Abortion Clinics Are Shuttering Even in Major Access States

The landscape of abortion access in the US is shifting in ways that are not immediately obvious from headline numbers, according to a new report from the Guttmacher Institute.¹

From March 2024 to December 2025, the number of brick‑and‑mortar abortion clinics in states without total abortion bans fell by about 2%, from 765 to 753. But that modest net decline masks meaningful shifts in where and how care is delivered—and highlights how policy, funding, and operational pressures continue to shape the landscape.²

Closures in Legal Access States Raise Alarms

Several key access states saw net clinic losses over this period, according to the report.¹ In New York, there were 8 fewer brick-and-mortar abortion clinics by the end of 2025 than a year earlier. One of those closures was a Planned Parenthood facility in Manhattan—historically one of the city’s busiest abortion providers—a development described as “a big blow” to access.³

Illinois also experienced a decrease in clinic numbers, down 2 from 2024, even though the state has strong protections for abortion care. These declines underscore that legal protections alone don’t ensure stability for clinics, which face financial, staffing, and logistical challenges. Experts say that fewer physical locations can strain remaining providers as they absorb higher patient volumes.

Policy and Funding Pressures

In states like Florida—which enacted a 6-week abortion ban in May 2024—clinic counts dropped by 4, an 8% decrease that aligns with restrictions narrowing the window for legal abortions.¹ Meanwhile, the federal government’s withholding of Title X family planning funds from reproductive health networks, including Planned Parenthood affiliates in some regions, likely contributed to clinic declines in places such as Michigan.²

Moreover, small shifts in clinic numbers can have outsized effects in states with relatively few providers. For instance, the closure of even a single clinic in Alaska, Nebraska, or Rhode Island can significantly reshape where patients must travel for care.¹

Churn and Instability Beyond Net Numbers

The researchers emphasize that the headline clinic count understates the instability in abortion service provision. During the 21‑month reporting period, 51 facilities that offered abortion care in early 2024 were no longer doing so by late 2025, while 39 others began or resumed services. Some paused abortion care while continuing other services, complicating efforts by patients to identify providers. That kind of churn can create unpredictable access patterns that make travel, scheduling, and referrals more difficult, particularly for people with limited resources.

Role of Telehealth and Online Care

Despite declines in physical clinic counts, in-clinic facilities still provide roughly 80% of abortions in states where the procedure is legal, underscoring their central role in care delivery. At the same time, telehealth and online-only providers are increasingly part of the ecosystem. As of early 2026, at least 25 online-only clinics were offering remote medication abortion in jurisdictions without telehealth restrictions—and in states with bans, shield-law providers mailed abortion medications to patients after virtual consultations.

Telehealth’s expansion has broadened options for many people, but physical clinics remain essential for procedural abortions and care later in pregnancy that cannot be delivered remotely.

An Uneven Access Patchwork

Providers and advocates say access isn’t determined solely by legal status, but also by where clinics are located, how well staffed they are, and whether patients can afford travel, childcare, or time off work.³ Even in states with protections, closures can leave regulatory safe zones with fewer resources to meet demand.

As reproductive health care continues to evolve in the post-Dobbs era, the new Guttmacher data illustrate a complex picture: legal protections, funding dynamics, and changing care models all influence who can access abortion—and how easily they can do so.¹

References

1. Jones RK, Braccia A, Stoskopf-Ehrlich E. Number of brick-and-mortar abortion clinics declined slightly between 2024 and 2025. Guttmacher Institute. February 18, 2026. Accessed February 18, 2026. https://www.guttmacher.org/report/abortion-clinics-united-states-2024-2025

2. Goldman M. Charted: Abortion clinic access by state. Axios. February 18, 2026. Accessed February 18, 2026. https://www.axios.com/2026/02/18/abortion-clinic-closures-guttmacher

3. McPhillips D. Abortion clinics are closing, even in states that have become key access points. CNN. February 18, 2026. Accessed February 18, 2026. https://www.cnn.com/2026/02/18/health/abortion-clinic-closures-guttmacher