Expert Commentary

Abortion incidence and access to services in the United States

2011 study from the Guttmacher Institute analyzes data from a survey of U.S. providers to give a snapshot of abortion rates in the United States and related trends.

Though abortion is most often framed as a matter of political and moral opinion, there is also ample factual data on its prevalence across the United States and the underlying factors that may drive increases and decreases.

A 2011 study from the Guttmacher Institute published in the journal Perspectives on Sexual and Reproductive Health, “Abortion Incidence and Access to Services in the United States,” analyzed data from a survey of U.S. abortion providers. Conducted 15 times since 1973, the survey gathered information from more than 1,500 facilities between 2008 and 2010; information from state health departments was also used to estimate figures at some 450 other facilities. In all, the number of abortions was established or estimated for more than 2,300 facilities across the country (some service providers run multiple facilities). More limited data was obtained to estimate rates at hospitals.

The study’s findings include:

  • Between 2005 and 2008 the incidence of abortion in the United States has been relatively stable: “The number of abortions increased by 0.5%, from 1,206,200 to 1,212,350, and the abortion rate increased 1%, from 19.4 to 19.6 per 1,000 women aged 15 to 44…. The abortion ratio did not change over this period, remaining at 22 abortions per 100 pregnancies.”
  • The states with the highest levels of abortions performed were Delaware, New York and New Jersey, with rates of 40, 38 and 31 per 1,000 women, respectively. High rates were also seen in the states of Maryland, California, Florida, Nevada and Connecticut (25 to 29 per 1,000 women).
  • The state with the lowest abortion rate was Wyoming, which had less than 1 per 1,000 women, followed by Mississippi, Kentucky, South Dakota, Idaho and Missouri (5 to 6 abortions per 1,000 women).
  • Because states’ abortion rates are not calculated according to the mothers’ residency, a state’s numbers may not reflect the true number of abortions its residents obtain. “For example, while only 70 abortions were reported in Wyoming in 2005, an estimated 1,100 were obtained by Wyoming residents in that year, and almost all of them occurred out of state.”
  • The number of providers of abortion services remained relatively constant from 2005 to 2008, when the figure stood at 1,793. (The number across the country stood at a high of 2,900 in 1982.) However, the overall number in the South declined by 10% over that period.
  • The vast majority of providers, 95%, provided services through eight weeks into a pregnancy; 64% offered them through 13 weeks, 23% through 20 weeks and 11% through 24 weeks.
  • The average fee in 2009 for a first-trimester surgical abortion was $451; the median cost of an early medication abortion was $490. The median charge for a surgical abortion at 20 weeks was $1500.
  • Some 42% of clinics reported harassment relating to the blocking of patient access, and 15% reported vandalism. Between 2000 and 2008, the percentage of those reporting bomb threats fell from 15% to 5%. Overall, the “incidence of harassment varied by region; 85% of providers in the Midwest and 75% in the South experienced any form of harassment, compared with 48% and 44% in the Northeast and the West, respectively.”

The study also notes the long-term trends relating to abortion: though the annual figure dropped 25% between 1991 and 2005, the 1% rise in the number of abortions between 2005 and 2008 ends this long period of decline.

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