,124,000 in 2024. It represents a 21 percent increase from 2020, the last year before Dobbs for which comprehensive national estimates exist.
The abortion rate in 2025 was 16.7 abortions per 1,000 women aged 15 to 44. That matches the 2024 rate. It is a 5 percent increase from 2023, when the rate was 15.9. It is a 16 percent increase from the 2020 rate.
These figures include medication abortions provided via telehealth. They include procedures performed in states without total bans. They do not include self-managed abortions using medications sourced from outside the United States or obtained through community networks. Evidence suggests self-managed abortions have increased since Dobbs.
In states without total bans, the number of abortions actually declined slightly in 2025, from 1.049 million to 1.036 million. In states with total bans, telehealth-provided abortions spiked from 74,000 to 91,000.
Medication abortion accounted for 65 percent of all clinician-provided abortions in 2023. By 2025, virtual-only clinics accounted for 24 percent of all clinician-provided abortions in the United States. That was 20 percent in 2024 and 12 percent in 2023.
People traveled. Travel across state lines for abortion care peaked in 2023, when more than 169,000 patients crossed borders to obtain care. That represented 16 percent of all abortions in the United States. Half as many people traveled in 2020. In 2025, approximately 142,000 people crossed state lines. That is still historically high. It represents 13 percent of all abortion patients that year.
Brick-and-mortar clinics closed. At the end of 2025, 753 physical clinics provided abortion services. That is a 2 percent decline from March 2024, when there were 765. It is a 7 percent decline from 807 in 2020. As of December 2025, zero clinics operated in the 13 states with total bans. Those states had 62 clinics in 2020.
The bans did not stop abortions. They displaced them. They pushed them underground. They made them harder, more expensive, and more dangerous for the people who needed them most.
What Happens When Women Cannot Access Abortion
A study published in the Journal of the American Medical Association (JAMA) in 2025 examined the 14 states with the most restrictive abortion policies. It found a roughly 2 percent increase in birth rates above trend predictions. The increase was concentrated among racial and ethnic minorities, Medicaid beneficiaries, unmarried individuals, and those without a college degree.
Women were carrying pregnancies they could not terminate. They were giving birth to children born into circumstances the mothers had sought to avoid.
The October 2025 Milbank Quarterly synthesized research tracking the aftermath of state-level bans. States with abortion restrictions experienced 22,000 additional births. They also experienced 478 excess infant deaths since Roe was overturned.
Independent maternal mortality research tells a similar story. Maternal mortality decreased by 21 percent in permissive states after Dobbs. The Gender Equity Policy Institute found that maternal mortality in Texas rose 56 percent overall in the first year of its ban. Among White women in Texas, it rose 95 percent. A separate ProPublica investigation documented a 50 percent increase in maternal sepsis cases in Texas following the ban.
Black mothers living in states with bans were 3.3 times more likely to die during pregnancy, childbirth, or postpartum, controlling for prior trends.
Infant death rates in states with abortion bans were 5.6 percent higher than expected. The increase was larger for deaths with congenital causes and among groups that already had higher-than-average infant mortality rates at baseline. Non-Hispanic Black infants saw a relative increase of 10.98 percent. Texas’s 6-week ban took effect in 2021. An American Journal of Preventive Medicine time-series analysis found that in the ban’s first year, infant mortality rates rose 17 percent over expected levels. The rate for non-Hispanic Black babies rose 21 percent.
The Turnaway Study provides the human dimension behind these statistics. Dr. Diana Greene Foster at UCSF tracked nearly 1,000 women over five years. Some received abortions. Others were denied them because they arrived too late for clinic gestational age limits.
The women who were denied abortions suffered worse outcomes across every measured category. They were three times more likely to be unemployed. They were four times more likely to live below the poverty line. They reported higher rates of inability to afford basic needs.
They experienced more severe physical health complications from childbirth. Two women died after delivery. One died of infection. One died of a common pregnancy complication. Carrying a pregnancy to term and delivering a child is more physically risky than having an abortion, even a later abortion.
Their existing children fared worse, too. Children whose mothers were denied abortions were less likely to achieve developmental milestones. Language acquisition lagged. Gross motor skills lagged. Fine motor skills lagged.
Sixty percent of people nationally who have abortions are already mothers. They cite caring for the children they already have as a reason for seeking termination. When those women are denied care, the ripple effects extend to families already struggling.
Ninety-five percent of study participants who received an abortion said they made the right decision. Positive emotions outweighed negative ones. Over time, both positive and negative emotions diminished. People moved on with their lives. The idea that abortion permanently disrupts mental health is not supported by the data.
Stigma predicts poor mental health outcomes more reliably than the procedure itself. The much larger predictor of poor mental health is a history of childhood abuse and neglect.
What Actually Reduces Abortion Rates
The World Health Organization publishes global data on abortion. Around 73 million induced abortions take place worldwide each year. Six out of 10 unintended pregnancies end in induced abortion. Three out of 10 of all pregnancies end in induced abortion.
WHO states clearly: Evidence shows that restricting access to abortions does not reduce the number of abortions. It affects whether the abortions that occur are safe and dignified.
The proportion of unsafe abortions is significantly higher in countries with highly restrictive laws than in countries with less restrictive laws. An unsafe abortion is defined as a procedure performed by persons lacking necessary information or skills, or in environments not conforming to minimal medical standards, or both.
Unsafe abortion is an important preventable cause of maternal deaths and morbidities. Deaths from safe abortion are negligible. The rate is less than one per 100,000. In regions where unsafe abortions are common, death rates exceed 200 per 100,000 abortions.
In Latin America and Africa, approximately three out of four abortions are unsafe. In Africa, nearly half of all abortions occur under the least safe circumstances.
Countries with some of the world’s highest abortion rates are countries where abortion is illegal or heavily restricted. Brazil prohibits abortion except in cases of rape, fetal anomaly, or risk to the mother’s life. Its rate is 32 per 1,000 women. Mexico, where abortion legality varies by state but remains restricted in many, sits at 31 per 1,000. Both are more than double the United States rate. Restricting access did not produce lower numbers.
Now look at the other direction. Western European countries have some of the world’s lowest abortion rates. Abortion is legal and covered as standard service by national health insurance systems.
Germany’s rate is 5.4 per 1,000 women. The Netherlands’ rate is 7.0. Finland’s is 6.5. Belgium’s is 8.0. Spain’s is 7.5. France sits at 15.7 and the United Kingdom at 20.6.
The Netherlands deserves specific attention. It has one of the lowest abortion rates in the world. Abortion is freely available on demand. Contraceptives excluding condoms are provided at no charge by the national health service. They are easily accessible to teenagers. Comprehensive sex education is standard. Open discussion about sexuality occurs in media and schools.
A peer-reviewed study published in Contraception explains the Dutch model. The reduction of unwanted pregnancies was accomplished through successful strategies for preventing teenage pregnancy. Sex education, open discussions on sexuality in mass media, educational campaigns, and low-barrier services drove the decline. Wide acceptance of sterilization also contributed. Modern contraceptives were stimulated by a strong voluntary family planning movement and the public health insurance system.
Russia provides another case study. The Guttmacher Institute documented Russia’s experience. Until the late 1980s, modern contraceptives were largely unavailable. Women relied on low-quality condoms and one-size-fits-all diaphragms. Russia legalized abortion in 1955 in response to the public health problem of illegal procedures. By 1990, Russia’s abortion rate exceeded 100 per 1,000 women of reproductive age.
Free market reforms in the late 1980s opened the door to modern contraceptives from western Europe. In 1992, the Russian government began subsidizing family planning programs and distributing free contraceptives. Between 1988 and 2001, modern contraceptive use increased by 74 percent. The abortion rate declined by 61 percent.
Then the government ceased support for contraceptive programs in 1997. Antiabortion sentiment grew. Restrictions were implemented in August 2003, sharply limiting second-trimester procedures. The rate continued to decline anyway, because more than 90 percent of abortions in Russia take place in the first trimester. Second-trimester restrictions do not affect the overall rate.
A leading antiabortion parliamentarian called the restrictions only the first step. A Russian obstetrician, Vladimir Serov, said something different. He called restrictions useless. He said the answer was promoting family planning.
South Korea offers a third example. During the 1960s and 1970s, desired family size dropped dramatically. For a period, both contraceptive use and abortion rates rose simultaneously. Eventually, as contraceptive prevalence climbed and fertility stabilized, the abortion rate turned downward. The shift took time. But it happened where contraception became widely available and effective.
Turkey provides further evidence. Between 1988 and 1998, Turkey’s abortion rate dropped from 45 to 24 per 1,000 married women while overall contraceptive use remained essentially the same. The difference was method mix. Use of modern contraceptives increased while use of traditional methods decreased. A researcher named Pinar Senlet concluded that marked reductions in abortions were achieved through improved contraceptive use rather than increased use. More effective methods replaced less effective ones.
Bangladesh demonstrates the role of quality. Since 1977, a project called MCH-FP has provided family planning services in the Matlab district. Compared to standard government services, MCH-FP offered a broader mix of methods, more home visits, and more individualized counseling. By 1998, the abortion rate in the comparison area was three times higher than in the MCH-FP area. Unintended pregnancy declined in both areas. It dropped much more where higher-quality services were available.
Fertility in Bangladesh fell from about 6.5 to 3.3 births per woman during this period. Researchers credited the government’s political priority on family planning. Even in the comparison area, abortion likely would have been higher without the services the government provided.
The Policy Contradiction
Here is what the evidence says. Here is what American policy does.
Between 2008 and 2011, the US abortion rate dropped 13 percent. Birthrates declined substantially during the same period. The Guttmacher Institute published findings in the New England Journal of Medicine in 2016. The unintended pregnancy rate declined 18 percent. It reached its lowest level in at least three decades.
Abortion opponents attributed the decline to restrictions and to a growing culture of life. The data contradicted both claims. The proportion of unintended pregnancies ending in abortion stayed stable at 40 to 42 percent. The unplanned birth rate dropped by almost one-fifth, from 27 to 22 per 1,000 women. Unplanned births were not replacing abortions.
The explanation was contraceptive use. Overall use of any contraceptive method increased slightly among women at risk of unintended pregnancy, from 89 percent in 2008 to 90 percent in 2012. More importantly, use of long-acting reversible contraceptives (LARC), such as IUDs and implants, more than tripled between 2007 and 2012. The rate jumped from 3.7 percent to 11.6 percent of all contraceptive users.
These methods are more than 99 percent effective. They may last up to 12 years. They do not require daily compliance. The 18 percent of women who use contraception inconsistently account for 41 percent of all unintended pregnancies. Increases in LARC use led to more consistent and effective contraceptive use overall.
Teen pregnancy declines followed the same pattern. Between 1995 and 2002, contraceptive improvement accounted for 86 percent of the teen pregnancy decline. Between 2003 and 2010, a period with no changes in teen sexual activity, the continued decline was entirely due to contraceptive use.
States that taught comprehensive sex education covering abstinence along with contraception and condom use tended to have the lowest teen pregnancy rates. States with abstinence-only education laws had higher rates.
And yet here is what happened after Dobbs. Republican lawmakers in North Dakota, Arkansas, and Texas pushed bills to defund comprehensive sex education programs for at-risk teenagers. The same states passed some of the most restrictive abortion laws in the nation.
The Trump administration paused $27.5 million in Title X family planning grants on March 31, 2025. These grants fund clinics that provide birth control, cancer screenings, and sexually transmitted infection treatment. Planned Parenthood affiliates were among those affected. HHS administratively restored the funds in December 2025, dropping related litigation as moot.
The CDC stopped publishing abortion surveillance data after the second Trump administration began. On May 9, 2025, Politico reported that Health Secretary Robert F. Kennedy Jr. had laid off approximately 80 federal employees who worked at the CDC’s Division of Reproductive Health. The most recent CDC data are from 2022.
This is not a coincidence. This is a strategy. The argument is that restricting abortion will reduce abortion. The evidence says it does not. The evidence says the opposite. Expanding access to contraception, to comprehensive sex education, to reproductive healthcare, that is what reduces unintended pregnancy. That is what reduces abortion.
Restricting abortion does not make pregnancy disappear. It makes pregnancy unwanted. It makes childbirth more dangerous. It makes infant mortality rise. It makes maternal mortality rise. It forces women who cannot afford an additional child to bring one into the world anyway. It destabilizes families that are already struggling.
The Turnaway Study documented this. The Milbank Quarterly documented this. JAMA documented this. WHO documented this. Decades of research from every continent documented this.
Epilogue
Olivia Rodrigo finished her set at Daisy Chain Fields with “Landslide.” She sang it with Stevie Nicks. They harmonized under a nearly full moon. The crowd took shuddering breaths.
The song is about getting older. About watching things change. About accepting that nothing stays the same.
Everything in that moment was real. The music was real. The solidarity was real. The $20 million was real. So was the regression Rodrigo named.
The policy choice is not between abortion and no abortion. The policy choice is between two paths. One path restricts abortion access and expects fewer abortions as a result. The other path expands contraception access, funds comprehensive sex education, supports reproductive healthcare infrastructure, and expects fewer unintended pregnancies as a result.
One path is supported by ideology. The other path path is supported by a century of data from dozens of countries.
The data does not bend. Women who want to control their fertility will find a way. The question is whether they do it safely, or whether they do it in conditions that kill them. The question is whether their children are born wanted, or whether they are born into circumstances their mothers sought to escape.
The question is whether the country chooses the math that works.
Sources: Guttmacher Institute (US abortion incidence, rate, clinic count, and travel/telehealth data — March 2026 fact sheet); KFF (monthly abortion volume trends before and after Dobbs); World Health Organization (global abortion incidence and safety data); Milbank Quarterly Opinion, Paula M. Lantz (excess births and infant deaths in ban states, October 2025); JAMA/PMC, Bell et al. (US Abortion Bans and Fertility, 2025); Gender Equity Policy Institute (Texas maternal mortality analysis); ProPublica (Texas maternal sepsis investigation); American Journal of Preventive Medicine via ScienceDirect (Texas infant mortality time-series by race and ethnicity); UCSF/ANSIRH (The Turnaway Study, primary research archive); NPR (Turnaway Study coverage); Associated Press via ADN (Daisy Chain Fields Festival coverage, August 30, 2026); NME, Rachel R. Carroll (Daisy Chain Fields Festival review, August 31, 2026); World Population Review (country-level abortion rate comparisons); Guttmacher Institute, Joerg Dreweke (contraceptive use driving US abortion decline, 2016); Guttmacher Institute, Amy Deschner and Susan A. Cohen (global contraceptive use and abortion, 2003); Contraception via ScienceDirect (Dutch abortion rate explained, 1994); PubMed (lessons from the Dutch abortion experience, 1996); KFF (Title X grantees and clinics affected by the funding freeze); The Washington Post (Title X funding freeze from Planned Parenthood); Politico (Dismantling one of the strongest tools we have, CDC Division of Reproductive Health layoffs, May 9, 2025)
“Whenever the people are well informed, they can be trusted with their own government.” — Thomas Jefferson, 1789