Number of Brick-and-Mortar Abortion Clinics Declined Slightly Between 2024 and 2025

While the abortion access landscape has shifted dramatically in recent years, brick-and-mortar clinics continue to play a critical role in both procedural and medication abortion provision. In the first half of 2025, such clinics accounted for approximately 80% of the abortions that were provided in the 37 states without total abortion bans.

This report will show that by the end of 2025, the number of brick-and-mortar abortion clinics had declined by 2% compared to March 2024. 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 Guttmacher Institute has long tracked the number of brick-and-mortar clinics—physical facilities, often specializing in sexual and reproductive health services—that routinely provide abortion care. As recently as 2020, these facilities were the only way to access clinician-provided abortion care in the United States. That changed in 2021, when the US Food and Drug Administration (FDA) removed the in-person dispensing requirement for mifepristone, one of two drugs used in most medication abortions. Since then, medication abortion provided through telehealth has become increasingly common. Remote provision of abortion is safe and effective, and for those living in abortion-restrictive states, it can be one of the only ways to access clinician-provided care.

Changes in Numbers of Brick-and-Mortar Clinics: March 2024‒December 2025

This report provides information about the number of brick-and-mortar clinics offering abortion care in states that did not have total bans in December 2025 and compares it to the number in March 2024, the last time that Guttmacher published data on clinic numbers.

Nationwide, the number of clinics in states without total bans declined 2%, from 765 in 2024 to 753 in 2025. Most state-level patterns reflected similarly small changes, and only nine states had a net increase or decrease of more than one clinic.

Four states had increases of more than one clinic:

• Massachusetts had six additional clinics, a 25% increase from March 2024.

• Missouri had three clinics compared to zero in March 2024.

• Ohio had three additional clinics, a 33% increase.

• Virginia had two additional clinics, an 11% increase.

At the time of the March 2024 clinic count, Missouri had a total abortion ban in effect. In November 2024, voters amended the state constitution to protect abortion rights, but ongoing litigation resulted in a series of pauses and resumptions of care. Missouri’s clinics resumed care in July 2025 and three were operating in December 2025.

Five states had decreases 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.

• New York had eight fewer clinics, an 8% decrease.

The decrease in Florida clinics was likely due to the 6-week gestational ban that went into effect in the state in May 2024. California, Illinois, Michigan and New York did not make any major changes to state policies that would directly impact the provision of abortion care. However, the federal withholding of Title X funds from reproductive health networks such as Planned Parenthood likely contributed to the decline in clinic numbers in at least one of these states, Michigan. It is likely that an array of policy, organizational and financial factors influenced trends in the other states.

While this report focuses on absolute increases or decreases of more than one clinic over a 21-month period, it is important to acknowledge that for states with a small number of clinics—such as Alaska, Nebraska and Rhode Island—the opening or closure of even one facility can substantially impact access to care. Such shifts can affect access both for residents of the states where clinics are located and for people who travel to those facilities from states where abortion is banned or otherwise inaccessible.

Similarly, these absolute figures are a simple measure of access and do not capture facets such as clinic location, volume, type(s) of abortion care offered or affordability. For example, some clinics have very small caseloads, do not advertise abortion services and primarily serve individuals with private health insurance.

Stability in Clinic Numbers Can Mask Churn

Nationally, the absolute number of brick-and-mortar clinics declined by 12, but this relatively small change masks a substantial amount of turnover. Specifically, 51 clinic facilities that provided abortion care in March 2024 no longer did so in December 2025, while 39 clinics that were not open or did not provide care in March 2024 were doing so in late 2025.

Turnover figures do not always represent clinic closures or the opening of new facilities. In some situations, clinics stopped or paused abortion provision but continued to provide other types of health care. Other clinics may have been operating in 2024 and added abortion care as a service later in the year or in 2025.

Additionally, these data do not fully capture the dynamic nature, or churn, of abortion care and access. Changes in clinic provision, such as pauses or resumptions of care, can make it harder for people needing abortions to figure out where to go, and can also result in unpredictable flows in care for other facilities, which have to adjust their own operations to accommodate fluctuating caseloads.

Wisconsin provides a useful example of clinic churn. The state had four clinics that provided abortion care in March 2024, and a new clinic opened in June 2025. On October 1, 2025, three Planned Parenthood facilities paused abortion care in response to the Trump administration’s new Medicaid restrictions, leaving two independent clinics providing care. The three Planned Parenthood facilities, which had continued to provide other types of sexual and reproductive health care, resumed abortion services by November 2025. Thus, the absolute increase of one clinic in Wisconsin masks a substantial amount of churn.

It is also important to acknowledge that opening a new brick-and-mortar clinic, whether it provides full spectrum reproductive health care or specializes in abortion, requires a substantial amount of work. Finding a building that will accommodate abortion care, raising the money to buy equipment, hiring and training staff, and obtaining appropriate licenses are just some of the upfront logistical and financial factors that have to be addressed before a clinic can provide even one abortion. Similarly, when a clinic closes, re-opening can be only slightly less arduous as new staff have to be hired and trained and facilities have to get relicensed.

Online-Only Clinics Are an Important Source of Abortion Care

Many brick-and-mortar clinics provide both medication and procedural abortion care and are typically the only option for pregnant people who need or prefer a procedural abortion. In recent years, however, 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 first half of 2025, these online-only clinics accounted for approximately 20% of abortions in these jurisdictions.

For people who live in states with total abortion bans, online-only clinics operating under the protection of shield laws can facilitate access, with licensed health care providers mailing them abortion medications after a telehealth consult. In the first half of 2025, shield-law providers accounted for as many as 50,000 abortions in states where abortion is completely banned, an indicator that these clinics are a vital source of care for people living in these states.

Everyone Deserves Access to Abortion Care on Their Own Terms

Like all heath care decisions, choosing if, when and how to have an abortion is deeply personal. While some people prefer to receive pills in the mail and have their abortion at home, for others in-clinic care better meets their needs and circumstances. The different timelines of procedural and medication abortion care, and the different options for sedation and pain control, can both factor into patients’ needs and preferences with regard to abortion methods and settings. Cost and insurance coverage, previous abortion(s) and other medical experiences, privacy concerns and being able to have support people present are also important considerations for many people.

For all of these reasons, it is critical that both procedural and medication abortion remain available and accessible to everyone, in a variety of settings that include brick-and-mortar clinics. Respect for reproductive and bodily autonomy requires that the method and setting of abortion care should be guided by patient need and preference and not coerced by restrictive state policies.

Methodology

Data on clinic numbers in this report come from the Guttmacher Institute’s database of facilities known to provide abortion care in the United States and reflect updates through December 31, 2025. This analysis focuses on brick-and-mortar clinics, defined as physical facilities—often specializing in sexual and reproductive health services—that routinely offer abortion care. For this analysis, we also consider the following to be brick and mortar clinics: hospital-affiliated outpatient facilities (which typically have higher abortion caseloads than hospitals) and physicians’ offices that provide more than 400 abortions per year. The universe of brick-and-mortar clinics for this analysis does not include: hospitals (sites where abortions are often provided in operating rooms); physicians' offices offering fewer than 400 abortions per year; or online-only clinics that offer medication abortion services without a physical location.

Changes in the number of clinics offering abortion services in this analysis refer to net changes. Lack of net change in the number of clinics in states without total bans does not necessarily mean that no clinics started or stopped providing abortions over the period—only that any closures or pauses to provision were offset by new clinics opening or existing clinics beginning to offer abortion care.