Abortion Incidence and Service Availability in the United States, 2017

Abstract

This study used new data from the Guttmacher Institute to examine trends in abortion incidence and rates between 2014 and 2017. In addition, we examined changes in the number of health care facilities that provide abortions. ■ ■ In 2017, an estimated 862,320 abortions were provided in clinical settings in the United States, representing a 7% decline since 2014 and the continuation of a long-term trend. ■ ■ The U.S. abortion rate dropped to 13.5 abortions per 1,000 women aged 15-44 in 2017, the lowest rate recorded since abortion was legalized in 1973. Abortion rates fell in most states and in all four regions of the country. ■ ■ A total of 339,640 medication abortions occurred in 2017-about 39% of all abortions. ■ ■ As in previous years, clinics provided the overwhelming majority of U.S. abortions (95%), while private physicians' offices and hospitals accounted for 5%. ■ ■ In 2017, 808 clinic facilities provided abortions, a 2% increase from 2014. However, regional and state disparities in clinic availability grew more pronounced; the number of clinics increased in the Northeast and the West, by 16% and 4% respectively, and decreased in the Midwest and the South, by 6% and 9%, respectively. ■ ■ Although the number of state abortion restrictions continued to increase in the Midwest and South between 2014 and 2017, these restrictive policies do not appear to have been the primary driver of declining abortion rates. There was also no consistent relationship between increases or decreases in clinic numbers and changes in state abortion rates. ■ ■ Fertility rates declined in almost all states between 2014 and 2017, and it is unlikely that the decline in abortion was due to an increase in unintended births. ■ ■ Factors that may have contributed to the decline in abortion were improvements in contraceptive use and increases in the number of individuals relying on self-managed abortions outside of a clinical setting.

Trends in Abortion Incidence and Availability in North Carolina, 1980–2013

“…Declines in abortion ratios observed in North Carolina likely reflect a combination of factors that influence reduction of pregnancy rates overall. 6,18 Our analyses suggest that women who are older, have already had a pregnancy, and belong to ethnic minority groups may have the most unintended pregnancies, based on their higher abortion ratios, and may benefit most from increased access to contraception. Alternatively, women who are non-Hispanic white may be having more difficulty obtaining abortions and thus could be traveling to other states to undergo abortions or continuing unwanted pregnancies because of a lack of access to abortion.…”

“…Like much of the southern US, North Carolina has experienced a decline in the abortion ratio 6 (ie, the number of abortions per 100 pregnancies ending in abortion or live birth); however, 54% of all pregnancies in North Carolina were estimated to be unintended in 2010, substantially higher than the national estimate at the time (45%). A little more than one-fourth of these pregnancies were estimated to end in abortion, a proportion that is lower than the national average.…”

Current Resources for Evidence‐Based Practice, January/February 2020

“…Although two‐thirds of abortions are done at 8 weeks’ gestation or earlier, only an estimated 39% of women obtain a medical abortion . The cost from time off work or the provision of childcare for follow‐up visits for medical abortion can be a barrier to women who perceive scheduling a one‐time vacuum aspiration to be more feasible.…”

Abortion attitudes, religious and moral beliefs, and pastoral care among Protestant religious leaders in Georgia

“…In the United States, 13.5 abortions per 1,000 women of reproductive age were reported in 2017. While national and regional abortion rates have been declining, rates in the state of Georgia have increased in recent years [ 2 ]. The rate of abortion in Georgia was 16.9 abortions/1,000 women aged 15–44 in 2017 [ 2 ].…”