Pro-life organizations have released a report suggesting that the Biden administration’s FDA policy, which permits abortion pills to be prescribed through telemedicine and mailed, has contributed to a rising number of abortions in the U.S. since 2020. They argue that this policy could potentially be reversed under a Trump administration.
The Restoring America Foundation (ROAF), referencing research from Guttmacher and WeCount, estimates that during the pandemic, the FDA’s policies may have resulted in over 500 mail-order chemical abortions daily. Additionally, they indicate that chemical abortions now make up about 63% of all abortions in 2023, a significant increase from 39% in 2017.
Furthermore, the report estimates about 170,000 additional abortions occurred in 2024 compared to what might have happened if the rates had stayed at 2019 levels.
“After a low in 2017, the national abortion rate has climbed steadily,” the report specifies. “In 2019, when mail-in abortions were illegal, there were approximately 916,460 abortions. By contrast, estimates indicate abortion rates increased by 22% from 2019 to 2024, while the U.S. population grew by only 2.9%.” It predicts that in 2024, abortion numbers could reach about 1.1 million.
The study highlights that by the first half of 2025, mail-in abortions constituted roughly 25% of total abortions. Data from WeCount also shows that about 244,590 self-managed abortions occurred in 2024, with many involving pills sent to states where abortion was heavily restricted or banned following the Supreme Court’s overturning of Roe v. Wade in 2022.
The report criticizes the Biden administration for removing a safety standard that mandated in-person doctor consultations for receiving mifepristone. It claims this change was justified by limited research, with previous reports indicating that the mechanisms in place for tracking complications from the drug were insufficient.
ROAF CEO Doug Tuax noted that individuals often find ways to obtain their medication through telemedicine, leading to a dramatic rise in abortions. He said, “We are witnessing an alarming increase — 874,000 in 2023, climbing to 1.1 million in 2024.” He mentioned that this trend might continue, suggesting the annual total could reach 1.4 million by the end of Trump’s potential presidency.
Tuax further expressed concern about health risks post-abortion, stating, “Roughly 150 women suffer severe complications daily due to this drug. We really need doctors involved in these cases, especially since ectopic pregnancies pose serious risks.” He reflected on the duality of the issue, emphasizing both the pro-life stance and the need for women’s health considerations.
He pointed out that the states with the largest populations are receiving the most abortion pills and noted that Democratic-led states have created laws that shield providers from pursuing legal action from Republican-led states.
The FDA has remained firm on its decision to keep in-person dispensing requirements for mifepristone suspended. This change came about after a moratorium that lasted due to the coronavirus pandemic. Legal challenges against this policy occurred during the previous administration, but a Supreme Court ruling allowed it to stay in effect, despite previous judicial doubts about the FDA’s decisions under Biden.
Tuax insisted that the Trump administration could reverse these policies, urging prompt action. “There’s a political hesitation here, perhaps. But what we’re highlighting is that if these numbers keep rising, we need decisive steps to address it,” he explained.
Amidst this backdrop, over 20 attorneys general previously urged Secretary of Health and Human Services Robert F. Kennedy Jr. and FDA Commissioner Marty McCulley to reassess the safety of mifepristone, advocating for reinstated safety measures or even the drug’s removal from the market. While Kennedy and McCulley have promised to undertake a safety review, no specific timeline has been provided.
The ROAF report concludes that the current administration has the means to revert FDA decisions and should quickly restore safety measures for chemical abortion drugs.
