Clinic Adaptations and Changes in Abortion Use After Dobbs in Illinois, July 2021-June 2023

Objectives. To assess changes in abortion service delivery in Illinois after the Dobbs v Jackson Women's Health Organization decision. Methods. We used data from a monthly survey of 2 Illinois abortion providers that provide half of Illinois's abortions. We collected data from 2021 to 2023 on abortion counts, overall and stratified by method, gestation duration, and patient state. We compared pre- and post-Dobbs findings. Results. A total of 24 071 abortions took place from July 2021 to June 2022 and 32 579 from July 2022 to June 2023. This 35% increase was driven by a 191% increase in out-of-state patients. Medication abortions increased by 22%, procedural abortions by 53%, and abortions occurring at 12 weeks or later by 75%. Conclusions. After Dobbs, 2 large Illinois abortion providers increasingly offered care to out-of-state patients and patients presenting at later gestations while maintaining in-state abortion rates. Public Health Implications. Policymakers in states where abortion remains legal can anticipate increased demand for care when other states restrict abortion. By passing legislation to protect access to medication and procedural abortions and abortions later in pregnancy, they can support facilities in meeting patient needs. (Am J Public Health. 2026;116(3):359-367. https://doi.org/10.2105/AJPH.2025.308273).