The number of abortions in the U.S. jumped 8 percent between 2017 and 2020 — the first documented increase after more than three decades of declining demand for the procedure amid improved access to contraception and sex education.
The survey of the nation’s abortion providers conducted every few years by The Guttmacher Institute found that there were 930,160 abortions performed during first year of the pandemic — up from 862,320 in 2017. The abortion rate — which takes into account changes in population — increased 7 percent, from 13.5 abortions per 1,000 women of reproductive age to 14.4 during that same time.
The true number is likely higher because the report only covers abortions obtained at a medical facility and not the increasing number of people who are ordering pills online or using other methods to terminate a pregnancy at home.
The survey completed in May and released Wednesday represents information from nearly 1,700 health care facilities across the U.S. that provided abortions in 2019 or 2020. The total number of abortions at roughly one-third of these facilities that didn’t respond to the survey — mostly hospitals, which typically provide fewer abortions — was estimated based on data from state and local public health departments.
Researchers at the abortion-rights think tank attribute the national increase to several factors, including the pandemic, changes to the Title X family planning program and expanded health insurance coverage of the procedure.
Covid-19 brought widespread disruption to Americans’ insurance status, economic stability, mental health and access to health care services, which public health experts say has fueled a rise in unprotected sex and record STD rates.
At the same time, many low-income Americans lost access to family planning services in 2019 when the Trump administration imposed new restrictions on Title X recipients, causing hundreds of providers to leave the program.
Additionally, some of the increase could be explained by the steps several states took over the last few years to expand access to abortion. Illinois and Maine, for example, allowed Medicaid to pay for the procedure, while other states passed laws requiring private insurance companies to cover abortion.
“The majority of people who obtain an abortion are poor or low income, and this coverage meant that many who would not otherwise have been able to afford an abortion could get care,” Guttmacher’s report noted.
While more than two-dozen states implemented restrictions on abortion during that same time — including waiting periods and limits on the distribution of abortion pills — many were blocked by courts. And because those states already had limited access to the procedure, the report’s authors posit that these new laws had a smaller impact than those in the states that expanded access to abortion.
In fact, some of the states that moved most aggressively to restrict abortion saw the biggest increases, including Mississippi and Oklahoma. The authors of the report hypothesize that as neighboring states passed more restrictions, more residents turned to Mississippi’s only clinic rather than travel to another state.
The report comes just before the U.S. Supreme Court is expected to issue a ruling overturning Roe v. Wade — a decision that would allow dozens of states to implement near-total bans on the procedure. Guttmacher argues the new data shows that the ruling may have a bigger impact than previously known, forcing hundreds of thousands of people who seek the procedure each year to either cross state lines, terminate their pregnancy illegally, or carry an unwanted pregnancy to term.
