Abortion access

U.S. abortion statistics: total number, abortion rates and abortion ratios

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Note on terminology:

Physicians, and pro-choice advocates agree on the definition of such common terms as "abortion" and "pregnancy." Pro-lifers and religious conservatives often assign different meanings to these terms. We use medical definitions in this section of our web site.

How one treats Emergency Contraception (EC) drastically effects abortion data. EC usually inhibits pregnancy by preventing ovulation or conception. However, if conception has already taken place, it can prevent the fertilized ovum from implanting in the wall of the uterus. Most religious conservatives define pregnancy as starting at conception. By this definition, EC can terminate a pregnancy and is thus considered to be an abortifacient.   Sources of abortion data, like the Center for Disease Control and Alan Guttmacher Institute generally define pregnancy as starting at implantation. Thus the effects of EC are generally ignored in the statistics. Abortion data is based on surgical and medical abortions.

How abortions are monitored:

The Center for Disease Control and Prevention (CDC) monitors abortion data in the U.S. as supplied by states, the District of Columbian and certain large urban areas. Among the data that they report annually are three key indicators:

	The total number of abortions performed in a given year. This quantity is of the greatest interest to pro-life supporters. To most of them, every abortion represents the murder of a human person. However, this number lacks precision: Some states will occasionally withhold data from the CDC; this will artificially reduce the total of reported abortions.   The total number of abortions does not include illegal abortions. These are believed to be on the increase as more states require underage women to inform or gain consent from a parent or guardian before they can obtain a legal abortion. Some young women, fearing physical assault, loss of support, or the emotionally and physically devastating effect that news of her pregnancy might have on their parents, prefer to risk the hazards of an illegal abortion rather than involve their parents in a legal abortion. Some of them die as a result.   The value does not include the number of abortions performed outside the U.S. to American women, or performed in the U.S. to foreign women. Some women who live in border states which have poor access to clinics or which have legal restrictions on abortions slip across the border into Canada or Mexico for their abortion.
	The abortion rate: This is expressed as the number of abortions performed per thousand women of childbearing age (15 to 44) in a given year. It also has some major disadvantages: It is the ratio of two numbers: the total number of abortions and the total number of women in this age group. Both values can only be approximated. Thus, the abortion rate value is subject to greater inaccuracy than the abortion number.   Since women who have abortions are mostly unmarried, the abortion rate will fluctuate from year to year depending upon marriage rates, divorce rates, and the distribution of ages at which women marry.   Since women who have abortions are mostly under 24 years of age, this value will also fluctuate from year to year depending on the country's age distribution of women which in turn depends upon earlier birth rates.
	The abortion ratio: This is defined in two different ways:   One of the main sources for abortion data is the Guttmacher Institute. Their website states: "The abortion ratio is the proportion of pregnancies (excluding miscarriages) ending in abortion. In 2003, the abortion ratio was 24%, meaning that about one-quarter of all U.S. pregnancies ended in abortion." 11 Another major source is the Division of Reproductive Health of the National Center for Chronic Disease Prevention and Health Promotion -- a division of the Centers for Disease Control and Prevention. Their website states: "The abortion ratio, defined as the number of abortions per 1,000 live births, was 246 in 2000 ..." 12 Thus, if you see a number on the order of 24% or 0.24, it most probably refers to the Guttmacher Institute's definition. If you see a number on the order of 240, it probably refers to the CDC's definition.

Whatever definition is used for the abortion ratio, the value has some of the disadvantages of the previous two measurements. However, it can be argued that this value, more than any other, reveals whether abortion is becoming more or less accepted in the country. If one overlooks miscarriages, and hysterotomies, then a pregnant woman has two choices: to have an abortion or to give birth to a newborn. The ratio of abortions to live births gives a good measure of how acceptable abortion is to American women.

One value that is rarely reported is the percentage of women at various ages who have had one or more abortions during their lifetimes. For all adult women, the value is approximately 42%. This value would be an even better measure of the acceptability of abortions in the U.S., if it were generally available.

The total number of abortions in the U.S.:

CDC data is available starting in 1973. This was the year when the U.S. Supreme Court made first trimester abortions freely available in the U.S. Prior to that, legal abortions were only legal in certain liberal states, like New York and California.

The CDC reported that:

"During 1990--1997, the number of legal induced abortions gradually declined. When the same 47 reporting areas are compared, the number of abortions decreased during 1996--2001, then slightly increased in 2002 and again decreased in 2003." ₁₀

CDC data, with percentage change rounded to the nearest percent:

2004 data should be available in 2007-NOV.

However, comparing two yearly values can be like equating apples and oranges.  Data for 1997 came from 52 reporting areas (the 50 states, District of Columbia and New York City). Data for 1998 was derived from only 48 reporting areas. Alaska, California, New Hampshire and Oklahoma did not release the number of abortions in their state. A better way to compare the total number of abortions from year to year is to look at data from the 48 jurisdictions that reported data in both years. For example:

The abortion rate:

The total number of reported legal abortions per 1,000 women aged 15 to 44 years was:  ₁₀

If one were to accept all of the data that the CDC was able to collect, then the abortion rate -- the number of abortions performed per thousand women of childbearing age (15 to 44) -- shows a significant drop from 20 in 1997 to 17 in 1998. This is a reduction of 15%! However, the apples and oranges problem occurs here as well. Analyzing data for only the 48 jurisdictions which reported both years, we find:

The abortion ratio:

The same problem appears here as well. The CDC's reported abortion ratio -- the total number of reported abortions per 1,000 live births -- dropped significantly from 306 to 264 between 1997 and 1998. This is an apparent reduction of 13.7%! But, when one looks only at the 47 reporting areas that submitted data for both years, the reduction was only 275 to 265, a reduction of 4%.  ₁₀

Year	Abortion ratio	Change from previous year
1973	196	-
1974	242	+46
1975	272	+30
1976	312	+40
1977	325	+13
1978	347	+22
1979	358	+11
1980	359	+1
1981	358	-1
1982	354	-4
1983	349	-5
1984	364	+15
1985	364	0
1986	354	-10
1987	356	+2
1988	352	-4
1989	346	-6
1990	344	-2
1991	338	-6
1992	334	-4
1993	333	-1
1994	321	-12
1995	311	-10
1996	315	+4
1997	306	-9
1998	264	-42
1999	256	-8
2000	245	-11
2001	246	+1
2002	246	0
2003	241	-5

The value for 1973 is unrealistically low. It does not include many illegal abortions in the first part of the year before the U.S. Supreme Court issued its Roe v. Wade ruling that made early abortions freely available throughout the U.S.

During the year 2000, the ratio of abortions to live births dropped below 1 in 4 for the first time since 1975.

Comparison of U.S. figures to worldwide data:

	Worldwide, about 210 million pregnancies occur each year. About 46 million women have abortions. 2 Presumably the rest, 164 million, give birth. If one overlooks the occurrence of stillbirths, this represents an abortion ratio of 280 abortions per 1000 live births -- a value fairly close to that seen in the U.S.
	The abortion rate in the U.S. is higher than rates reported for Australia, Canada, the UK, and other Western European countries.
	The U.S. abortion rate is lower than rates reported by China, Cuba, most Eastern European countries, and several of the states in Russia. 3,4 A major cause may be legal restrictions on the distribution of condoms, or an inadequate supply of contraceptives in some of these countries.
	Abortion and birth rates for teenagers are higher in the U.S. than in most Western European countries and some Eastern European countries apparently because of cultural and educational differences. 5

What influences the abortion number, rate and ratio in the U.S.?

There are many factors can reduce abortions. Some are:

	Good economic conditions: women might elect to not have an abortion if they are more secure financially.
	"...a shift in the age distribution of reproductive-age women toward the older and less fertile ages..." 1
	"reduced access to abortion services..." 1 Many counties in the U.S. have no medical facility which performs abortions. Increasing numbers of medical facilities are being operated by the Roman Catholic church, which refuses to provide abortions. Many states have passed laws requiring parental notification or consent for young women before they can have an abortion. This drives some women to have an illegal abortion (which are not counted) or to have an abortion in another state or country where laws are more lax. Some states have implemented mandatory waiting periods before a woman can obtain an abortion. This can discourage some women from continuing with an abortion.
	An increase in oral sex, anal sex and other non-procreative sexual activities in place of sexual intercourse.
	Fear of attending an abortion clinic. Some women's health centers have been bombed and set on fire; some clinic staff have been shot and/or killed; demonstrators and "sidewalk counselors" have harassed patients entering the building, etc.
	An increase in the frequency of contraception usage, for whatever reason: Access to comprehensive sex education. Near universal access to contraceptive information via the Internet. Greater openness to discussing sex. Easier access to condoms. Some high schools and colleges have installed condom dispensers and/or distribute contraceptive through in-school clinics.
	A change in the U.S. culture which makes abortion less acceptable to women.
	The introduction of RU-486 and other non-surgical, medically induced abortifacients. A woman who might reject a surgical abortion might find an "abortion pill" more acceptable.
	The use of more reliable contraceptive methods. Long-acting hormonal contraceptive methods were introduced in the early 1990s.
	An increase in the usage of emergency contraception -- a.k.a. the morning-after pill. This reduces the number of unwanted pregnancies, and thus the number of abortions. See below.
	A reduction in the frequency of heterosexual intercourse, due to fear of AIDS or other STDs.
	A growth in the number of born-again, and/or Fundamentalist, and/or Evangelical Christians. "Born again" Protestants constitute about 30% of the American adult population, but are responsible for only about 18% of abortions in the U.S. 6
	An small increase in the number of youths who choose abstinence until marriage. This program fails in about 90% of all youth, but that number is slowly dropping.
	The increasing rates of STDs among women, which can causes infertility by blocking or scarring their fallopian tubes.

Pro-life and religiously conservative groups and individuals frequently associate the reduction in the number and rate of abortion with the decrease in comprehensive sex-ed classes, the increase in abstinence only sex-ed classes, and the implementation of the "True Love Waits" and similar programs.

Pro-choice and religiously liberal groups and individual frequently associate the reduction with the availability of emergency contraceptive, more frequent use of birth control, and other factors.

The effect of emergency contraception on the number of abortions:

In the year 2000, the Alan Guttmacher Institute evaluated the effect on emergency contraception (EC) on the total number of abortions in the U.S. It is generally acknowledged that this medication is 75% to 90% effective in preventing pregnancy.

	The Institute estimates that the total number of abortions was 1.4 million in 1994 and 1.3 million in 2000 - a reduction of 110,000 abortions or 11%.
	In their 1994 survey of women who had an abortion, they found 1,400 who had become pregnant in spite of using emergency contraception. Thus, they conservatively estimated that three times as many women (4,200 in total) had successfully used EC and had avoided becoming pregnant and having an abortion.
	In 1998, a more convenient form of EC, Preven, became available. In 1999, a second specially packaged EC came on the market. EC usage became much more common.
	In their year 2000 survey, the Institute found 17,000 who had become pregnant in spite of having using EC. They computed that 51,000 women had prevented pregnancy and a subsequent abortion in the year 2000 by using EC.
	The study concluded that the growth in emergency contraceptive usage was responsible for up to 43% of the decline in the number of abortions from 1994 to 2000.

A 2000-NOV poll indicated that one out of four women had never heard of emergency contraceptives or morning-after pills. Nearly two out of three women did not realize that the pills were available in the U.S. ₈ As more women become aware of the availability of EC, the potential for major future reductions in abortions is great.

References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

1. "Abortion Surveillance---United States, 1998," CDC, 2002-JUN-7, at: http://www.cdc.gov/mmwr/preview/
2. Alan Guttmacher Institute data, released 1999-JAN.
3. S.K. Henshaw, et al., "The incidence of abortion worldwide." International Family Planning Perspectives, 1999;25(suppl): S30--S37. (Cited in Ref. 1)
4. "Therapeutic abortions, 1996 and 1997," The Daily Statistics Canada. Ottawa: Minister of Industry, (2000). (Cited in Ref. 1)
5. S.W. McElroy & K.A. Moore, "Trends over time in teenage pregnancy and childbearing: the critical changes." In: R.A. Maynard RA, Ed., "Kids having kids: economic costs and social consequences of teen pregnancy," Urban Institute Press, 1997: 23--53. (Cited in Ref. 1)
6. J.L. Lambert & Fred Jackson, "Study shows high percentage of abortions performed on Evangelicals," Agape Press, at: http://headlines.agapepress.org/
7. "Abortion decline linked to morning-after pill," 2003-JAN-4, Toronto Star. Reprinted from an article "Birth control linked to drop in abortions," in the Philadelphia Inquirer, 2002-DEC-17, Page A01.
8. Julie Severens Lyons, "Law makes morning-after pill available without prescription: Pharmacies will be able to dispense emergency contraceptives," The Mercury News, 2001-OCT-16, was at: http://www0.mercurycenter.com/
9. Rebecca wind, "Emergency contraception (EC) played key role in abortion rate declines. In 2000 Alone, AGI Estimates EC Averted As Many As 51,000 Abortions," Alan Guttmacher Institute, 2002-DEC-17, at: http://www.agi-usa.org/
10. Lilo T. Strauss, et al., "Abortion Surveillance --- United States, 2003," CDC, 2006-NOV-24, at: http://www.cdc.gov/
11. "Get 'In the Know': Questions About Pregnancy, Contraception and Abortion," Guttmacher Institute, at: http://www.guttmacher.org/
12. Laurie D, Elam-Evans, et al., "Abortion Surveillance --- United States, 2000" CDC, at: http://www.cdc.gov/

Copyright © 2003 to 2009 by Ontario Consultants on Religious Tolerance
Originally written: 2003-JAN-4
Latest update: 2009-SEP-05
Author: B.A. Robinson

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