Across the United States, the aftermath of the Supreme Court’s 2022 Dobbs decision continues to reshape the landscape of abortion care, with ripple effects extending far beyond reproductive health. Two recent reports—one from Physicians for Human Rights (PHR) and another from the Guttmacher Institute—shed light on the cascading harms of abortion bans, the shifting patterns of abortion access, and the mounting challenges faced by both patients and clinicians.
Physicians for Human Rights published a comprehensive report on September 30, 2025, examining the consequences of abortion restrictions across 20 states with varying legal frameworks. Drawing on 33 in-depth interviews with physicians from both reproductive and non-reproductive specialties, the report finds that abortion bans are not just a reproductive health issue; they are undermining the quality and safety of medical care across the board.
“Doctors waiting for ‘irreversible damage’ before offering care. Patients given less effective medicines instead of the best available treatments. Health systems offering substandard and discriminatory care to pregnant patients. The consequences of state abortion bans are not only manifesting in harms to reproductive health care, but across many other medical specialties. From cancer care to pulmonology and beyond, the harms of abortion bans are cascading across the health system,” explained Dr. Michele Heisler, medical director at PHR and professor at the University of Michigan, in a statement quoted by the Colorado Times Recorder.
The report’s findings are particularly concerning given the prevalence of chronic and complex conditions among women of reproductive age in the U.S. As of 2019, about one in three women in this demographic had at least one chronic condition that could compromise their health or lead to adverse pregnancy outcomes, according to PHR.
One physician interviewed for the report recounted a harrowing case: “I had a patient the other day who came to me at 15 weeks and had chronic kidney disease. And at the start of her pregnancy her creatinine was 4... And by the time she had gotten to us at 15 weeks, her creatinine was [at a dangerously high level]… But if you just were to look at her and talk to her, you would say, ‘Oh, you’re stable, you look healthy.’... What we are doing is sitting and waiting almost for irreversible damage to occur before we do something and offer them [abortion care].”
Delays in care are not limited to chronic conditions. In states with abortion restrictions, treatment for ectopic pregnancies—potentially life-threatening situations—has been dangerously delayed. One provider described a patient who was sent home instead of receiving immediate care for a suspected ectopic pregnancy, only to return hours later with a ruptured ectopic and severe instability.
The patchwork nature of state laws further complicates care. Patients sometimes must travel across multiple states to obtain needed services, a journey that can result in severe complications. “I know of a patient who was on the border [between states with early gestational age limits]... She went back to where she got IVF, which was also a state with a [later gestational-age abortion] restriction and she was too far along, so then she had to go to a third state. And then by the time she got there she was septic,” said another participant.
Medication abortion—using drugs such as mifepristone and misoprostol—has come under particular scrutiny. These medications are not only central to abortion care but also vital for managing miscarriages and treating conditions like ectopic pregnancies. Restrictions on these drugs, as well as methotrexate (used for ectopic pregnancies and autoimmune conditions), are raising alarms among physicians. “If it becomes challenging to mail medications to our patients... it could become potentially dangerous to their health,” noted a gastroenterologist interviewed for the report.
Another physician highlighted the stress imposed on patients denied timely medication abortion. “She made a decision to medically terminate and she was no longer in a window where she could have a medication abortion. And so she had to do procedural termination. And it was a huge stress for her. In a lot of our neurological diseases, stress actually triggers attacks... the patient was suffering quite directly in that respect. And that of course puts her disease management at risk.”
Yet, the true extent of the harm is likely underestimated. “It’s really, really, really hard to document all of the ways that these laws are harming and frankly killing women,” said another participant. “When we get the report that these are the number of women who died because of restricted access to [abortion] care, that number is 100 percent going to be an underestimate.”
While states like Colorado have sought to protect abortion access, federal funding cuts to organizations like Planned Parenthood have left gaps in care, particularly for Medicaid recipients. Jack Teter, vice president of government affairs at Planned Parenthood of the Rocky Mountains, described a case where a patient was referred for miscarriage care but had to be turned away due to funding restrictions. In response, Colorado legislators passed a bill in a special session in September 2025 to restore Medicaid access to Planned Parenthood patients. “I’m proud to stand up for Coloradans with this new law that will restore access to life-saving care,” said Rep. Jenny Willford in an August 26 news release.
Meanwhile, the national picture is shifting. According to The Hill, new data from the Guttmacher Institute show that for the first time since the Dobbs decision, clinician-provided abortions in states without near-total bans declined by 5 percent in the first half of 2025 compared to the same period in 2024. The drop was most pronounced in states with six-week bans and in those bordering states with total bans. Out-of-state travel for abortion care also fell by 8 percent, though it remains much higher than before Roe was overturned.
The reasons for these declines are complex. While new restrictions play a role, so does the expanding availability of medication abortion prescribed under shield laws—state statutes that protect providers offering telemedicine abortion care to patients in ban states. Online clinics are increasingly stepping in to fill gaps, reducing the need for travel and in-person clinician visits. However, abortion funds that help cover travel costs are struggling financially as the surge of donations seen after Dobbs has receded.
Florida, once a key access point for abortion in the Southeast, saw a dramatic 27 percent drop in abortions in the first half of 2025 compared to the previous year, with over 12,000 fewer procedures—a figure that accounts for more than 40 percent of the overall decline in states without total bans, according to Guttmacher.
“Shield laws and direct financial assistance for patients are necessary to help people living in restrictive states access the abortion care they need. As even more extreme threats to abortion loom, bold and decisive policy responses are more necessary than ever,” Kelly Baden, Guttmacher’s vice president of public policy, stated.
As the legal and medical landscape continues to shift, the stories of patients and providers reveal the tangible human cost of abortion bans. From delayed care and dangerous travel to the erosion of trust in the medical system, the cascading effects are being felt in exam rooms, hospital wards, and legislative chambers across the country.
