State Figures Provide Important Context for National Abortion Trends

NRLC Analysis of New Abortion Reports, Part Four

By Randall K. O’Bannon, Ph.D., NRL Director of Education & Research

National abortion figures attempt to show the direction of the country as a whole, but state numbers sometimes offer a more complete or at least more nuanced view of the trends and currents.  And differences between the states, their laws, and the relative dominance of the abortion industry may affect the direction the abortion numbers go and how well they are counted.

National increase in recent years
Though the most recent report from the U.S. Centers for Disease Control (CDC) shows a decrease over last year and that from the Guttmacher Institute shows an increase for the same period, both entities show national increases and more states adding abortions over the past three years (2017-2020).

Guttmacher shows abortions increasing from 862,320 in 2017 to 930,160 in 2020 with abortions rising every year.

The CDC starts with 612,7119 in 2017 and then shows small increases for 2018 (+ 6,872) and 2019 (+10,307), before dropping 9,510 abortions back to 620,327 for 2020. Overall, that results in a net increase of 7,608 from 2017 to 2020.

Remember that the CDC gets its figures from state health departments and that not all of these track their numbers and report back to the CDC. The nation’s most populous state, California, has been missing from CDC since 1998, along with at least two other states, which is one reason its numbers are always hundreds of thousands lower than those from Guttmacher, which surveys abortion clinics directly.

Changes in state abortion totals
Generally, Guttmacher showed states in the Northeast section of the country had the highest abortion rates, led by New Jersey with 29.2 abortions per thousand women aged 15-44 (measured at July 1st), followed by New York, with an abortion rate of 28.8 in 2020.  States in the South had the lowest, though three states–Florida, Georgia, and Maryland– all had rates over 18.

Washington, D.C. reported the highest abortion rate, 48.9 abortions for every thousand women of reproductive age.

Both the CDC and Guttmacher also record abortions by state.

Between 2017 and 2020, Guttmacher showed abortions up in 34 states and down in 17 (also counting Washington, D.C.).  The CDC show the numbers going up in 29 states and down in 19 states during that same time frame (no data for California, Maryland, or New Hampshire.)

According to Guttmacher, large jumps were seen in California (+16%), Georgia (+15%), Kentucky (+28%), Idaho (+31%), Illinois (+25%), Kansas (+21%), Maine (+16%), Michigan(+18%), Mississippi (+40%), New Mexico (+27%), Oklahoma (+103%) and the District of Columbia (+67%).

Substantial drops were seen in Louisiana (- 26%), Missouri (-96%), South Dakota (-74%) Rhode Island (-21%), West Virginia (-31%), and Wyoming (-29%).

Percentages are instructive but can be deceiving.  In more lightly populated states like Maine, Idaho, Rhode Island, South Dakota, West Virginia, or Wyoming, a couple of hundred or even a few dozen abortions can have a huge proportional impact.  But in the larger states, a few percentage points can easily mean thousands more or thousands fewer abortions.

State differences may explain CDC/Guttmacher disparity

Though the vectors in most states matched for Guttmacher and the CDC, there were some differences. 

Generally, the variations were slight, perhaps one showing a slight increase, the other a slight decline, but nothing of serious statistical consequence. Other differences, though, were striking, possibly pointing to the reason Guttmacher and the CDC totals pointed in different directions for 2020.

For example, Guttmacher showed New York with a 5% overall increase, from 105,380 in 2017 to 110,360 in 2020, adding just under 5,000 abortions. The CDC, on the other hand, showed an enormous decrease for New York for the same years, dropping from 82,966 in 2017 to 63,142 in 2020.

A couple of things are obvious from this. First, the CDC, relying on the New York state health department, typically grossly undercounts that state’s abortions, missing more than 20,000 abortions even in 2017. Second, the CDC and the state health department appear to have had an especially poor counting year in 2020, when Guttmacher, who relied on direct surveys of abortionists, found nearly 50,000 more abortions than the CDC.

Whether this is a function of the confusion caused by all the 2020 COVID shutdowns when so many clinics and state offices were closed or operating with reduced staffs (some clinics were only open for abortions), compromising reporting, or the state somehow missed many of the telemedical abortions that many clinics added to their offerings is unknown. But clearly Guttmacher found a lot abortions that the CDC missed.

Guttmacher also found a significant jump in the number of abortions performed in Oklahoma between 2017 and 2020, rising from 4,780 to 9,690 in just three years’ time. During that same time frame, the CDC showed a decrease, from 4,681 to 3,797.  

It is unclear what happened here, but Guttmacher’s sources obviously found and reported more abortions than did the CDC and the Oklahoma state health department. A lot of legal and legislative activity that closed clinics in neighboring states was supposed to send some patients to nearby Oklahoma, but the CDC recorded only 598 abortions to out-of-state residents in 2020, not near enough to account for the difference.

There were a few other states where both data collectors showed an increase, but Guttmacher showed much larger increases than the CDC in Nevada and New Mexico. This, too, may be part of the discrepancy between the two sources.  

When they did agree on some of the bigger changes, it confirmed the relationship between supply and demand, e.g., the effectiveness of policies resulting in the closure of abortion clinics.

For example, both sources showed a major drop-off in Missouri, with Guttmacher showing a drop from 4,710 in 2017 to just 170 in 2020 after two of the three clinics in that state closed and the CDC reporting numbers quite similar.

Rhode Island saw its abortions fall 21% after one of the state’s two abortion clinics closed. Louisiana saw a big drop (26%) when just one of its abortion clinics closed.

Hinting at the factors involved
The story in each state is different, but numbers rise or fall when a state passes legislation limiting or funding abortion; when states or private citizens encourage or support alternatives; when big clinics open or close (or shift to another state); or when court cases impact any of these factors somehow affecting either supply or demand.

Sometimes, particularly with the CDC, it may just be that a state health department does a better (or worse) job tracking the numbers from one year to the next, particularly when a new administration moves in and takes over the department.

Economic or social factors (like the pandemic) can also play a role, but these are harder to correlate on an individual state basis. Pregnancy care centers compete with abortion clinics for the lives of moms and their unborn babies, but measuring the effectiveness of these outreaches in anything but the broadest measures is difficult.

Teasing out the full set of factors and causes for the increases and decreases seen in each of these states requires more in-depth analysis than is possible in this limited space.

But clearly pro-life legislation, education, and outreach make a difference. And so do counter-efforts by the abortion industry and its lobby building new clinics and promoting new mail-order abortion pills.

As these statistics show, thousands of lives hang in the balance.

Our final installment will deal with some of the demographic information from these latest abortion reports, showing us where we have made progress and where we might still have a ways to go.

You can read the first three parts of this series here; here; and here.