Report: Number of abortion facilities cut nearly in half since the 1980s

By Carole Novielli 

Abortion-providing facilities — which include hospitals, specialized and nonspecialized abortion facilities, as well as physician offices — have reportedly declined nearly 45% since the early 1980s. In addition, while stand-alone abortion facilities increased over 212% just after the Roe v. Wade Supreme Court decision in 1973 (284 in 1974 to 885 in 1988), the number has dropped nearly 9% in recent years.

The Data

These reported numbers come primarily from the Guttmacher Institute, which sends annual questionnaires to “facilities known or suspected to have provided abortion care for any part.” Guttmacher then categorizes these facilities into four types: hospitals, physicians’ offices, specialized abortion clinics, and nonspecialized clinics. Hospitals are sites that typically have operating rooms, emergency departments, and labor and delivery and maternal-fetal departments, while physicians’ offices are facilities offering fewer than 400 abortions per year whose names suggested they were a private practice.

Guttmacher’s “specialized or non-specialized clinics” are as follows:

  • Specialized clinics are facilities that accounted for half or more of all client visits were for abortion, including physicians’ offices that committed more than 400 abortions per year.
  • Nonspecialized clinics are facilities where fewer than half of all client visits were for abortion.
  • Hospital-affiliated clinics were categorized as specialized or non-specialized clinics.

The total of all facility categories is referred to in this analysis as “abortion-providing facilities” while the total of “specialized or non-specialized clinics” will be referred to as “abortion clinics or abortion facilities.”

Abortions and abortion-providing facilities (abortion clinics) by select year data per Guttmacher Institute (Graph: Live Action News)

Abortions and abortion-providing facilities (abortion clinics) by select year data per Guttmacher Institute (Graph: Live Action News)

Abortion-Providing Facilities

In 1973, the Guttmacher Institute documented 1,558 abortion-providing facilities. But as the abortion industry began to flourish and unscrupulous abortion profiteers began opening across the country, those numbers skyrocketed nearly 87% to 2,908 (1,405 hospitals/789 abortion facilities/714 physician offices) by 1982.

But due to the efforts of peaceful pro-life activists and sidewalk counselors, by 2020, Guttmacher documented 1,603 total abortion-providing facilities (530 hospitals, 807 abortion facilities, and 266 physician offices), a decrease of nearly 45% from the 2,908 recorded in 1982.

Increasing Abortion Providers

While abortions peaked by the 1990s, the “graying” of abortion providers created a shortage. In 1973, according to the New York Times, “hospitals made up 80 percent of the country’s abortion facilities. By 1981, however, clinics outnumbered hospitals, and 15 years later, 90 percent of the abortions in the U.S. were performed at clinics. The American Medical Association did not maintain standards of care for the procedure. Hospitals didn’t shelter them in their wings. Being a pro-choice doctor came to mean referring your patients to a clinic rather than doing abortions in your own office.”

“In a 1992 survey of OB-GYNs, 59 percent of those age 65 and older said that they performed abortions, compared with 28 percent of those age 50 and younger. The National Abortion Federation [NAF] started warning about ‘the graying of the abortion provider,’” NYT added.

In response, former NAF director Uta Landy, along with University of California San Francisco (UCSF) abortionist Philip Darney, created the Kenneth J. Ryan Residency Training Program in 1999 — suspected of being heavily funded by billionaire Warren Buffett. Buffett, whose billions have been funneled to pro-abortion organizations for decades, gave $78 million to the University of California which houses the Bixby Center’s Ryan Residency Program at UCSF, training many abortionists.

The NYT reviewed the 990’s of the Susan Thompson Buffett Foundation and observed that while “[t]here is no line item for the Ryan program or the Family Planning Fellowship,” the Warren Buffett foundation paid out millions “to universities with one or both of the programs.”

Abortion Facilities

Studies conducted by abortion proponents prior to 1973 indicated that distance to facility was a factor in convincing women, especially minority women to participate in abortion. According to research cited in the documentary film Maafa21:

In 1973, the year abortion was legalized nationwide, Dr. Christopher Tietze, produced a study on abortion demographics at the request of the Population Council, a New York-based eugenics organization. In this report, Tietze confirmed previous research showing that, when abortion is illegal, the abortion rate is much higher for white women than for black women but that this completely reverses whenever abortion is legalized. 

At the time he published these findings, Tietze was a consultant to both Planned Parenthood and the National Abortion Federation.

“Other researchers within the eugenics and abortion movements were also documenting that easy access to abortion clinics produces higher abortion rates in the surrounding area. And at least one expert discovered that having a nearby clinic is a bigger factor in the black abortion rate than it is in the while abortion rate,” the film’s narrator also noted.

Then, research published in 2020 confirmed what Big Abortion knew all along: “Increased distance to a provider was associated with a decreased abortion rate.”

So, to market abortion more effectively, stand-alone facilities were set up across the country. Data showed that in 1974, while hospitals made up the majority of abortion-providing facilities (1,471) in the early days of decriminalization, stand-alone abortion businesses only totaled around 284 — growing a whopping 212% by 1988 to 885 abortion facilities.

In 1973, when there were just 1,558 total abortion-providing facilities, the abortion rate (abortions per 1,000 women aged 15–44) was 16.3, growing to 19.3 by 1974. By 1982, the abortion rate grew to 28.8, when all abortion-providing facilities reached 2,908 with abortion businesses totaling 789. A few years later in 1988, stand-alone abortion facilities grew to 885 when nearly 1.6 million babies were killed by abortion and the abortion rate was recorded at 27.3. Abortion numbers and rates peaked at 1.6 million in 1990, just a few years after Guttmacher documented increased abortion clinics nationwide. But abortion numbers declined steadily in the years that followed, due in part to an increased presence of pro-life activism and sidewalk counseling outside abortion facilities.

By 2017, the total number of abortion-providing facilities had decreased to 1,587, close to where they were when Roe was decided. By 2017, Guttmacher recorded 808 abortion clinics, while between 1990 (27.4) and 2017 (13.5) the abortion rate dropped nearly 51%. A few years later, as abortion-providing facilities grew slightly to 1,603 in 2020, the abortion rate also began to tick up, rising 7% from 13.5 in 2017  to 14.4 in 2020, due in part to the rising proliferation of chemical abortion pills.

At this time, Guttmacher recorded 807 stand-alone abortion facilities, a nearly nine percent decrease from the 885 clinics documented in 1988. In addition, a review published in ACOG’s Obstetrics and Gynecology journal, documented just 750 abortion facilities as of June of 2023, indicating that abortion facilities in the United States may have decreased over 15% since 1988.

Image: Guttmacher Institute graph on abortion facilities 2017 to 2020

Guttmacher Institute graph on abortion facilities 2017 to 2020

Hospital Abortions

In the years immediately following Roe v. Wade, the majority of abortion-providing facilities were hospitals not stand-alone abortion businesses. Shockingly, these hospitals also committed most abortions until that trend changed in the ensuing years. Today, data reveals that hospital abortions are a small amount of the overall abortions reported in the United States.

“The decline in the number of [abortion] providers has occurred entirely among hospitals. In 1977, there were 1,654 hospitals offering abortion services, the number fell to 1,405 in 1982, to 1,191 in 1985 and to 1,040 in 1988… Since 1973, there has been a major shift in the proportion of abortions performed by hospitals and nonhospital facilities, especially abortion clinics,” Stanley K. Henshaw wrote in Family Planning Perspectives in 1990. “The shift of abortions from hospitals to clinics is probably due in large part to the cost advantage of clinics, as well as to the increasing ability of clinics to provide abortions at later gestations.”

“In 1973 slightly more than half of all abortions were performed in hospitals, compared with 46 percent in clinics. However, the proportion of abortions performed in hospitals has declined steadily to just 10 percent in 1988, while the proportion handled by clinics increased each year, to 86 percent in 1988,” he added.

“In 1973, 81 percent of all providers were hospitals,” Henshaw wrote in 1988; in 1984, he claimed that “The number of abortions performed in hospitals has fallen from 336,000 in 1973 (52 percent of all procedures performed in that year) to 341,000 in 1980 (22 percent) and to 281,000 in 1982 (18 percent).”

Henshaw later found that by the mid-1990’s hospitals were committing far fewer abortions, writing in 1998 that “Between 1992 and 1996… The number of providers fell 14%, to 2,042, with the greatest decline among hospitals and physicians’ offices rather than clinics…. Seventy percent of abortions were performed in specialized clinics and only 7% in hospitals.”

By 2014, 95% of abortions were committed by abortion facilities, 4% by hospitals and 1% by physicians’ offices, reported Guttmacher. “Between 2011 and 2014, the number of clinics providing abortions had declined by 6%,” Guttmacher also reported. By 2014, there were 1,641 total abortion-providing facilities (638 hospitals, 789 abortion facilities, and 245 physician offices). Then by 2017, Guttmacher documented 1,587 total abortion-providing facilities (518 hospitals/808 abortion facilities/261 physician offices), a 3% decline from 2014. That year, the number of hospitals providing abortions had also declined by nearly 19%, from 638 to 518.

“While hospitals accounted for one-third of facilities providing abortion care in 2020, they only accounted for 3% of all abortions,” Rachel K. Jones wrote in Perspectives on Sexual and Reproductive Health, “This is because 71% of hospitals provide fewer than 30 abortions per year… and these are often restricted to high-risk pregnancies and/or those for fetal indications… Notably, the total number of clinics providing [abortion] nationally was stable between 2017 and 2020.”