A new study of more than 16,000 people who sought help from a nationwide abortion and miscarriage hotline found demand for confidential clinical support surged both before and after the U.S. Supreme Court decision that overturned federal abortion protections.
Researchers found use of the Miscarriage & Abortion Hotline spiked 210% from June 2022 to June 2023, the year after the Dobbs v. Jackson Women's Health Organization ruling overturned Roe v. Wade.
But the study, published online in June 2026 in The Lancet Regional Health – Americas , found demand was already rising by double digits before Dobbs, especially in states that later enacted abortion bans.
"People often think the crisis in abortion access began with the Dobbs decision, but our findings show patients were already facing growing barriers to care long before Roe was overturned," said the paper's senior author, Jennifer Karlin , MD, PhD, a UC San Francisco associate professor of Family and Community Medicine. Since 2025, Karlin has directed a separate hotline, called the UCSF Reproductive Health Hotline, which provides guidance for health care professionals across the United States.
In the year before Dobbs, hotline use increased 10% per month even in states that did not go on to enact abortion bans. States that later enacted abortion bans saw an additional 7% monthly increase relative to non-ban states during the same period.
In states that later enacted abortion bans, average monthly hotline use rose from 183 contacts before Dobbs to 640 after Dobbs. In states without abortion bans, average monthly contacts increased from 125 to 315 over the same period.
The researchers found that in both states with and without abortion bans, people were increasingly turning to the hotline for guidance while managing abortions outside traditional clinical settings.
The data offers rare insight into how people are navigating abortion care increasingly turning to confidential, clinician-staffed hotlines as access to traditional health care grew more fragmented and uncertain.
"That tells us patients are continuing to find ways to access care, even in highly restrictive environments, and that real-time medical support has become an essential part of the reproductive health landscape," Karlin said.
Authors: Other authors include Sara K. Redd, PhD, MSPH, Taylor Jones, MPH, Alina A. Luke, MPH, and Whitney Rice, DrPH, MPH, of Emory University in Atlanta, Ga.; Alexandra A. Gavidia, Sage Dillon, Marissa J. Arzate, and Ashley Martinez of UC Davis School of Medicine; Mindy Brittner, MD, of the Icahn School of Medicine at Mount Sinai in New York; and April Lockley, DO, of the Miscarriage and Abortion Hotline in New York, NY and Emma Chew Murphy, MD, from UCSF.
Funding: The study was funded by the Society of Family Planning and the Center for Reproductive Health Research in the Southeast (RISE). Author disclosures are included in the paper.
About UCSF: The University of California, San Francisco (UCSF) is exclusively focused on the health sciences and is dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. UCSF Health , which serves as UCSF's primary academic medical center, includes among the nation's top specialty hospitals and other clinical programs, and has affiliations throughout the Bay Area. UCSF School of Medicine also has a regional campus in Fresno. Learn more at ucsf.edu or see our Fact Sheet .
