The fourth anniversary of the Dobbs decision offers a grim reminder to pro-life advocates that, despite winning the battle to overturn Roe v. Wade, they are losing the war.
Elective pregnancy terminations have climbed since the Supreme Court eliminated the federal right to abortion in Dobbs v. Jackson Women’s Health Organization on June 24, 2022, driven by a booming mail-order abortion pill industry that has made state restrictions largely unenforceable.
“Are we better off today? No, we’re killing more babies today,” Bob Vander Plaats, president and CEO of The Family Leader, said on a Tuesday press call. “We’re being more creative about how we kill more babies. We’re endangering more women today.”
Clinicians performed 1.13 million abortions in 2025, up 16% from 2020. This does not include at-home abortions using pills obtained from community networks and foreign providers, according to the pro-choice Guttmacher Institute.
Bishop Daniel Thomas, chairman of the U.S. Conference of Catholic Bishops’ Committee on Pro-Life Activities, warned that “the victory of the Dobbs decision risks being undone by the massive influx of abortion pills.”
“While the Dobbs decision gave states the freedom to pass pro-life laws and protect pre-born children, these laws are now being undermined,” Bishop Thomas said in a Monday statement.
Twenty states enacted tighter restrictions on abortion after Dobbs, in some cases banning all abortions except to save the life of the mother or prevent serious physical harm.
Those laws were largely bypassed by actions taken under the Biden-era Food and Drug Administration. In 2023, the agency eliminated the in-person prescribing requirement for mifepristone, one of two drugs in the abortion pill protocol, and allowed it to be delivered by mail.
The shift has fueled growing tension between the second Trump administration and the pro-life movement.
Pro-life advocates have urged the FDA to reinstate its pre-Biden safeguards, but the agency has declined to do so. The advocates have urged President Trump to support a federal minimum, such as a 20-week gestational limit on most abortions, but he supports allowing the states to decide their own policies.
Thanks to the mail-order abortion pill, however, the political strategy has shifted. “The whole states-only experiment is a failure,” said Marjorie Dannenfelser, president of SBA Pro-Life America.
“We find that the abortion drug has usurped sovereignty of those states, and that people like Gavin Newsom, the governor of California, and Kathy Hochul, the governor of New York, are determining policy for pro-life states,” she said. “To the extent that now 15,000 children a month are dying in pro-life states, states that have strong pro-life protections. That is the definition of failure.”
Still, she said, there is reason for optimism. The FDA confirmed last month that it has opened a safety review into mifepristone under acting Commissioner Kyle Diamantas, who took over after the resignation of embattled Commissioner Marty Makary.
Ryan Bomberger, founder of the Radiance Foundation, said the movement is regaining its footing after the post-Dobbs onslaught, which included nearly 100 attacks on pro-life centers and what he described as a slew of “hugely deceptive state ballot initiatives” ensuring virtually unlimited abortion access.
“It’s always hard to compete when you’re outspent 20-to-1 and have to overcome blatant mainstream media bias,” he told The Washington Times. “I think we’re better, though, since Dobbs, because we’re finding new ways to break through the political noise. We see this success, culturally, with viral messaging on social media.”
He said 19 states now offer alternatives to abortion, including more than $200 million in pregnancy and postpartum resources, adoption options, counseling and material support.
“Funding for pregnancy centers has increased significantly,” he said. “That’s a win for mothers, fathers and children, born and unborn. Pro-life policies implemented at [the Department of Health and Human Services] is a win. Defunding Planned Parenthood in Trump’s big beautiful bill was a win.”
Eighty-three pro-life groups sent a letter Tuesday to acting Attorney General Todd Blanche, urging him to settle the lawsuit, Louisiana v. FDA, by entering into a consent decree that returns to the pre-Biden safeguards.
“Pro-life states cannot enforce their laws while an FDA regulation gives cover to mail-order abortionists and [the Justice Department] defends the profits of abortion drug manufacturers,” the letter stated. “The current regime undermines state laws, including basic protections against practicing medicine without a license, while shield-law abortionists ship drugs across state lines with impunity.”
They cited a McLaughlin & Associates poll showing 71% of likely voters favor requiring an in-person medical visit to receive a mifepristone prescription.
Despite their disagreements with the Trump administration, abortion opponents took care to praise Mr. Trump for his pro-life accomplishments, starting with his first-term appointments of the three Supreme Court justices who swung the majority in the 2022 Dobbs decision.
“President Trump’s done a lot of great things with the pro-life movement, from the appointment of judges, the speeches, all those types of things, and we applaud him,” Mr. Vander Plaats said.
He urged the president to “go to where the battle really is. And the battle really is right now with this abortion pill.”
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