Abortion clinics decline across US, impacting access to care; what factors are behind the shift and which states are hardest hit

The United States has witnessed a significant shift in the abortion access landscape in recent years with the decline in the number of abortion clinics across the country. A report from the Guttmacher Institute has emerged, which claims that there is a two percent drop in the number of brick-and-mortar abortion clinics in the US.

Brick-and-mortar clinics are physical facilities that routinely provide abortion care and often specialize in sexual and reproductive health services. In 2020, they were the only way to access clinician-provided abortion care in the U.S., according to the Guttmacher Institute.

According to Guttmacher’s report, 753 abortion clinics were active in the U.S. as of December 2025, down 12 from March 2024 and 54 from 2020. The report claims that the net decrease might seem small, but it is yet significant considering abortion access.


“This net decrease, while small, nevertheless reflects substantial changes or ‘churn’ in abortion access, as many clinics paused or resumed abortion provision or closed or reopened their doors in response to new regulatory, financial, and staffing challenges,” the report states.

According to the report, which has been prepared by Rachel Jones, Ava Braccia, and Emma Stoskopf-Ehrlich, all of the Guttmacher Institute states that have only a few abortion clinics to begin with, like Alaska, Nebraska, and Rhode Island, the closure of just one facility could bring a dramatic shift in access for residents and increase travel times for care.

Speaking on the report, Rachel Jones, principal research scientist and report author, said, “These data underscore how abortion access is constantly shifting across the United States,” as quoted by online platform US News & World Report.

“Changes in clinic provision, such as pauses or resumptions in services, create yet another obstacle for abortion patients who are already struggling to understand how and where to seek care,” he added.

What are the reasons behind decline in number of clinics?

Decreases in the number of clinics in Florida: a six-week ban went into effect in May 2024. As far as other states like California, Illinois, Michigan, and New York, the declines came without any major state policy changes.

According to the Guttmacher report, the contributing factors behind those drops likely included the Trump administration’s freezing of Title X funds from reproductive health networks, including Planned Parenthood.

Also things changed in 2021 when the US Food and Drug Administration (FDA) removed the in-person dispensing requirement for mifepristone. It is one of two drugs used in most medication abortions. However, brick-and-mortar clinics are still crucial in abortion care. The report reveals that in the first half of 2025, these clinics provided about 80% of the abortions in the 37 states without total abortion bans.

Online-only clinics become crucial

Meanwhile, Guttmacher’s report also suggests that online-only clinics have become a critical new source of care. As of February 2026, there are at least 25 online-only clinics providing remote abortion care in the 28 states (plus DC) that have neither a total abortion ban nor other restrictions (e.g., gestational duration bans or bans on mailing pills) that prohibit the provision of telehealth abortion.

In the 13 states with total abortion bans, some online-only clinics can still provide abortion care under shield laws, which protect in-state providers from legal actions by other states where abortion is restricted. In the first half of 2025, shield-law providers accounted for up to 50,000 abortions in states where abortion is completely banned, according to the Guttmacher Institute.

Five states saw decrease of more than one clinic

California had two fewer clinics, a 1% decrease; Florida had four fewer clinics, an 8% decrease; Illinois had two fewer clinics, a 6% decrease; Michigan had three fewer clinics, a 12% decrease; and New York had eight fewer clinics, an 8% decrease.