Abortion is one of the most common procedures in the US, with over 1.06 million performed, in 2011. The number of abortion providers has decreased by 40% since 1981, resulting in 89% of counties without a provider. Efforts to counteract this decline include legislation to expand the types of abortion providers and training programs to support residents in a dedicated family planning rotation. However, states are increasingly passing laws impacting abortion access, from gestational age limits, TRAP laws, and funding restrictions. This article reviews the incidence of abortion in the United States and explores the myriad of factors affecting the availability of abortion services.