Respect Accessibility

Abortions in the US increased in 2020, reversing a more than 30-year decline

The Guttmacher Institute, an abortion advocacy group, published new data that showed there were 930,160 abortions in the US in 2020—a 1 percent increase from 2019 and an 8 percent increase from 2017.
A sign supporting women seeking abortions rests beside the clinic’s side door, where all visitors must pass through a security vestibule before being allowed in, Saturday, Oct. 9, 2021, at Hope Medical Group for Women in Shreveport, La. Rebecca Blackwell/ AP

Story at a glance

  • The Guttmacher Institute published new data Wednesday that revealed abortions in the U.S. increased for the first time in 30 years. 

  • In 2020, there were 930,160 abortions, equating to about 1 in 5 pregnancies ending in abortion. 

  • The data comes as the Supreme Court is expected to release its decision on a pivotal abortion case that could overturn abortion access as a constitutional right.  

For the first time in more than 30 years, the number of abortions performed in the U.S. has risen, as new data shows there was an 8 percent increase in 2020. The news comes as the country awaits a pivotal Supreme Court decision that could reverse the constitutional right to have an abortion.  

The Guttmacher Institute, an abortion advocacy group, published new data Wednesday that showed there were 930,160 abortions in the US in 2020 — a 1 percent increase from 2019 and an 8 percent increase from 2017.  

That equates to about 1 in 5 pregnancies ending in abortion in 2020.  

At the same time between 2017 and 2020, the U.S. experienced a 6 percent decline in births — with 3.6 million births and about 930,00 abortions — which hints at a larger pattern of fewer people getting pregnant and, among those who did, a larger proportion choosing to have an abortion. 

Before this, the abortion rate in the U.S. was declining along a steady decades-long trend. For instance, the abortion rate fell by 20 percent between 2011 and 2017. The Guttmacher Institute attributed the decline in abortions to several possible explanations, including changes around abortion attitudes and stigma, contraceptive use, sexual activity, infertility and self-managed abortion.  

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The institute also found the rate of abortions varied around the country, with the Southeastern U.S taking the lead with fewer than 300,000 abortions being done in a slew of states. Florida, Georgia, Maryland, North Carolina, Tennessee and Texas logged some of the highest number of abortions in that region of the country. 

Other notable increases were in New York, where abortion incidence grew by 5 percent between 2017 and 2020 but declined 6 percent between 2019 and 2020. That could be attributed to at least 10 percent of clinics in the state reporting that they had paused or stopped providing abortion care in 2020 due to COVID-19. 

Illinois experienced a 25 percent increase in abortions between 2017 and 2020. The institute attributed this to not only more Illinois residents seeking an abortion but clinics also receiving out-of-state patients, including from Missouri — which experienced a 96 percent decrease in abortions during the same time period. 

The institute found that in 2017, some 97 percent of Missouri counties had no clinics that provided abortions, and 78 percent of Missouri women lived in such counties. 

Notably, in January 2018 Illinois allowed the use of state Medicaid funds to pay for abortion care. The state also saw 15 additional abortion clinics open between 2017 and 2020. 

Rachel Jones, principal research scientist at Guttmacher, told Changing America that for the first time since 2005 she’s seeing an increase in abortion figures and, “it’s just recognizing an increase in abortion can be a positive thing, if It means more people are getting the access to care that they need.” 

Treating abortion as standard health care for women is something medical experts have consistently pushed for, as women denied an abortion are more likely to experience serious complications from the end of pregnancy, like eclampsia and death.  

The National Bureau of Economic Research also found that women denied an abortion experienced an increase in household poverty lasting at least four years relative to those who did receive one. They also ended up with higher unemployment and leaned more heavily on public assistance programs. 

The future of abortion access is currently under the national spotlight as the nation awaits a pivotal Supreme Court decision that’s likely to overturn the 1973 ruling on Roe v. Wade, which affirmed abortion access as a constitutional right. A leaked Supreme Court draft opinion in the Dobbs v. Jackson Women’s Health Organization case indicated justices are poised to overturn abortion rights. 

Preparations are underway for the decision, with 26 states likely to ban abortion following the court’s official ruling and among them 13 have trigger laws already in place, designed to take effect automatically or by quick state action if Roe no longer applies.  

Activists, educators and health experts across the country have warned how a world without Roe will be catastrophic for women’s health.  

Lauren Ralph, an epidemiologist at the Bixby Center for Global Reproductive Health at the University of California San Francisco, told Changing America that if some variation of the court’s leaked opinion becomes the court’s official decision, “I do anticipate a rise in maternal deaths as a result, and I think that is something that we, as a public health community, have to prepare for.” 

On the flip side, some parts of the country are reaffirming their commitment to abortion access, with New York passing a series of laws this week that includes protecting the confidentiality of providers and patients from out-of-state inquiries. 

The city of Austin, Texas — a state where abortion is currently legal only up to about six weeks of pregnancy — proposed a resolution that would decriminalize abortion if Roe were struck down. 

Though those efforts may sound positive, for those low-income families that want an abortion but can’t get one in their home state, traveling out of state may not be possible, as Jones explained.  

“These are people who have struggled to get abortions in the state where they live, coming up with the hundreds of dollars that it takes to pay for the procedure,” Jones said. “If you add travel and childcare and all the other factors on top of that, it’s just going to make it inaccessible.”  

—Updated Tuesday at 12:11 a.m.