The number and rate of U.S. abortions increased between 2017 and 2020 after a 30-year decline, according to a new report from the Guttmacher Institute.
More than 930,000 abortions took place in the U.S. in 2020, up 8% from 862,000 abortions in 2017. About 1 in 5 pregnancies ended in abortion in 2020, the report said.
The Guttmacher Institute, a research organization that supports abortion rights, said the trend shows a rising need for abortion care as the Supreme Court is poised to overturn the Roe v. Wade decision in coming weeks.
National abortion numbers reached the lowest point in 2017 since the landmark 1973 ruling that legalized the procedure. In the years following the ruling, abortion numbers rose above 1.5 million annually throughout the 1980s and then began declining in the 1990s, though they remained above 1 million annually through the early 2010s.
The latest data shows that the abortion rate increased from 13.5 abortions per 1,000 women between ages 15 to 44 in 2017 to 14.4 abortions per 1,000 women in 2020, marking a 7% increase.
Similarly, the abortion ratio — or the number of abortions per 100 pregnancies — increased from 18.4% in 2017 to 20.6% in 2020, marking a 12% increase.
The increase in abortions was accompanied by a 6% decline in births between 2017 and 2020, the Guttmacher Institute said.
“Because there were many more births (3.6 million) than abortions (930,000) in 2020, these patterns mean that fewer people were getting pregnant and, among those who did, a larger proportion chose to have an abortion,” the institute wrote.
Medication-related abortions accounted for 54% of U.S. abortions in 2020, according to the report, which was the first time they made up more than half of abortions.
The number of abortions increased in every region of the country between 2017 and 2020, the report shows. The increases were largest in the West (12%) and Midwest (10%), followed by 8% in the South and 2% in the Northeast.
In some states — Illinois, Mississippi, and Oklahoma — there were substantial increases in the number of abortions, the institute said. In others — such as Missouri, Oregon, and North Dakota — there were substantially fewer abortions in 2020 compared with 2017.
The COVID-19 pandemic may have led to a decline in some states. In New York, abortions increased 5% from 2017 to 2019 and then fell 6% between 2019 and 2020. About 10% of clinics in New York paused or stopped abortion care in 2020 when the pandemic started.
New laws likely affected the numbers as well. Texas had a 7% increase between 2017 and 2019, followed by a 2% decrease between 2019 and 2020, which overlapped with restrictions that deemed abortions “nonessential” health care at the beginning of the pandemic.
In contrast, some numbers may have increased due to expanded Medicaid funding. Illinois began allowing state Medicaid funds to pay for abortions in January 2018, and abortions increased 25% between 2017 and 2020.
In Missouri, abortions decreased substantially from 4,710 in 2017 to 170 in 2020, the report shows, but the number of Missouri residents who traveled to Illinois for abortions increased to more than 6,500.
Every 3 years, the Guttmacher Institute contacts U.S. facilities that provide abortions to collect information about services, including the total number of abortions. The most recent count was completed in May, representing 1,687 health care facilities that provided abortions in 2019 or 2020. A full summary of the data will be published later this year in a peer-reviewed journal article.
Guttmacher Institute: “Long-Term Decline in US Abortions Reverses, Showing Rising Need for Abortion as Supreme Court Is Poised to Overturn Roe v. Wade.”