An Exclusive Special Investigative Report from Operation Rescue

Part One of Two

By Cheryl Sullenger

The number of abortion facilities in the U.S. increased in 2021, according to results from Operation Rescue’s annual survey of U.S. abortion facilities. Today there is a total of 720 in the U.S. – 14 more than were operating in 2020.  This represents the largest increase in abortion facilities since 2016.* The total is still far below the all time high of 2,176 abortion facilities in 1991.

A total of 41 new abortion locations opened or resumed abortions in 2021, while there were 27 abortion facilities that closed or halted abortions.  At the end of 2021, there were eight additional facilities that had temporarily suspended abortions until further notice but were expected to resume theme in the near future.

Other noteworthy facts were revealed by Operation Rescue’s survey of every U.S. abortion facility.

  • Since Operation Rescue began tracking the number of abortion facilities in 2009, surgical abortion facilities have decreased in number by 265
  • Today, there are 448 surgical and 272 chemical abortion facilities operating in the U.S.
  • Overall, the number of abortion pill facilities rose by 24 locations, while the number of surgical abortion facilities fell by 10.
  • The number of Planned Parenthood abortion facilities rose slightly in 2021.  Planned Parenthood affiliated clinics now account for 54 percent of all abortion facilities nationwide.
  • The number of abortion facilities/businesses that use telemedicine to distribute abortion drugs rose a significant 44 percent in 2021 to a record high of 123 locations.  Those now account for 17 percent of all abortion facilities nationwide.


Each year, Operation Rescue conducts a nationwide survey that involves contact with each abortion business in the U.S.  The information gathered about the abortion clinics and their practices represents the most current and accurate data available.

This most recent data was compiled by Operation Rescue from November 15 through December 17, 2021.

Operation Rescue defines “abortion clinics” as those businesses that conduct abortions outside a hospital setting.  There are two categories of abortion clinics:

  • Surgical Abortion Clinics: These offices conduct surgical abortions. Almost always, surgical facilities also distribute abortion-inducing drugs.
  • Abortion Pill or “Medication” Clinics: These offices supply abortions through the administration of drugs (pills) or other chemical means. They do not conduct surgical abortions.

Abortion facilities by the numbers

The uptick in the number of abortion facilities to a 13-year high of 720 is primarily due to an expansion in chemical abortion facilities.

The number of surgical abortion clinics continues to decline.  In fact, the number of surgical abortion clinics has fallen each year for at least the past 13 years. In 2009 there were 713 surgical abortion facilities nationwide.  Today, surgical abortions have decreased 37 percent since 2009, and are now at a record low of 448.  

“Surgical abortion facilities are still the most numerous and the most profitable, so when they shut down, it is great news that means lives are being saved,” said Operation Rescue President Troy Newman.  “However, with the increase in abortion pill distribution points and the added approval by the current administration of allowing abortion drugs to be distributed by mail, this year’s survey results are a mixed bad of good news and bad.”

Abortion pill facility numbers have been steadily on the rise since 2009, increasing by 52 percent.

Today, there are 227 facilities that abort using only chemical means – a significant increase of eight percent in just the past year alone. 

We will discuss the causes of this increase later.

Opens and closures in 2021

Of the 41 new abortion businesses to open or resume abortions in 2021, eight were surgical facilities while 33 were chemical abortion businesses.  This dramatic increase in abortion pill locations is attributable primarily to changes in policy made by the Biden Administration over the past eleven months that encouraged the distribution of abortion-inducing drugs.

In all, 27 abortion facilities closed or halted abortion services in 2021.  Sixteen of those were surgical facilities, while 11 were abortion pill facilities.

Some notable facilities that closed or stopped conducting abortions are highlighted below.

The Pro-Choice Medical Center in Beverly Hills, California, was one of the few abortion facilities in the U.S. to conduct abortions throughout all nine months of pregnancy.  Because it catered to Hollywood’s elite, it became known as the “Abortion Clinic to the Stars.” The China Virus hit this abortion business hard in 2020, contributing to its closure in January 2021

Operation Rescue documented ten medical emergencies there that required ambulance transport to a local hospital during the last three years of the facility’s operation, nine of which occurred in 2018-2019.

After 47 years of conducting abortions, Larry Burns retired and halted abortions at his Abortion Surgery Center in Norman, Oklahoma.  A receptionist at the abortion center told Operation Rescue that it remained open at the end of 2021, only to take care of long-standing clients and provide medical records to former patients.

“It’s a pathetic thing when your legacy is 47 years of dead babies and a lawsuit that protected child rapists,” said Troy Newman, President of Operation Rescue.  “Oklahoma is a better place today without Burns’ abortion business preying on vulnerable woman and profiting off the backs of dead babies.”

Lovejoy Surgi-Center conducted abortion through the later terms of pregnancy for fifty years in Portland, Oregon.  It was the longest-running abortion facility in the Pacific Northwest.  The abortion business ceased operations on January 16, 2021. A note posted to its website noted the closure in language that made it appear the closure was permanent.  However, an update indicated it planned to reopen in March 2022, at a new location and under a new name and new ownership.  Time will tell, but in the meantime, Oregon has one less facility harming women and killing babies.


There are currently six states with just one active abortion facility.

Reproductive Health Services Planned Parenthood, the last abortion facility in Missouri, halted all abortions in the waning weeks 2020, but once that was made public by Operation Rescue, it immediately scheduled new appointments for February 2021, for the sake of optics.  It continues to be a very part-time abortion facility, referring all chemical abortions and nearly all surgical abortions to its facility in Fairview Heights, Illinois, where it does not have to be bothered with strong pro-life laws that troubled it in Missouri. 

Of the single-clinic states, four are independent abortion facilities and two are affiliated with Planned Parenthood.

A total of 13 states and the District of Columbia saw modest increases of one to three facilities in 2021, while the number of abortion facilities dropped slightly in just seven states.

Twenty-one states had no net change in the number of abortion clinics in the past year. (See map at the top.) 

Planned Parenthood

Of the 720 abortion facilities currently open for business, 387 are Planned Parenthood facilities.  Planned Parenthood abortion locations now account for 54% of all abortion facilities nation wide. 

Planned Parenthood’s 176 surgical abortion facilities represent 39 percent of all surgical abortion facilities – an increase of two percent over 2020.

But while Planned Parenthood’s 272 abortion pill facilities account for an impressive 78 percent all abortion pill locations currently in operation, that represents a decrease of six percent of the total number of abortion pill locations nationwide. 

The reason for that decrease in Planned Parenthood’s market share of pill clinics can be attributed to several new abortion pill businesses that only deliver abortion drugs by mail, which popped up in the past year due the current administration rolling back Trump-era rules that prohibited distributing abortion drugs without an in-person visit with a licensed physician or other approved licensee.

While Planned Parenthood operates more facilities than independently owned clinics, it is the independent clinics that still conduct the most abortions, according to a report published in 2020 by the Abortion Care Network.

There are currently five states with no active Planned Parenthood abortion facility.  Those states are Louisiana, Mississippi, North Dakota, West Virginia, and Wyoming.

Rise of Telemedicine

While telemedicine programs were restricted to a handful of abortion facilities prior to the China Virus pandemic in 2020.  That year, Operation Rescue documented 69 facilities that used telemedicine to dispense abortion-inducing drugs. 

That number skyrocketed in 2021.

Operation Rescue’s survey found there was a 44 percent rise in the use of telemedicine for abortions in just one year.  Today, there are 123 businesses in 22 states that use telemedicine to distribute abortion-inducing drugs.  That trend shows no sign of abating under the current circumstances.

Of those, 36 in 13 states distribute abortion pills through the mail.  At least five of those facilities have no brick-and-mortar address and operate solely through the Internet.

So why the sudden increase in the use of telemedicine to distribute abortion drugs?  The answer to that lies in politics and has nothing to do with health.

Risks downplayed

A report by Dr. Michael J. New that appeared in the National Review on August 30, 2021, indicates that abortion pill complications are at least four times the rate of surgical abortions.  It also discussed data from Great Britain of great interest involving emergency calls made after chemical abortions.

A closer look at the United Kingdom raises some very serious concerns about the safety of telehealth abortions. In early 2020, the U.K. began allowing women to obtain chemical abortions via telemedicine. In the first six months of 2020, the overall number of abortions in the U.K. increased by about 4 percent.

Researcher Kevin Duffy found that between 2019 and 2020, emergency calls for  follow-up care after a chemical abortion increased by 54 percent when extrapolated across England and Wales, and ambulance responses rose by 19 percent. Furthermore, Britain’s Care Quality Commission identified eleven cases in which women went the hospital after taking chemical-abortion pills via telemedicine beyond the gestational-age limit.

There is good reason to believe similar effects of telemedicine abortions are occurring in the U.S., but are being suppressed in favor of pro-abortion political talking points that declare abortion drugs are safe.


There is also a huge profit motive in mailing abortion drugs to women, so there is a financial incentive to downplaying and/or misrepresenting the dangers of chemical abortions. 

There are several advantages over surgical facilities that have led to the increase in chemical abortion businesses, especially those that deliver abortion drugs through the mail. Those businesses need not lease or purchase an office where women might be seen by a highly paid licensed physician.  They need not hire qualified professionals to staff a facility or pay to furnish and stock it.  There are no utilities to pay and no property taxes or property insurance premiums.  They also avoid the time and money required to license a facility in states that require it.  In fact, each abortion transaction can take place in just minutes over the Internet for next to nothing in overhead.

Operation Rescue’s survey found that Planned Parenthood’s model is slightly different.  It takes primarily existing chemical abortion facilities and referral centers and adds telemedicine as another service.  The overhead remains the same, but there is expanded potential for dramatically increasing profits.

In 2016, it cost about $100 dollars for an abortion business to purchase enough Mifepristone and Misoprostol – the two drugs that induce abortions – for one abortion.  Today, those drugs can be sold by abortion facilities for between approximately $400-800, making abortion pill distribution a lucrative business.  [More about abortion pricing in Part 2 of this report.]

Political shift

At the request of the abortion lobby, which cited fear of the China Virus as an excuse, in July 2020, the U.S. Food and Drug Administration temporarily relaxed a 2000 law that required women to visit a clinic, doctor’s office, or hospital before they could receive the two-drug abortion cocktail.  This opened the door to the distribution of the dangerous drugs through the mail.

The Trump Administration sought to have that law reinstated and filed an appeal to the U.S. Supreme Court on December 15, 2020.  On January 12, 2021, the Supreme Court ruled in favor of the Trump Administration and blocked the distribution of abortion pills through the mail.

When the current administration took power on January 20, 2021, one of its priorities was to get rid of the restrictions on how abortion drugs are dispensed.  As predicted, on April 12, 2021, the Biden Administration exercised its enforcement discretion and lifted the regulation once again, citing the dubious excuse that mail distribution of abortion drugs kept women and abortion clinic workers safe from the China Virus.

Some abortion businesses, such as a Seattle, Washington, based internet company called Abortion on Demand, seemed to have colluded with the administration on the timing of the policy change. 

The day after the announcement, Abortion on Demand officially opened for business, offering to mail abortion drugs to women in 20 states.  They received free publicity in the form of a pre-written interview that appeared in Marie Claire within hours of the policy announcement.

Last month the FDA permanently lifted the rule that had protected women and babies from harm and exploitation for over twenty years.

“Because of the Biden Administration’s dangerous policy change, it is expected that there will be more Internet abortion businesses cropping up attempting to cash in on the profitable ‘pills by post’ scheme – and we expect that more women will be hospitalized after suffering complications from the abortion drugs,” said Newman.

However, on the brighter side, 20 state legislatures had the foresight to enact state laws that require women to obtain abortion drugs at a facility in person after having been seen by a licensed physician.  So far, the laws in those states have held up, preventing the exploitation of women and their babies by unscrupulous abortions who dump out abortion drugs to the public by mail with little to no accountability.

States push back

Pro-life legislative advances have traditionally been much more numerous and effective at the state level than the Federal level, and 2021 was no different. In all 19 states passed a record 106 pro-life laws.

Most notably, the Texas Heartbeat Act was a game changer in the landscape of abortion.  That new law prohibits abortion after the time when a fetal heartbeat can be detected.  It also allows for the public to enforce the law through the filing of civil suits against abortionists who violate the law.  The Texas Heartbeat Act was followed up by a law shutting down the distribution of abortion drugs through the mail in Texas.

This has led to an estimated 50 percent decrease in abortions in that state.

However, while Texas abortionists are open and committing abortions prior to six-weeks gestation, the law has yet to lead to the closure of abortion businesses in Texas.  It is believed that abortionists are holding out despite lost revenue, with the hope that the Texas Heartbeat Act will be blocked in a lower court.  So far, efforts to do that have been unsuccessful in every court, including the U.S. Supreme Court, which has declined to enjoin it. 

“Once all court challenges are exhausted by the abortionists in Texas, we expect to see a number of abortion clinics to close there.  One cannot lose half its customers and expect to stay in business,” said Newman.  “I anticipate that 2022 may be the year we see that happening.”

Also, in 2021, the U.S. Supreme Court heard oral arguments in the  Dobbs v. Jackson Women’s Health Organization case, which centers on a Mississippi law that prohibits abortion after 15 weeks gestation. 

The High Court was asked by the State of Mississippi to overturn the landmark 1973 Roe v. Wade case, leaving the decision to allow or prohibit abortions to each state. If that occurs, it is expected that the landscape of abortion facilities throughout the nation will dramatically change. So far, there are 26 states with “trigger laws” that would prohibit abortions immediately should Roe be overturned.

However, should Roe be overturned, Operation Rescue anticipates a major push-back from the current administration that may involve court-packing, efforts to pass Federal Legislation codifying abortion nationwide, and other strategies.

A decision on Dobbs is expected in the spring of 2022, which will determine America’s future path on the matter of abortion.

Factors Contributing to More Abortion Facilities

The increase in the number of abortion facilities in 2021 is attributable primarily to the following factors:

  • Continued exploitation of China Virus fears to promote the use of telemedicine to distribute abortion drugs.
  • Biden administration policies that restored funding to abortion businesses and turned back Trump-era pro-life protections.
  • The FDA’s decision to permanently ban the rule established in 2000 that prevented the distribution of abortion drugs through the mail.
  • The ramped-up mainstream media propaganda campaign to convince the public that abortion pills – especially those distributed by mail – are completely safe.
  • The removal of pro-life laws and passage of laws to protect abortion businesses in Democrat-dominated state legislatures over the past two years.

In past years, a decrease in demand for abortions played a role in clinic closures, however, that trend has been reversed due to an economic downturn caused by China Virus fear, lock downs, and restrictions that have driven more women to seek abortions, according to preliminary numbers.

Also in past years, the retirement of abortionists played a role in the shrinking number of abortion facilities.  While at least one facility in Oklahoma closed due to an abortionist’s retirement, that trend is fading due to the rapid training of new abortionists through programs affiliated with the Bixby Center for Global Reproductive Health, which trains hundreds of new abortionists each year to accomplish their depopulation agenda.

The mainstream media outdid themselves in 2021 repeating Planned Parenthood’s talking points about the safety and desirability of abortion pills, especially in light of a myriad of China Virus variants and the possibility that Roe v. Wade may fall.  This is believed to have contributed to an increase in demand, and thus, an increase in abortion facilities that seek to profit financially from this newly expanding market.


In 2021, we have seen a continued shake-up in some abortion industry trends that began in 2020.  For example, surgical abortion facilities continue to dominate for now, occupying 62% of all abortion facilities.  But that percentage of the pie continued to shrink in 2021, with the surge in new chemical abortion facilities meant to accommodate a growing demand and industry lust for profits.

Operation Rescue’s survey also found that most abortion pill facilities continue the previously documented trend of being comprised primarily of part-time facilities, whereas surgical facilities tend to have more abortion days available.  The survey found that some abortion pill clinics are only open to dispense abortion drugs as infrequently as once a month, and some have shown no abortion availability for weeks on end. 

The trend into telemedicine ramped up dramatically, as previously mentioned, due to Biden Administration policy changes.  For the first time, this has led to a substantial increase in abortion facilities and businesses nationwide – the largest documented increase in the past 13 years.

This trend was predicted by Operation Rescue in an exposé published in May 2019.  The China Virus, the Texas Heartbeat Act, and the Dobbs v. Jackson Women’s Health Organization’s potential to overturn Roe has accelerated that timeline, with the aid of the FDA’s decision to permanently relax abortion pill distribution guidelines.  We expect this trend to continue into 2022 and beyond.  It is likely that only a change of administration to one that is once again pro-life, will stop it.

“We are living in a pivotal time in history that is being driven by dramatic political upheaval,” said Newman. “Will the current administration lead our nation into communism and install China-like totalitarian population controls that are promoted by communists and globalists alike?  Or will the American people arise and reject totalitarian communism, return to open-market capitalism, and embrace traditional American values that include the protection of babies in the womb?”

The answer to those questions may lie in the results of the 2022 mid-term elections, in which a lack of election integrity may once again play a decisive role.  This makes the issue of election integrity a vital concern to all supporters of Life and may indeed — barring the Hand of God intervening in the affairs of men — have the greatest impact on whether American can ever become abortion-free.

Click to read Part 2 of this exclusive report!


*Correction: The text has been corrected to indicate the rise in the number of abortion facilities in 2021 is the largest increase since 2016 instead of 2009.