Abortion Surveillance — United States, 2019

Katherine Kortsmit, PhD1; Michele G. Mandel1; Jennifer A. Reeves, MD1; Elizabeth Clark, MD1; H. Pamela Pagano, DrPH1; Antoinette Nguyen, MD1; Emily E. Petersen, MD1; Maura K. Whiteman, PhD1 (View author affiliations)

View suggested citation
Article Metrics
Altmetric:
Citations:
Views:

Views equals page views plus PDF downloads

Related Materials

Abstract

Problem/Condition: CDC conducts abortion surveillance to document the number and characteristics of women obtaining legal induced abortions and number of abortion-related deaths in the United States.

Period Covered: 2019.

Description of System: Each year, CDC requests abortion data from the central health agencies for 50 states, the District of Columbia, and New York City. For 2019, 49 reporting areas voluntarily provided aggregate abortion data to CDC. Of these, 48 reporting areas provided data each year during 2010–2019. Census and natality data were used to calculate abortion rates (number of abortions per 1,000 women aged 15–44 years) and ratios (number of abortions per 1,000 live births), respectively. Abortion-related deaths from 2018 were assessed as part of CDC’s Pregnancy Mortality Surveillance System (PMSS).

Results: A total of 629,898 abortions for 2019 were reported to CDC from 49 reporting areas. Among 48 reporting areas with data each year during 2010–2019, in 2019, a total of 625,346 abortions were reported, the abortion rate was 11.4 abortions per 1,000 women aged 15–44 years, and the abortion ratio was 195 abortions per 1,000 live births. From 2018 to 2019, the total number of abortions increased 2% (from 614,820 total abortions), the abortion rate increased 0.9% (from 11.3 abortions per 1,000 women aged 15–44 years), and the abortion ratio increased 3% (from 189 abortions per 1,000 live births). From 2010 to 2019, the total number of reported abortions, abortion rate, and abortion ratio decreased 18% (from 762,755), 21% (from 14.4 abortions per 1,000 women aged 15–44 years), and 13% (from 225 abortions per 1,000 live births), respectively.

In 2019, women in their 20s accounted for more than half of abortions (56.9%). Women aged 20–24 and 25–29 years accounted for the highest percentages of abortions (27.6% and 29.3%, respectively) and had the highest abortion rates (19.0 and 18.6 abortions per 1,000 women aged 20–24 and 25–29 years, respectively). By contrast, adolescents aged <15 years and women aged ≥40 years accounted for the lowest percentages of abortions (0.2% and 3.7%, respectively) and had the lowest abortion rates (0.4 and 2.7 abortions per 1,000 women aged <15 and ≥40 years, respectively). However, abortion ratios in 2019 were highest among adolescents (aged ≤19 years) and lowest among women aged 25–39 years. Abortion rates decreased from 2010 to 2019 for all women, regardless of age. The decrease in abortion rate was highest among adolescents compared with any other age group. From 2018 to 2019, abortion rates decreased or did not change among women aged ≤24 years; however, the abortion rate increased among those aged ≥25 years. Abortion ratios also decreased or did not change from 2010 to 2019 for all age groups, except adolescents aged <15 years. The decrease in abortion ratio was highest among women aged ≥40 years compared with any other age group. From 2018 to 2019, abortion ratios increased for all age groups, except adolescents aged <15 years. In 2019, 79.3% of abortions were performed at ≤9 weeks’ gestation, and nearly all (92.7%) were performed at ≤13 weeks’ gestation. During 2010–2019, the percentage of abortions performed at >13 weeks’ gestation remained consistently low (≤9.0%). In 2019, the highest proportion of abortions were performed by surgical abortion at ≤13 weeks’ gestation (49.0%), followed by early medical abortion at ≤9 weeks’ gestation (42.3%), surgical abortion at >13 weeks’ gestation (7.2%), and medical abortion at >9 weeks’ gestation (1.4%); all other methods were uncommon (<0.1%). Among those that were eligible (≤9 weeks’ gestation), 53.7% of abortions were early medical abortions. In 2018, the most recent year for which PMSS data were reviewed for pregnancy-related deaths, two women died as a result of complications from legal induced abortion.

Interpretation: Among the 48 areas that reported data continuously during 2010–2019, overall decreases were observed during 2010–2019 in the total number, rate, and ratio of reported abortions; however, from 2018 to 2019, 1%–3% increases were observed across all measures.

Public Health Action: Abortion surveillance can be used to help evaluate programs aimed at promoting equitable access to patient-centered quality contraceptive services in the United States to reduce unintended pregnancies.

Introduction

This report summarizes data on legal induced abortions for 2019 that were provided voluntarily to CDC by the central health agencies of 49 reporting areas (47 states, the District of Columbia, and New York City, excluding California, Maryland, and New Hampshire) and comparisons over time for the 48 reporting areas that reported each year during 2010–2019 (47 states and New York City). This report also summarizes abortion-related deaths reported voluntarily to CDC for 2018 as part of the Pregnancy Mortality Surveillance System (PMSS).

Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States. After nationwide legalization of abortion in 1973, the total number, rate (number of abortions per 1,000 women aged 15–44 years), and ratio (number of abortions per 1,000 live births) of reported abortions increased rapidly, reaching the highest levels in the 1980s, before decreasing at a slow yet steady pace (1,2). During 2006–2008, a break occurred in the previously sustained pattern of decrease (3,4), although this break was followed in subsequent years by even greater decreases (5,6). In 2017, the total number, rate, and ratio of reported abortions reached historic lows, followed by 1%–2% increases across all measures from 2017 to 2018 (5). Nonetheless, despite the overall decreases, abortion incidence and practices have varied over the years and continue to vary across subpopulations (711), highlighting the need for continued surveillance.

Methods

Description of the Surveillance System

Each year, CDC requests aggregated data from the central health agencies of the 50 states, the District of Columbia, and New York City to document the number and characteristics of women obtaining legal induced abortions in the United States. Not all persons who obtain abortions identify as women; the term “women” has been maintained in this report to be consistent with the collection and reporting of denominator data used to calculate abortion rates and ratios. This report contains data voluntarily reported to CDC as of April 9, 2021. For the purpose of surveillance, legal induced abortion is defined as an intervention performed within the limits of state law by a licensed clinician (e.g., a physician, nurse-midwife, nurse practitioner, or physician assistant) intended to terminate a suspected or known intrauterine pregnancy and that does not result in a live birth. All abortions in this report are considered to be legally induced unless stated otherwise.

In most states and jurisdictions, collection of abortion data is facilitated by a legal requirement for hospitals, facilities, or physicians to report abortions to a central health agency (12); however, reporting is not complete in all areas, including in some areas with reporting requirements (13). Because the reporting of abortion data to CDC is voluntary, many reporting areas have developed their own data collection forms and might not collect or provide all the information requested by CDC. As a result, the level of detail reported by CDC on the characteristics of women obtaining abortions might vary from year to year and by reporting area. To encourage uniform collection of data, CDC has collaborated with the National Association for Public Health Statistics and Information Systems to develop reporting standards and provide technical guidance for vital statistics personnel who collect and summarize abortion data within the United States.

Variables and Categorization of Data

Each year, CDC sends a suggested template to central health agencies in the United States for compilation of aggregated abortion data among women obtaining legal induced abortions. Aggregate abortion numbers, without individual-level records, are requested for the following variables:

  • Age group in years of women obtaining legal induced abortions (<15, 15–19 [age group and by individual year], 20–24, 25–29, 30–34, 35–39, or ≥40)
  • Gestational age of pregnancy in completed weeks at the time of abortion (≤6, 7–20 by individual week, or ≥21)
  • Race (Black, White, or other [including Asian, Pacific Islander, other races, and multiple races]), ethnicity (Hispanic or non-Hispanic), and race by ethnicity
  • Method type (surgical abortion, intrauterine instillation, medical [nonsurgical] abortion, or hysterectomy/hysterotomy)
  • Marital status (married [including currently married or separated] or unmarried [including never married, widowed, or divorced])
  • Number of previous live births (zero, one, two, three, or four or more)
  • Number of previous induced abortions (zero, one, two, or three or more)
  • Residence (the state, jurisdiction, territory, or foreign country in which the women obtaining the abortion lived, or, if additional details are unavailable, in-reporting area versus out-of-reporting area)

In addition, the template provided by CDC requests that aggregate numbers for certain variables be cross-tabulated by a second variable. The cross-tabulations presented in this report include weeks of gestation separately by method type, by age group, and by race/ethnicity.

Beginning with 2014 data, instead of reporting the clinicians’ estimates of gestational age or estimates of gestational age based on last menstrual period, some areas have reported “probable postfertilization age,” “clinician’s estimate of gestation based on date of conception,” and “probable gestational age” to CDC. To ensure consistency between data reported as postfertilization age and the data collection practices for gestational age recommended by CDC’s National Center for Health Statistics (14), 2 weeks were added to probable postfertilization age. This method was used to account for time after last menstrual period until ovulation in a standard 28-day cycle because fertilization occurs around the time of ovulation (15). No modifications were made to data reported as clinician’s estimate of gestational age based on date of conception or data reported as probable gestational age.

In this report, medical and surgical abortions are further categorized by gestational age when available in the categories reported by CDC. Early medical abortion is defined as the administration of medications (typically mifepristone followed by misoprostol) to induce an abortion at ≤9 completed weeks’ gestation consistent with the current Food and Drug Administration (FDA) labeling for mifepristone (implemented in 2016) (16). CDC collects information only on the estimated number of weeks (not days) of gestation and acknowledges the conventional use of completed weeks of gestation to describe pregnancy duration; therefore, CDC’s category of ≤9 weeks’ gestation includes abortions through 9 weeks and 6 days. Medications (typically serial prostaglandins, sometimes administered after mifepristone) may also be used to induce an abortion at >9 weeks’ gestation. Surgical abortions, which include uterine aspiration (i.e., dilation and curettage, aspiration curettage, suction curettage, manual vacuum aspiration, menstrual extraction, or sharp curettage) and dilation and evacuation procedures, are categorized as having been performed at ≤13 weeks’ gestation or at >13 weeks’ gestation because of differences in surgical technique at these gestational ages (17). Finally, because intrauterine instillations are unlikely to be performed early in gestation (18), abortions reported to have been performed by intrauterine instillation at ≤12 weeks’ gestation are excluded from calculation of the percentage of abortions by known method type and are grouped with unknown type. The cutoff of ≤12 weeks was selected because this procedure is unlikely to be performed at earlier gestational ages.

Measures of Abortion

Four measures of abortion are presented in this report: 1) the number of abortions in a given population, 2) the percentage of abortions among women by selected characteristics, 3) the abortion rate (number of abortions per 1,000 women within a given population), and 4) the abortion ratio (number of abortions per 1,000 live births within a given population). Abortion rates adjust for differences in population size. Abortion ratios measure the relative number of pregnancies in a population that end in abortion compared with live birth.

The U.S. Census Bureau estimates of the resident female population were used as the denominator for calculating abortion rates (1928). Overall abortion rates were calculated from the population of women aged 15–44 years living in the reporting areas that provided continuously reported data. For adolescents aged <15 years, abortion rates were calculated using the number of adolescents aged 13–14 years; for women aged ≥40 years, abortion rates were calculated using the number of women aged 40–44 years. For the calculation of abortion ratios, live birth data were obtained from CDC natality files and included births to women of all ages living in the reporting areas that provided abortion data (29,30). For calculation of the total abortion rates and total ratios only, women with unknown data on selected characteristics (e.g., age, race/ethnicity, and marital status) were distributed according to the distribution of abortions among those with known information on the characteristic. For calculation of totals only, abortions for women with an unknown gestational age of pregnancy but known method type were distributed according to the distribution of abortions among those with known information on method type by gestational age to the following categories: surgical, ≤13 weeks’ gestation; surgical, >13 weeks’ gestation; medical ≤9 weeks’ gestation; and medical >9 weeks’ gestation.

Data Presentation and Analysis

This report provides aggregate and reporting area–specific abortion numbers, rates, and ratios for the 49 areas that reported to CDC for 2019, which excluded California, Maryland, and New Hampshire. In addition, this report describes characteristics of women who obtained abortions in 2019. The data in this report are presented by the reporting area in which the abortions were performed.

The completeness and quality of data received vary by year and by variable; this report only describes the characteristics of women obtaining abortions in reporting areas that met CDC reporting standards (i.e., reported at least 20 abortions overall, provided data categorized in accordance with requested variables, and had <15% unknown values for a given characteristic). Cells with a value in the range of 1–4 or cells that would allow for calculation of these values have been suppressed in this report to maintain confidentiality in tables presented by reporting area of occurrence.

Trends in the number, rate, and ratio of reported abortions and annual data are presented for the 48 areas that reported every year during 2010–2019. The percentage change in abortion measures from the most recent past year (2018 to 2019) and during the 10-year period of analysis (2010 to 2019) were calculated for these 48 reporting areas.

Trends are also reported for abortions by age group, weeks of gestation, and early medical abortions (≤9 completed weeks’ gestation). Annual data are presented for areas that met reporting standards every year during 2010–2019; the percentage change was calculated from the beginning to the end of the 10-year period of analysis (2010–2019), in 5-year increments from the beginning to the end of the first and second halves of this period (2010–2014 and 2015–2019), and from the most recent past year (2018 to 2019). Consistent with previous reports (5), key findings for trends are presented to highlight observed changes over time and differences between groups. Trends for early medical abortions are reported to monitor any changes in clinical practice that might have occurred with the accumulation of evidence on the safety and effectiveness of medical abortion past 63 days of gestation (8 completed weeks’ gestation) (31), changes in professional practice guidelines published in 2013 and 2014 (32,33), and the 2016 FDA extension of the gestational age limit for the use of mifepristone for early medical abortion from 63 days to 70 days (9 completed weeks’ gestation) (34). No statistical testing was performed. Comparisons do not imply statistical significance, and lack of comment regarding the difference between values does not imply that no statistically significant difference exists.

Data from reporting areas are not included in trends if the data did not meet reporting standards every year during 2010–2019. As a result, aggregate measures for 2019 in trend analyses might differ from the point estimates reported for 2019.

Abortion Mortality

CDC has reported data on abortion-related deaths periodically since information on abortion mortality first was included in the 1972 abortion surveillance report (5,35). An abortion-related death is defined as a death resulting from a direct complication of an abortion (legal or illegal), an indirect complication caused by a chain of events initiated by an abortion, or an aggravation of a preexisting condition by the physiologic or psychologic effects of abortion (36). An abortion is categorized as legal when it is performed by a licensed clinician within the limits of state law.

Since 1987, CDC has monitored abortion-related deaths through PMSS (37). Sources of data to identify abortion-related deaths have included state vital records; media reports, including computerized searches of full-text newspaper and other print media databases; and individual case reports by public health agencies, including maternal mortality review committees, health care providers and provider organizations, private citizens, and citizen groups. For each death that is possibly related to abortion, CDC requests clinical records and autopsy reports. Two medical epidemiologists independently review these reports to determine the cause of death and whether the death was abortion related. Discrepancies are discussed and resolved by consensus. Each death is categorized by abortion type as legal induced, illegal induced, spontaneous, or unknown type.

This report provides PMSS data on induced abortion-related deaths that occurred in 2018, the most recent year for which PMSS data are available. Data on induced abortion-related deaths that occurred during 1972–2017 have been published (1,5,38). For 1998–2018, abortion surveillance data reported to CDC cannot be used alone to calculate national case-fatality rates for legal induced abortions (number of legal induced abortion-related deaths per 100,000 reported legal induced abortions in the United States) because eight reporting areas did not report abortion data every year during this period (Alaska, 1998–2000; California, 1998–2018; District of Columbia, 2016; Louisiana, 2005; Maryland, 2007–2018; New Hampshire, 1998–2018; Oklahoma, 1998–1999; and West Virginia, 2003–2004). Thus, denominator data for calculation of national legal induced abortion case-fatality rates were obtained from a published report by the Guttmacher Institute that includes estimated total numbers of abortions in the United States from a national survey of abortion-providing facilities (6). For 2018, the case-fatality rate was calculated using denominator data for 2017, the most recent year for which data from the Guttmacher Institute are available. Because rates determined on the basis of a numerator of <20 deaths are unstable (39), national case-fatality rates for legal induced abortion were calculated for consecutive 5-year periods during 1973–2012 and then for a consecutive 6-year period during 2013–2018.

Results

Total Abortions Reported to CDC by Occurrence

Among the 49 reporting areas that provided data for 2019, a total of 629,898 abortions were reported. Of these abortions, 625,346 (99.3%) were from 48 reporting areas that provided data every year during 2010–2019. In 2019, these continuously reporting areas had an abortion rate of 11.4 abortions per 1,000 women aged 15–44 years and an abortion ratio of 195 abortions per 1,000 live births (Table 1). From 2018 to 2019, the total number of reported abortions increased 2% (from 614,820 total abortions), the abortion rate increased 0.9% (from 11.3 abortions per 1,000 women aged 15–44 years), and the abortion ratio increased 3% (from 189 abortions per 1,000 live births). From 2010 to 2019, the total number of reported abortions decreased 18% (from 762,755), the abortion rate decreased 21% (from 14.4 abortions per 1,000 women aged 15–44 years), and the abortion ratio decreased 13% (from 225 abortions per 1,000 live births) (Figure).

In 2019, a considerable range existed in abortion rates by reporting area of occurrence (from 0.3 to 27.2 abortions per 1,000 women aged 15–44 years in Wyoming and New York City) and abortion ratios (from 5 to 501 abortions per 1,000 live births in Wyoming and the District of Columbia) (Table 2). The percentage of abortions obtained by out-of-state residents also varied among reporting areas (from 0.5% in Arizona to 68.7% in the District of Columbia). Overall, 0.9% of abortions were reported to CDC with unknown residence.

Age Group, Race/Ethnicity, and Marital Status

Among the 49 areas that reported abortion numbers by women’s age for 2019, women in their 20s accounted for the majority (56.9%) of abortions (Table 3). Women aged 20–24 and 25–29 years accounted for the highest percentages of abortions (27.6% and 29.3%, respectively) and had the highest abortion rates (19.0 and 18.6 abortions per 1,000 women aged 20–24 and 25–29 years, respectively). By contrast, those in the youngest (<15 years) and oldest (≥40 years) age groups accounted for the smallest percentages of abortions (0.2% and 3.7%) and had the lowest abortion rates (0.4 and 2.7 abortions per 1,000 women aged <15 and ≥40 years). However, abortion ratios in 2019 were highest among adolescents (873 and 348 abortions per 1,000 live births among those aged <15 years and 15–19 years) and lowest among women aged 25–39 years (194, 132, and 145 abortions per 1,000 live births among those aged 25–29, 30–34, and 35–39 years, respectively).

Among the 44 reporting areas that provided data each year by women’s age for 2010–2019, this pattern across age groups was stable, with the majority of abortions and the highest abortion rates occurring among women aged 20–29 years and the lowest percentages of abortions and abortion rates occurring among those in the youngest and oldest age groups (Table 4). From 2010 to 2019, abortion rates decreased among all age groups, although the decreases for adolescents (60% and 50% for adolescents aged <15 and 15–19 years) were greater than the decreases for all older age groups. From 2010 to 2014, the abortion rates decreased for all age groups, and from 2015 to 2019, the abortion rates decreased or did not change for all age groups except women aged 30–34 years and ≥40 years. From 2018 to 2019, abortion rates decreased or did not change for women aged ≤24 years; however, the abortion rate increased among those aged ≥25 years. During 2010–2019, abortion ratios decreased or did not change among all age groups, except for adolescents aged <15 years. The abortion ratio decreased for all age groups from 2010 to 2014; however, from 2015 to 2019, abortion ratios only decreased for women aged ≥35 years. From 2018 to 2019, abortion ratios increased for all age groups, except adolescents aged <15 years, for which it decreased.

Among the 47 areas that reported age by individual year among adolescents for 2019, adolescents aged 18–19 years accounted for the majority (70.2%) of adolescent abortions and had the highest adolescent abortion rates (8.6 and 12.2 abortions per 1,000 adolescents aged 18 and 19 years, respectively) (Table 5). Adolescents aged <15 years accounted for the smallest percentage of adolescent abortions (2.6%) and had the lowest adolescent abortion rate (0.4 abortions per 1,000 adolescents aged 13–14 years). In 2019, the abortion ratio for adolescents was highest among adolescents aged <15 years (853 abortions per 1,000 live births) and was lowest among adolescents aged 17–19 years (344, 358, and 294 abortions per 1,000 live births among adolescents aged 17, 18, and 19 years).

Among the 30 areas that reported race by ethnicity data for 2019, non-Hispanic White women and non-Hispanic Black women accounted for the largest percentages of all abortions (33.4% and 38.4%, respectively), and Hispanic women and non-Hispanic women in the other race category accounted for smaller percentages (21.0% and 7.2%, respectively) (Table 6). Non-Hispanic White women had the lowest abortion rate (6.6 abortions per 1,000 women) and ratio (117 abortions per 1,000 live births), and non-Hispanic Black women had the highest abortion rate (23.8 abortions per 1,000 women) and ratio (386 abortions per 1,000 live births).

Among the 42 areas that reported by marital status for 2019, 14.5% of women who obtained an abortion were married, and 85.5% were unmarried (Table 7). The abortion ratio was 46 abortions per 1,000 live births for married women and 394 abortions per 1,000 live births for unmarried women.

Previous Live Births and Previous Induced Abortions

Among the 45 areas that reported the number of previous live births for 2019, 40.2%, 24.5%, 20.0%, 9.2%, and 6.0% of women had zero, one, two, three, or four or more previous live births (Table 8). Among the 44 areas that reported the number of previous induced abortions for 2019, the majority of women (58.2%) had previously had no abortions, 23.8% had previously had one abortion, 10.5% had previously had two abortions, and 7.5% had previously had three or more abortions (Table 9).

Weeks of Gestation and Method Type

Among the 43 areas that reported gestational age at the time of abortion for 2019, 79.3% of abortions were performed at ≤9 weeks’ gestation, and nearly all (92.7%) were performed at ≤13 weeks’ gestation (Table 10). Fewer abortions were performed at 14–20 weeks’ gestation (6.2%) or at ≥21 weeks’ gestation (<1.0%). Among the 34 reporting areas that provided data every year on gestational age for 2010–2019, the percentage of abortions performed at ≤13 weeks’ gestation changed negligibly, from 91.9% to 92.0% (Table 11). However, within this gestational age range, a shift occurred toward earlier gestational ages, with the percentage of abortions performed at ≤6 weeks’ gestation increasing 8% and the percentage of abortions performed at 7–9 weeks’ and 10–13 weeks’ gestation decreasing 0.5% and 14%, respectively.

Among the 47 areas that reported by method type for 2019 and included medical abortion on their reporting form, 49.0% of abortions were surgical abortions at ≤13 weeks’ gestation, 42.3% were early medical abortions (a nonsurgical abortion at ≤9 weeks’ gestation), 7.2% were surgical abortions at >13 weeks’ gestation, and 1.4% were medical abortions at >9 weeks’ gestation; other methods, including intrauterine instillation and hysterectomy/hysterotomy, were both uncommon (<0.1%) (Table 12). During 2010−2019, 35 reporting areas (excludes Alabama, Arizona, California, Delaware, District of Columbia, Florida, Hawaii, Illinois, Louisiana, Maine, Maryland, New Hampshire, New Mexico, Tennessee, Vermont, Wisconsin, and Wyoming) provided continuous data and included medical abortion on their reporting form. Among these 35 areas, use of early medical abortion increased 10% from 2018 to 2019 (from 37.5% of abortions to 41.1%) and 123% from 2010 to 2019 (from 18.4% of abortions to 41.1%).

Among the 42 areas that reported abortions categorized by individual weeks of gestation and method type for 2019, surgical abortion accounted for the largest percentage of abortions within every gestational age category, except ≤6 weeks’ gestation (Table 13). At ≤6 weeks’ gestation, surgical abortion accounted for 41.3% of abortions. Surgical abortion accounted for 52.2% of abortions at 7–9 weeks’ gestation, 93.2% of abortions at 10–13 weeks’ gestation, 96.9%–99.2% of abortions at 14–20 weeks’ gestation, and 87.0% of abortions at ≥21 weeks’ gestation. In contrast, medical abortion accounted for 58.6% of abortions at ≤6 weeks’ gestation, 47.8% of abortions at 7–9 weeks’ gestation, 6.8% of abortions at 10–13 weeks’ gestation, 0.8%–2.3% of abortions at 14–20 weeks’ gestation, and 11.6% of abortions at ≥21 weeks’ gestation. For each gestational age category as applicable, abortions performed by intrauterine instillation or hysterectomy/hysterotomy were rare (<0.1%–1.3% of abortions).

Weeks of Gestation by Age Group and Race/Ethnicity

In selected reporting areas, abortions that were categorized by weeks of gestation were further categorized by age and by race/ethnicity (Table 14). In every subgroup for these characteristics, the largest percentage of abortions occurred at ≤9 weeks’ gestation. In 43 reporting areas, by age, 61.3% of adolescents aged <15 years and 73.6% of adolescents aged 15–19 years obtained an abortion at ≤9 weeks’ gestation, compared with ≥78.6% among women in older age groups. Conversely, 19.8% of adolescents aged <15 years and 9.6% of adolescents aged 15–19 years obtained an abortion after 13 weeks’ gestation, compared with 6.8%–7.5% for women in older age groups. In 29 reporting areas, by race/ethnicity, 76.2% of non-Hispanic Black women obtained an abortion at ≤9 weeks’ gestation, compared with 80.6%–82.4% of women in other racial/ethnic groups. Differences in abortions after 13 weeks’ gestation across race/ethnicity were minimal (7.8% among non-Hispanic Black women, compared with 6.1%–7.7% among women in other racial/ethnic groups).

Abortion Mortality

Using national PMSS data (37), CDC identified two abortion-related deaths for 2018, the most recent year for which data were reviewed for abortion-related deaths (Table 15). Investigation of these cases indicated that both deaths were related to legal abortion.

The annual number of deaths related to legal induced abortion has fluctuated from year to year since 1973 (Table 15). Because of this variability and the limited number of deaths related to legal induced abortions every year, national case-fatality rates for legal abortion were calculated for consecutive 5-year periods during 1973–2012 and then for a consecutive 6-year period during 2013–2018. The national case-fatality rate for legal induced abortion for 2013–2018 was 0.41 deaths related to legal induced abortions per 100,000 reported legal abortions. This case-fatality rate was lower than the rates for the previous 5-year periods.

Discussion

For 2019, a total of 629,898 abortions were reported to CDC by 49 areas. Of these reporting areas, 48 submitted data every year for 2010–2019, thus providing the information necessary for consistently reporting trends. Among these 48 areas, for 2019, the abortion rate was 11.4 abortions per 1,000 women aged 15–44 years, and the abortion ratio was 195 abortions per 1,000 live births. From 2018 to 2019, the number of abortions increased 2%, the abortion rate increased 0.9%, and the abortion ratio increased 3%. Although the rate of reported abortions declined overall from 2010 to 2019, after reaching a historic low in 2017, the abortion rates increased overall between 2017 and 2019.

Approximately 18% of all pregnancies in the United States end in induced abortion (6). Multiple factors influence the incidence of abortion, including access to health care services and contraception (4043); the availability of abortion providers (4,6,4447); state regulations, such as mandatory waiting periods (4850), parental involvement laws (51,52), and legal restrictions on abortion providers (5357); and changes in the economy and the resulting impact on family planning decisions and contraceptive use (58).

Among areas that reported data continuously by age during 2010–2019, women in their 20s accounted for the majority of abortions and had the highest abortion rates, whereas adolescents aged <15 years had the lowest abortion rates, and adolescents aged <15 years and 15−19 years had the highest abortion ratios. During 2010–2019, women aged ≥40 years accounted for a relatively small proportion of reported abortions (3.4%–3.7%). However, the abortion ratio among women aged ≥40 years continues to be higher than among women aged 25–39 years. These data underscore important age differences in abortion measures.

The trends in adolescent abortions described in this report are important for monitoring trends in adolescent pregnancies in the United States. From 2010 to 2019, national birth data indicate that the birth rate for adolescents aged 15–19 years decreased 51% (30), and the data in this report indicate that the abortion rate for the same age group decreased 50%. These findings highlight that decreases in adolescent births in the United States have been accompanied by large decreases in adolescent abortions (30).

As in previous years, abortion rates and ratios differ across racial/ethnic groups. For example, in 2019, compared with non-Hispanic White women, abortion rates and ratios were 3.6 and 3.3 times higher among non-Hispanic Black women and 1.8 and 1.5 times higher among Hispanic women. Similar differences have been demonstrated in other U.S.-based studies (2,710,59). The factors leading to higher abortion rates among certain racial/ethnic minority groups are complex. In addition to disparities in rates of unintended pregnancies, structural factors, including unequal access to quality family planning services (60,61), economic disadvantage, and distrust of the medical system (62), might contribute to observed differences. Strategies are needed to address these broader structural inequities.

In 2019, the majority of abortions occurred early in gestation (≤9 weeks), when the risks for complications are lowest (6366). In addition, over the past 10 years, approximately three fourths of abortions were performed at ≤9 weeks’ gestation, and this percentage increased from 74.8% in 2010 to 77.4% in 2019. Moreover, among areas that reported abortions at ≤13 weeks’ gestation by individual week, the distribution of abortions by gestational age continued to shift toward earlier weeks of gestation, with the percentage of early abortions performed at ≤6 weeks’ gestation increasing from 34.7% in 2010 to 37.5% in 2019. Previous research indicates that the distribution of abortions by gestational age differs by various sociodemographic characteristics (6769). In this report, the percentage of adolescents aged ≤19 years who obtained abortions at >13 weeks’ gestation was higher than the percentage of abortions obtained among older age groups. The gestational age when abortions are performed might be influenced by multiple factors, including state abortion restrictions, accurate estimation of gestational age, income level, age, and presence of pregnancy-related health conditions (48,59,66,6873).

Changes in abortion practices have facilitated the trend of obtaining abortions earlier in pregnancy. Research conducted in the United States during the 1970s indicated that surgical abortion procedures performed at ≤6 weeks’ gestation, compared with 7–12 weeks’ gestation, were less likely to result in successful termination of the pregnancy (74). However, subsequent advances in technology (e.g., improved transvaginal ultrasonography and sensitivity of pregnancy tests) have allowed very early surgical abortions to be performed with completion rates exceeding 97% (7578). Likewise, the development of early medical abortion regimens has allowed for abortions to be performed early in gestation, with completion rates for regimens that combine mifepristone and misoprostol reaching 96%–98% (7881). Among those that were eligible (≤9 weeks’ gestation), 53.7% were reported as early medical abortions. Moreover, among areas that reported by method type and included medical abortion on their reporting form, the percentage of all abortions performed by early medical abortion increased 123% from 2010 to 2019.

Because the annual number of deaths related to legal induced abortion is small and statistically unstable, case-fatality rates were calculated for consecutive 5-year periods during 1973–2012 and then for a consecutive 6-year period during 2013–2018. The national case-fatality rate for legal induced abortion for 2013–2018 was 0.41 deaths per 100,000 abortions; since the late 1970s, all rates for the preceding 5-year periods have been fewer than 1 death per 100,000 abortions, demonstrating the low risk for death associated with legal induced abortion.

Limitations

The findings in this report are subject to at least four limitations. First, because reporting to CDC is voluntary and reporting requirements vary by the individual reporting areas (13), CDC is unable to report the total number of abortions performed in the United States. Of the 52 areas from which CDC requested data for 2019, California, Maryland, and New Hampshire did not submit abortion data. In 2017, the most recent year for which data are available through the Guttmacher Institute’s national survey of abortion-providing facilities, abortions performed in these states accounted for approximately 19% of all abortions in the United States (6). In addition, New Jersey did not have abortion reporting requirements to a centralized health agency during the period covered in this report (12), which potentially affects the representativeness of data provided to CDC. Some reporting areas (the District of Columbia and Wyoming) implemented new legislation that could improve reporting of 2019 abortion data. Nonetheless, even in reporting areas that legally require clinicians to submit a report for every abortion they perform, enforcement of this requirement varies.

Second, many states use abortion reporting forms that differ from the technical guidance that CDC developed in collaboration with the National Association for Public Health Statistics and Information Systems. Consequently, some reporting areas do not collect all variables requested by CDC (e.g., age and race/ethnicity) or do not report the data in a manner consistent with this guidance (e.g., gestational age). Missing demographic information can reduce the extent to which the statistics in this report represent women who have had abortions. Findings in this report on the age of women seeking abortions were generally similar to previously published data from Guttmacher Institute’s national survey of abortion patients in 2014, although the percentage of abortions among non-Hispanic Black women was lower and among Hispanic women was higher compared with data provided to CDC (82). Differences might be attributable to the fact that only 30 reporting areas reported race/ethnicity data to CDC that met CDC’s reporting standards. Some areas that either do not report to CDC (e.g., California) or do not report race/ethnicity data (e.g., Illinois) have sufficiently large populations of racial/ethnic minority groups that the absence of data from these areas likely reduces the representativeness of CDC data for these variables. In addition, some areas collect gestational age data that are based on estimated date of conception or probable postfertilization age, which are not consistent with medical conventions for gestational age reporting. Without medical guidance on how to report these data, the validity and reliability of gestational age for these reporting areas is uncertain.

Third, abortion data are compiled and reported to CDC by the central health agency of the reporting area in which the abortion was performed rather than the reporting area in which the person lived. Thus, the available population (1928) and birth data (29,30), which are organized by the states in which women live, might differ from the population of women who undergo abortions in a given reporting area. This likely results in an overestimation of abortions for reporting areas in which a higher percentage of abortions are obtained by out-of-state residents and an underestimation of abortions for reporting areas where residents more frequently obtain abortions out of state. Limited abortion services, stringent regulatory requirements for obtaining an abortion, or geographic proximity to services in another state might influence where women obtain abortion services (83).

Finally, CDC reporting of sociodemographic characteristics of women obtaining abortions is limited to data collected on jurisdiction reporting forms. Therefore, examining additional demographic variables (e.g., socioeconomic status) is not possible.

Public Health Implications

Ongoing surveillance of legal induced abortion is important for several reasons. First, abortion surveillance can be used to help evaluate programs aimed at promoting equitable access to patient-centered contraceptive care in the United States to reduce unintended pregnancies. Cost, inadequate provider reimbursement and training, insufficient patient-centered counseling, lack of youth-friendly services, and low client awareness of available contraceptive methods are reported barriers to accessing contraception (4042,8490). Reducing these barriers might help ensure equitable access to patient-centered contraceptive care and promote equitable reproductive health in the United States (91).

Second, routine abortion surveillance is needed to assess trends in clinical practice patterns over time. Information in this report on the number of abortions performed through different methods (e.g., medical or surgical) and at different gestational ages provides the denominator data that are necessary for analyses of the relative safety of abortion practices (38). Finally, information on the number of pregnancies ending in abortion is needed in conjunction with data on births and fetal losses to estimate the number of pregnancies in the United States and determine rates for various outcomes of public health importance (e.g., adolescent pregnancies) (11).

Corresponding author: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. E-mail: cdcinfo@cdc.gov.


1Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC

Conflicts of Interest

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

References

  1. Gamble SB, Strauss LT, Parker WY, Cook DA, Zane SB, Hamdan S; CDC. Abortion surveillance—United States, 2005. MMWR Surveill Summ 2008;57(No. SS-13). PMID:19037196external icon
  2. Jones RK, Kost K, Singh S, Henshaw SK, Finer LB. Trends in abortion in the United States. Clin Obstet Gynecol 2009;52:119–29. https://doi.org/10.1097/GRF.0b013e3181a2af8fexternal icon PMID:19407518external icon
  3. Pazol K, Zane SB, Parker WY, Hall LR, Berg C, Cook DA; CDC. Abortion surveillance—United States, 2008. MMWR Surveill Summ 2011;60(No. SS-15). PMID:22108620external icon
  4. Jones RK, Kooistra K. Abortion incidence and access to services in the United States, 2008. Perspect Sex Reprod Health 2011;43:41–50. https://doi.org/10.1363/4304111external icon PMID:21388504external icon
  5. Kortsmit K, Jatlaoui TC, Mandel MG, et al. Abortion surveillance—United States, 2018. MMWR Surveill Summ 2020;69(No. SS-7). https://doi.org/10.15585/mmwr.ss6907a1external icon PMID:33237897external icon
  6. Jones RK, Witwer E, Jerman J. Abortion incidence and service availability in the United States, 2017. New York, NY: Guttmacher Institute; 2019. https://www.guttmacher.org/report/abortion-incidence-service-availability-us-2017external icon
  7. Henshaw SK, Silverman J. The characteristics and prior contraceptive use of U.S. abortion patients. Fam Plann Perspect 1988;20:158–68. https://doi.org/10.2307/2135791external icon PMID:3243346external icon
  8. Jones RK, Darroch JE, Henshaw SK. Patterns in the socioeconomic characteristics of women obtaining abortions in 2000–2001. Perspect Sex Reprod Health 2002;34:226–35. https://doi.org/10.2307/3097821external icon PMID:12392215external icon
  9. Jones RK, Kavanaugh ML. Changes in abortion rates between 2000 and 2008 and lifetime incidence of abortion. Obstet Gynecol 2011;117:1358–66. https://doi.org/10.1097/AOG.0b013e31821c405eexternal icon PMID:21606746external icon
  10. Jones RK, Jerman J. Population group abortion rates and lifetime incidence of abortion: United States, 2008–2014. Am J Public Health 2017;107:1904–9. https://doi.org/10.2105/AJPH.2017.304042external icon PMID:29048970external icon
  11. Maddow-Zimet I, Kost K. Pregnancies, births and abortions in the United States, 1973–2017: national and state trends by age. New York, NY: Guttmacher Institute; 2021. https://www.guttmacher.org/report/pregnancies-births-abortions-in-united-states-1973-2017external icon
  12. Guttmacher Institute. Abortion reporting requirements. New York, NY: Guttmacher Institute; 2021. https://www.guttmacher.org/state-policy/explore/abortion-reporting-requirementsexternal icon
  13. Saul R. Abortion reporting in the United States: an examination of the federal-state partnership. Fam Plann Perspect 1998;30:244–7. https://doi.org/10.2307/2991612external icon PMID:9782049external icon
  14. National Center for Health Statistics. Guide to completing the facility worksheets for the certificate of live birth and report of fetal death. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2016. https://www.cdc.gov/nchs/data/dvs/GuidetoCompleteFacilityWks.pdfpdf icon
  15. Fritz MA, Speroff L. Clinical gynecologic endocrinology and infertility. Philadelphia, PA: Wolters Kluwer Health; 2012.
  16. Mifeprex (mifepristone) [Package insert]. New York, NY: Danco Laboratories; 2016.
  17. Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD. Management of unintended and abnormal pregnancy: comprehensive abortion care. Oxford, England: Blackwell Publishing Ltd.; 2009.
  18. Lichtman AS, Brenner P, Mishell DR Jr. Intrauterine administration of prostaglandin F2alpha as an outpatient procedure for termination of early pregnancy. Contraception 1974;9:403–8. https://doi.org/10.1016/0010-7824(74)90083-3external icon PMID:4442283external icon
  19. CDC. Bridged-race population estimates, April 1, 2010. [File census_0401_2010.sas7bdat.zip]. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2011. https://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#april2010
  20. CDC. Postcensal estimates of the resident population of the United States as of July 1, 2011, by year, state and county, age, bridged race, sex, and Hispanic origin (Vintage 2011). [File pcen_v2011_y11.sas7bdat]. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2012. https://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2011
  21. CDC. Postcensal estimates of the resident population of the United States as of July 1, 2012, by year, state and county, age, bridged race, sex, and Hispanic origin (Vintage 2012) [File pcen_v2012_y12.sas7bdat]. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2013. https://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2012
  22. CDC. Postcensal estimates of the resident population of the United States as of July 1, 2013, by year, state and county, age, bridged race, sex, and Hispanic origin (Vintage 2013) [File pcen_v2013_y13.sas7bdat]. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2014. https://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2013
  23. CDC. Postcensal estimates of the resident population of the United States as of July 1, 2014, by year, state and county, age, bridged race, sex, and Hispanic origin (Vintage 2014). [File pcen_v2014_y14.sas7bdat]. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2015. http://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2014
  24. CDC. Postcensal estimates of the resident population of the United States as of July 1, 2015, by year, state and county, age, bridged race, sex, and Hispanic origin (Vintage 2015). [File pcen_v2015_y15.sas7bdat]. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2016. https://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#vintage2015
  25. CDC. Postcensal estimates of the resident population of the United States as of July 1, 2016, by year, state and county, age, bridged race, sex, and Hispanic origin (Vintage 2016). [File pcen_v2016_y16.sas7bdat]. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2017. https://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#Vintage2016
  26. CDC. Postcensal estimates of the resident population of the United States as of July 1, 2017, by year, state and county, age, bridged race, sex, and Hispanic origin (Vintage 2017). [File pcen_v2017_y17.sas7bdat]. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2018. https://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#Vintage2017
  27. CDC. Postcensal estimates of the resident population of the United States as of July 1, 2018, by year, state and county, age, bridged race, sex, and Hispanic origin (Vintage 2018). [File pcen_v2018_y18.sas7bdat]. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2019. https://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#Vintage2018
  28. CDC. Postcensal estimates of the resident population of the United States as of July 1, 2019, by year, state and county, age, bridged race, sex, and Hispanic origin (Vintage 2019). [File pcen_v2019_y19.sas7bdat]. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2020. https://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#Vintage2019
  29. CDC. Natality files. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics. https://wonder.cdc.gov/Natality.html
  30. Martin JA, Hamilton BE, Osterman MJK, Driscoll AK. Births: final data for 2019. Natl Vital Stat Rep 2021;70:1–51. PMID:33814033external icon
  31. Winikoff B, Dzuba IG, Chong E, et al. Extending outpatient medical abortion services through 70 days of gestational age. Obstet Gynecol 2012;120:1070–6. https://doi.org/10.1097/AOG.0b013e31826c315fexternal icon PMID:23090524external icon
  32. National Abortion Federation. 2013 clinical policy guidelines. Washington, DC: National Abortion Federation; 2013. https://www.prochoice.org/pubs_research/publications/documents/2013NAFCPGsforweb.pdfpdf iconexternal icon
  33. Creinin M, Grossman DA. Medical management of first-trimester abortion. Contraception 2014;89:148–61. https://doi.org/10.1016/j.contraception.2014.01.016external icon PMID:24795934external icon
  34. Food and Drug Administration. Mifeprex (mifepristone) information. Silver Spring, MD: US Department of Health and Human Services, Food and Drug Administration; 2016. https://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm111323.htmexternal icon
  35. CDC. Abortion surveillance, 1972. Atlanta, GA: US Department of Health, Education, and Welfare, Public Health Service, CDC; 1974.
  36. CDC. Abortion surveillance, 1977. Atlanta, GA: US Department of Health, Education, and Welfare, Public Health Service, CDC; 1979.
  37. CDC. Pregnancy Mortality Surveillance System. Atlanta, GA: US Department of Health and Human Services, CDC; 2020. https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm
  38. Zane S, Creanga AA, Berg CJ, et al. Abortion-related mortality in the United States: 1998–2010. Obstet Gynecol 2015;126:258–65. https://doi.org/10.1097/AOG.0000000000000945external icon PMID:26241413external icon
  39. Hoyert DL. Maternal mortality and related concepts. Vital Health Stat 3 2007;33:1–13. PMID:17460868external icon
  40. Peipert JF, Madden T, Allsworth JE, Secura GM. Preventing unintended pregnancies by providing no-cost contraception. Obstet Gynecol 2012;120:1291–7. https://doi.org/10.1097/AOG.0b013e318273eb56external icon PMID:23168752external icon
  41. Biggs MA, Rocca CH, Brindis CD, Hirsch H, Grossman D. Did increasing use of highly effective contraception contribute to declining abortions in Iowa? Contraception 2015;91:167–73. https://doi.org/10.1016/j.contraception.2014.10.009external icon PMID:25465890external icon
  42. Ricketts S, Klingler G, Schwalberg R. Game change in Colorado: widespread use of long-acting reversible contraceptives and rapid decline in births among young, low-income women. Perspect Sex Reprod Health 2014;46:125–32. https://doi.org/10.1363/46e1714external icon PMID:24961366external icon
  43. Roth LP, Sanders JN, Simmons RG, Bullock H, Jacobson E, Turok DK. Changes in uptake and cost of long-acting reversible contraceptive devices following the introduction of a new low-cost levonorgestrel IUD in Utah’s Title X clinics: a retrospective review. Contraception 2018;98:63–8. https://doi.org/10.1016/j.contraception.2018.03.029external icon PMID:29574095external icon
  44. Jones RK, Jerman J. Abortion incidence and service availability in the United States, 2011. Perspect Sex Reprod Health 2014;46:3–14. https://doi.org/10.1363/46e0414external icon PMID:24494995external icon
  45. Finer LB, Henshaw SK. Abortion incidence and services in the United States in 2000. Perspect Sex Reprod Health 2003;35:6–15. https://doi.org/10.1363/3500603external icon PMID:12602752external icon
  46. Henshaw SK. Abortion incidence and services in the United States, 1995–1996. Fam Plann Perspect 1998;30:263–70, 287. https://doi.org/10.2307/2991501external icon PMID:9859016external icon
  47. Quast T, Gonzalez F, Ziemba R. Abortion facility closings and abortion rates in Texas. Inquiry 2017;54:46958017700944. https://doi.org/10.1177/0046958017700944external icon PMID:28351188external icon
  48. Joyce TJ, Henshaw SK, Dennis A, Finer LB, Blanchard K. The impact of state mandatory counseling and waiting period laws on abortion: a literature review. New York, NY: Guttmacher Institute; 2009. https://www.guttmacher.org/pubs/MandatoryCounseling.pdfpdf iconexternal icon
  49. Sanders JN, Conway H, Jacobson J, Torres L, Turok DK. The longest wait: examining the impact of Utah’s 72-hour waiting period for abortion. Womens Health Issues 2016;26:483–7. https://doi.org/10.1016/j.whi.2016.06.004external icon PMID:27502901external icon
  50. Ely G, Polmanteer RSR, Caron A. Access to abortion services in Tennessee: does distance traveled and geographic location influence return for a second appointment as required by the mandatory waiting period policy? Health Soc Work 2019;44:13–21. https://doi.org/10.1093/hsw/hly039external icon PMID:30561624external icon
  51. Dennis A, Henshaw SK, Joyce TJ, Finer LB, Blanchard K. The impact of laws requiring parental involvement for abortion: a literature review. New York, NY: Guttmacher Institute; 2009. https://www.guttmacher.org/pubs/ParentalInvolvementLaws.pdfpdf iconexternal icon
  52. Ramesh S, Zimmerman L, Patel A. Impact of parental notification on Illinois minors seeking abortion. J Adolesc Health 2016;58:290–4. https://doi.org/10.1016/j.jadohealth.2015.11.004external icon PMID:26794433external icon
  53. Grossman D, Baum S, Fuentes L, et al. Change in abortion services after implementation of a restrictive law in Texas. Contraception 2014;90:496–501. https://doi.org/10.1016/j.contraception.2014.07.006external icon PMID:25128413external icon
  54. Joyce T. The supply-side economics of abortion. N Engl J Med 2011;365:1466–9. https://doi.org/10.1056/NEJMp1109889external icon PMID:22010912external icon
  55. Grossman D, White K, Hopkins K, Potter JE. Change in distance to nearest facility and abortion in Texas, 2012 to 2014. JAMA 2017;317:437–9. https://doi.org/10.1001/jama.2016.17026external icon PMID:28114666external icon
  56. White K, Baum SE, Hopkins K, Potter JE, Grossman D. Change in second-trimester abortion after implementation of a restrictive state law. Obstet Gynecol 2019;133:771–9. https://doi.org/10.1097/AOG.0000000000003183external icon PMID:30870293external icon
  57. Jones RK, Ingerick M, Jerman J. Differences in abortion service delivery in hostile, middle-ground, and supportive states in 2014. Womens Health Issues 2018;28:212–8. https://doi.org/10.1016/j.whi.2017.12.003external icon PMID:29339010external icon
  58. Guttmacher Institute. A real-time look at the impact of the recession on women’s family planning and pregnancy decisions. New York, NY: Guttmacher Institute; 2009. https://www.guttmacher.org/pubs/RecessionFP.pdfpdf iconexternal icon
  59. Jones RK, Jerman J. Characteristics and circumstances of U.S. women who obtain very early and second-trimester abortions. PLoS One 2017;12:e0169969. https://doi.org/10.1371/journal.pone.0169969external icon PMID:28121999external icon
  60. Dehlendorf C, Rodriguez MI, Levy K, Borrero S, Steinauer J. Disparities in family planning. Am J Obstet Gynecol 2010;202:214–20. https://doi.org/10.1016/j.ajog.2009.08.022external icon PMID:20207237external icon
  61. Pazol K, Robbins CL, Black LI, et al. Receipt of selected preventive health services for women and men of reproductive age—United States, 2011–2013. MMWR Surveill Summ 2017;66(No. SS-20). https://doi.org/10.15585/mmwr.ss6620a1external icon PMID:29073129external icon
  62. Dehlendorf C, Harris LH, Weitz TA. Disparities in abortion rates: a public health approach. Am J Public Health 2013;103:1772–9. https://doi.org/10.2105/AJPH.2013.301339external icon PMID:23948010external icon
  63. Buehler JW, Schulz KF, Grimes DA, Hogue CJ. The risk of serious complications from induced abortion: do personal characteristics make a difference? Am J Obstet Gynecol 1985;153:14–20. https://doi.org/10.1016/0002-9378(85)90582-4external icon PMID:4036997external icon
  64. Ferris LE, McMain-Klein M, Colodny N, Fellows GF, Lamont J. Factors associated with immediate abortion complications. CMAJ 1996;154:1677–85. PMID:8646655external icon
  65. Bartlett LA, Berg CJ, Shulman HB, et al. Risk factors for legal induced abortion-related mortality in the United States. Obstet Gynecol 2004;103:729–37. https://doi.org/10.1097/01.AOG.0000116260.81570.60external icon PMID:15051566external icon
  66. Lichtenberg ES, Paul M; Society of Family Planning. Surgical abortion prior to 7 weeks of gestation. Contraception 2013;88:7–17. https://doi.org/10.1016/j.contraception.2013.02.008external icon PMID:23574709external icon
  67. Foster DG, Kimport K. Who seeks abortions at or after 20 weeks? Perspect Sex Reprod Health 2013;45:210–8. https://doi.org/10.1363/4521013external icon PMID:24188634external icon
  68. Jones RK, Finer LB. Who has second-trimester abortions in the United States? Contraception 2012;85:544–51. https://doi.org/10.1016/j.contraception.2011.10.012external icon PMID:22176796external icon
  69. Kiley JW, Yee LM, Niemi CM, Feinglass JM, Simon MA. Delays in request for pregnancy termination: comparison of patients in the first and second trimesters. Contraception 2010;81:446–51. https://doi.org/10.1016/j.contraception.2009.12.021external icon PMID:20399953external icon
  70. Drey EA, Foster DG, Jackson RA, Lee SJ, Cardenas LH, Darney PD. Risk factors associated with presenting for abortion in the second trimester. Obstet Gynecol 2006;107:128–35. https://doi.org/10.1097/01.AOG.0000189095.32382.d0external icon PMID:16394050external icon
  71. Finer LB, Frohwirth LF, Dauphinee LA, Singh S, Moore AM. Timing of steps and reasons for delays in obtaining abortions in the United States. Contraception 2006;74:334–44. https://doi.org/10.1016/j.contraception.2006.04.010external icon PMID:16982236external icon
  72. Goyal V, Wallace R, Dermish AI, et al. Factors associated with abortion at 12 or more weeks gestation after implementation of a restrictive Texas law. Contraception 2020;102:314–7. https://doi.org/10.1016/j.contraception.2020.06.007external icon PMID:32592799external icon
  73. Janiak E, Kawachi I, Goldberg A, Gottlieb B. Abortion barriers and perceptions of gestational age among women seeking abortion care in the latter half of the second trimester. Contraception 2014;89:322–7. https://doi.org/10.1016/j.contraception.2013.11.009external icon PMID:24332434external icon
  74. Kaunitz AM, Rovira EZ, Grimes DA, Schulz KF. Abortions that fail. Obstet Gynecol 1985;66:533–7. PMID:4047543external icon
  75. Creinin MD, Edwards J. Early abortion: surgical and medical options. Curr Probl Obstet Gynecol Fertil 1997;20:1–32.
  76. Edwards J, Carson SA. New technologies permit safe abortion at less than six weeks’ gestation and provide timely detection of ectopic gestation. Am J Obstet Gynecol 1997;176:1101–6. https://doi.org/10.1016/S0002-9378(97)70410-1external icon PMID:9166176external icon
  77. Paul ME, Mitchell CM, Rogers AJ, Fox MC, Lackie EG. Early surgical abortion: efficacy and safety. Am J Obstet Gynecol 2002;187:407–11. https://doi.org/10.1067/mob.2002.123898external icon PMID:12193934external icon
  78. Baldwin MK, Bednarek PH, Russo J. Safety and effectiveness of medication and aspiration abortion before or during the sixth week of pregnancy: A retrospective multicenter study. Contraception 2020;102:13–7. https://doi.org/10.1016/j.contraception.2020.04.004external icon PMID:32298713external icon
  79. Kapp N, Baldwin MK, Rodriguez MI. Efficacy of medical abortion prior to 6 gestational weeks: a systematic review. Contraception 2018;97:90–9. https://doi.org/10.1016/j.contraception.2017.09.006external icon PMID:28935220external icon
  80. Kapp N, Eckersberger E, Lavelanet A, Rodriguez MI. Medical abortion in the late first trimester: a systematic review. Contraception 2019;99:77–86. https://doi.org/10.1016/j.contraception.2018.11.002external icon PMID:30444970external icon
  81. Nippita S, Paul M. Abortion. In: Hatcher R, Nelson A, Trussell J, et al., eds. Contraceptive technology. 21st ed. New York, NY: Ayer Company Publishers, Inc.; 2018:779–827.
  82. Jerman J, Jones RK, Onda T. Characteristics of U.S. abortion patients in 2014 and changes since 2008. New York, NY: Guttmacher Institute; 2016. https://www.guttmacher.org/sites/default/files/report_pdf/characteristics-us-abortion-patients-2014.pdfpdf iconexternal icon
  83. Jerman J, Frohwirth L, Kavanaugh ML, Blades N. Barriers to abortion care and their consequences for patients traveling for services: qualitative findings from two states. Perspect Sex Reprod Health 2017;49:95–102. https://doi.org/10.1363/psrh.12024external icon PMID:28394463external icon
  84. Goyal V, Canfield C, Aiken ARA, Dermish A, Potter JE. Postabortion contraceptive use and continuation when long-acting reversible contraception is free. Obstet Gynecol 2017;129:655–62. https://doi.org/10.1097/AOG.0000000000001926external icon PMID:28277358external icon
  85. Gyllenberg FK, Saloranta TH, But A, Gissler M, Heikinheimo O. Induced abortion in a population entitled to free-of-charge long-acting reversible contraception. Obstet Gynecol 2018;132:1453–60. https://doi.org/10.1097/AOG.0000000000002966external icon PMID:30399102external icon
  86. Biggs MA, Taylor D, Upadhyay UD. Role of insurance coverage in contraceptive use after abortion. Obstet Gynecol 2017;130:1338–46. https://doi.org/10.1097/AOG.0000000000002361external icon PMID:29112661external icon
  87. Boulet SL, D’Angelo DV, Morrow B, et al. Contraceptive use among nonpregnant and postpartum women at risk for unintended pregnancy, and female high school students, in the context of Zika preparedness—United States, 2011–2013 and 2015. MMWR Morb Mortal Wkly Rep 2016;65:780–7. https://doi.org/10.15585/mmwr.mm6530e2external icon PMID:27490117external icon
  88. Kumar N, Brown JD. Access barriers to long-acting reversible contraceptives for adolescents. J Adolesc Health 2016;59:248–53. https://doi.org/10.1016/j.jadohealth.2016.03.039external icon PMID:27247239external icon
  89. Parks C, Peipert JF. Eliminating health disparities in unintended pregnancy with long-acting reversible contraception (LARC). Am J Obstet Gynecol 2016;214:681–8. https://doi.org/10.1016/j.ajog.2016.02.017external icon PMID:26875950external icon
  90. Klein DA, Berry-Bibee EN, Keglovitz Baker K, Malcolm NM, Rollison JM, Frederiksen BN. Providing quality family planning services to LGBTQIA individuals: a systematic review. Contraception 2018;97:378–91. https://doi.org/10.1016/j.contraception.2017.12.016external icon PMID:29309754external icon
  91. Holt K, Reed R, Crear-Perry J, Scott C, Wulf S, Dehlendorf C. Beyond same-day long-acting reversible contraceptive access: a person-centered framework for advancing high-quality, equitable contraceptive care. Am J Obstet Gynecol 2020;222(4S):878.e1, 878.e6. https://doi.org/10.1016/j.ajog.2019.11.1279external icon PMID:31809706external icon
TABLE 1. Number, percentage, rate,* and ratio of reported abortions — selected reporting areas, United States, 2010–2019Return to your place in the text
Year Selected reporting areas§ Continuously reporting areas
No. No. (%)** Rate Ratio
2010 765,651 762,755 (99.6) 14.4 225
2011 730,322 727,554 (99.6) 13.7 217
2012 699,202 696,587 (99.6) 13.1 208
2013 664,435 661,874 (99.6) 12.4 198
2014 652,639 649,849 (99.6) 12.1 192
2015 638,169 636,902 (99.8) 11.8 188
2016 623,471 623,471 (100.0) 11.6 186
2017 612,719 609,095 (99.4) 11.2 185
2018 619,591 614,820 (99.2) 11.3 189
2019 629,898 625,346 (99.3) 11.4 195

* Number of abortions per 1,000 women aged 15–44 years.
Number of abortions per 1,000 live births.
§ For each given year, excludes reporting areas that did not report that year’s abortion numbers to CDC: California (2010–2019), District of Columbia (2016), Maryland (2010–2019), and New Hampshire (2010–2019).
For all years, excludes reporting areas that did not report abortion numbers every year during the period of analysis (2010–2019): California, District of Columbia, Maryland, and New Hampshire.
** Abortions from areas that reported every year during 2010–2019 as a percentage of all reported abortions for a given year.

Return to your place in the textFIGURE. Number, rate,* and ratio of abortions performed, by year — selected reporting areas,§ United States, 2010–2019
This figure is a line graph showing the number, rate, and ratio of abortions performed in the United States (excluding California, District of Columbia, Maryland, and New Hampshire) during 2010–2019.

* Number of abortions per 1,000 women aged 15–44 years.

Number of abortions per 1,000 live births.

§ Data are for 48 reporting areas; excludes California, District of Columbia, Maryland, and New Hampshire.

TABLE 2. Number, rate,* and ratio of reported abortions, by reporting area of occurrence and number of abortions obtained by out-of-state residents§ — United States, 2019Return to your place in the text
State/Area Abortions reported by area of occurrence** Abortions obtained by out-of-state residents
No. Rate Ratio No. (%)
Alabama 6,009 6.3 103 1,040 (17.3)
Alaska 1,270 8.8 129 19 (1.5)
Arizona 13,097 9.4 165 67 (0.5)
Arkansas 2,963 5.1 81 338 (11.4)
Colorado 9,002 7.6 143 946 (10.5)
Connecticut 9,202 13.7 269 334 (3.6)
Delaware 2,042 11.3 193 277 (13.6)
District of Columbia 4,552 23.9 501 3,126 (68.7)
Florida 71,914 18.5 327 2,256 (3.1)
Georgia 36,907 16.9 292 6,500 (17.6)
Hawaii 2,003 7.6 119 49 (2.4)
Idaho 1,513 4.4 69 78 (5.2)
Illinois 46,517 18.6 332 7,534 (16.2)
Indiana 7,637 5.8 94 618 (8.1)
Iowa 3,566 6.0 95 490 (13.7)
Kansas 6,894 12.3 195 3,372 (48.9)
Kentucky 3,664 4.3 69 643 (17.5)
Louisiana 8,144 8.8 138 1,358 (16.7)
Maine 2,021 8.7 172 107 (5.3)
Massachusetts 18,593 13.3 269 631 (3.4)
Michigan 27,339 14.6 253 1,435 (5.2)
Minnesota 9,940 9.2 151 888 (8.9)
Mississippi 3,194 5.5 87 335 (10.5)
Missouri 1,471 1.2 20 128 (8.7)
Montana 1,568 8.0 142 169 (10.8)
Nebraska 2,068 5.5 84 267 (12.9)
Nevada 8,414 14.0 240 434 (5.2)
New Jersey†† 22,178 13.2 223 1,309 (5.9)
New Mexico 3,942 9.9 172 939 (23.8)
New York 78,587 20.3 355 6,989 (8.9)
      New York City 49,784 27.2 472 4,668 (9.4)
      New York State 28,803 14.1 248 2,321 (8.1)
North Carolina 28,450 13.8 240 5,079 (17.9)
North Dakota 1,121 7.6 107 289 (25.8)
Ohio 20,102 9.1 150 1,186 (5.9)
Oklahoma 4,995 6.4 102 407 (8.1)
Oregon 8,688 10.5 208 795 (9.2)
Pennsylvania 31,018 13.0 231 2,222 (7.2)
Rhode Island 2,099 10.1 206 274 (13.1)
South Carolina 5,101 5.2 89 312 (6.1)
South Dakota 414 2.6 36 82 (19.8)
Tennessee 9,719 7.3 121 1,823 (18.8)
Texas 57,275 9.5 152 1,303 (2.3)
Utah 2,922 4.2 62 146 (5.0)
Vermont 1,195 10.4 223 265 (22.2)
Virginia 15,601 9.2 160 867 (5.6)
Washington 17,262 11.4 203 848 (4.9)
West Virginia 1,183 3.8 65 168 (14.2)
Wisconsin 6,511 6.0 103 139 (2.1)
Wyoming 31 0.3 5 5 (16.1)
Total 629,898 NA NA NA

Abbreviation: NA = not applicable.
* Number of abortions per 1,000 women aged 15–44 years.
Number of abortions per 1,000 live births.
§ Additional details on the reporting area in which abortions were provided, cross-tabulated by the state/area of residence, are available at https://www.cdc.gov/reproductivehealth/data_stats/Abortion.htm.
Data from 49 reporting areas; excludes three reporting areas (California, Maryland, and New Hampshire) that did not report or did not meet reporting standards.
** The total abortions include those with known and unknown residence status.
†† Reporting to the central health agency is not required. Data are requested from hospitals and licensed ambulatory care facilities only.

TABLE 3. Number of reported abortions, by known age group and reporting area of occurrence — selected reporting areas,* United States, 2019Return to your place in the text
State/Area Age group (yrs) Total abortions reported by known age
<15 15–19 20–24 25–29 30–34 35–39 ≥40
No. (%) No. (%) No. (%) No. (%) No. (%) No. (%) No. (%) No. (% of all reported abortions)§
Alabama 23 (0.4) 526 (8.8) 1,807 (30.1) 1,783 (29.7) 1,119 (18.6) 565 (9.4) 183 (3.0) 6,006 (100.0)
Alaska 123 (9.7) 351 (27.6) 363 (28.6) 246 (19.4) 137 (10.8) 1,270 (100.0)
Arizona 19 (0.1) 1,163 (8.9) 3,932 (30.0) 3,631 (27.7) 2,446 (18.7) 1,420 (10.8) 482 (3.7) 13,093 (100.0)
Arkansas 10 (0.3) 294 (9.9) 892 (30.1) 901 (30.4) 513 (17.3) 260 (8.8) 90 (3.0) 2,960 (99.9)
Colorado 27 (0.3) 812 (9.0) 2,596 (28.9) 2,557 (28.4) 1,735 (19.3) 948 (10.5) 319 (3.5) 8,994 (99.9)
Connecticut 20 (0.2) 788 (8.7) 2,382 (26.3) 2,600 (28.8) 1,885 (20.9) 1,042 (11.5) 323 (3.6) 9,040 (98.2)
Delaware 8 (0.4) 240 (11.8) 575 (28.2) 574 (28.1) 388 (19.0) 209 (10.2) 48 (2.4) 2,042 (100.0)
District of Columbia 10 (0.2) 386 (8.5) 1,262 (27.7) 1,388 (30.5) 870 (19.1) 483 (10.6) 152 (3.3) 4,551 (100.0)
Florida 118 (0.2) 5,231 (7.3) 18,889 (26.5) 20,741 (29.1) 15,051 (21.1) 8,425 (11.8) 2,907 (4.1) 71,362 (99.2)
Georgia 71 (0.2) 2,832 (7.7) 10,185 (27.6) 11,361 (30.8) 7,254 (19.7) 3,932 (10.7) 1,272 (3.4) 36,907 (100.0)
Hawaii 6 (0.3) 190 (9.5) 549 (27.4) 546 (27.3) 381 (19.0) 238 (11.9) 93 (4.6) 2,003 (100.0)
Idaho 187 (12.4) 477 (31.5) 378 (25.0) 252 (16.7) 161 (10.6) 1,512 (99.9)
Illinois** 75 (0.2) 3,492 (9.1) 10,960 (28.4) 11,819 (30.6) 7,166 (18.6) 3,813 (9.9) 1,255 (3.3) 38,580 (99.5)
Indiana 18 (0.2) 768 (10.1) 2,324 (30.4) 2,168 (28.4) 1,354 (17.7) 745 (9.8) 260 (3.4) 7,637 (100.0)
Iowa 12 (0.3) 357 (10.0) 957 (26.8) 1,000 (28.1) 679 (19.0) 401 (11.2) 159 (4.5) 3,565 (100.0)
Kansas 12 (0.2) 632 (9.2) 2,148 (31.2) 1,932 (28.0) 1,239 (18.0) 692 (10.0) 239 (3.5) 6,894 (100.0)
Kentucky 11 (0.3) 294 (8.0) 1,071 (29.2) 1,069 (29.2) 719 (19.6) 384 (10.5) 116 (3.2) 3,664 (100.0)
Louisiana 26 (0.3) 726 (8.9) 2,302 (28.3) 2,521 (31.0) 1,534 (18.8) 782 (9.6) 253 (3.1) 8,144 (100.0)
Maine 5 (0.2) 198 (9.8) 585 (29.0) 534 (26.4) 381 (18.9) 254 (12.6) 63 (3.1) 2,020 (100.0)
Massachusetts 28 (0.2) 1,306 (7.0) 4,613 (24.8) 5,313 (28.6) 4,028 (21.7) 2,390 (12.9) 910 (4.9) 18,588 (100.0)
Michigan 51 (0.2) 2,328 (8.6) 7,538 (27.7) 8,697 (32.0) 5,201 (19.1) 2,545 (9.4) 831 (3.1) 27,191 (99.5)
Minnesota 26 (0.3) 823 (8.3) 2,693 (27.1) 2,837 (28.6) 2,015 (20.3) 1,205 (12.1) 336 (3.4) 9,935 (99.9)
Mississippi 7 (0.2) 295 (9.2) 970 (30.4) 1,003 (31.4) 574 (18.0) 276 (8.6) 69 (2.2) 3,194 (100.0)
Missouri 5 (0.3) 141 (9.6) 422 (28.7) 436 (29.6) 253 (17.2) 156 (10.6) 58 (3.9) 1,471 (100.0)
Montana 5 (0.3) 157 (10.0) 458 (29.2) 454 (29.0) 269 (17.2) 161 (10.3) 64 (4.1) 1,568 (100.0)
Nebraska 7 (0.3) 187 (9.0) 625 (30.2) 534 (25.8) 400 (19.3) 234 (11.3) 81 (3.9) 2,068 (100.0)
Nevada 19 (0.2) 691 (8.6) 2,200 (27.2) 2,257 (27.9) 1,630 (20.2) 918 (11.4) 363 (4.5) 8,078 (96.0)
New Jersey†† 50 (0.2) 1,958 (8.8) 5,648 (25.5) 6,497 (29.3) 4,462 (20.1) 2,604 (11.7) 959 (4.3) 22,178 (100.0)
New Mexico 22 (0.6) 507 (13.8) 1,111 (30.3) 921 (25.1) 621 (16.9) 379 (10.3) 104 (2.8) 3,665 (93.0)
New York 186 (0.2) 6,919 (8.8) 20,238 (25.8) 22,267 (28.4) 16,014 (20.4) 9,438 (12.0) 3,386 (4.3) 78,448 (99.8)
      New York City 109 (0.2) 4,052 (8.1) 12,471 (25.1) 14,159 (28.4) 10,414 (20.9) 6,260 (12.6) 2,318 (4.7) 49,783 (100.0)
      New York State 77 (0.3) 2,867 (10.0) 7,767 (27.1) 8,108 (28.3) 5,600 (19.5) 3,178 (11.1) 1,068 (3.7) 28,665 (99.5)
North Carolina 60 (0.2) 2,252 (8.3) 7,768 (28.8) 8,270 (30.6) 5,095 (18.9) 2,687 (9.9) 880 (3.3) 27,012 (94.9)
North Dakota 0 (—) 121 (10.8) 349 (31.1) 326 (29.1) 189 (16.9) 107 (9.5) 29 (2.6) 1,121 (100.0)
Ohio 63 (0.3) 1,737 (8.6) 5,887 (29.3) 6,057 (30.1) 3,720 (18.5) 1,983 (9.9) 655 (3.3) 20,102 (100.0)
Oklahoma 89 (1.8) 440 (8.8) 1,517 (30.4) 1,384 (27.7) 901 (18.0) 491 (9.8) 172 (3.4) 4,994 (100.0)
Oregon 19 (0.2) 837 (9.6) 2,373 (27.3) 2,326 (26.8) 1,702 (19.6) 1,049 (12.1) 382 (4.4) 8,688 (100.0)
Pennsylvania 71 (0.2) 2,474 (8.0) 8,435 (27.2) 9,529 (30.7) 6,188 (19.9) 3,244 (10.5) 1,077 (3.5) 31,018 (100.0)
Rhode Island 185 (8.8) 611 (29.1) 584 (27.8) 411 (19.6) 222 (10.6) 2,098 (100.0)
South Carolina 10 (0.2) 499 (9.8) 1,403 (27.5) 1,500 (29.4) 961 (18.8) 544 (10.7) 184 (3.6) 5,101 (100.0)
South Dakota 129 (31.2) 117 (28.3) 61 (14.7) 45 (10.9) 414 (100.0)
Tennessee 17 (0.2) 830 (8.6) 2,884 (29.8) 2,982 (30.8) 1,791 (18.5) 913 (9.4) 275 (2.8) 9,692 (99.7)
Texas 106 (0.2) 5,041 (8.8) 16,647 (29.1) 16,327 (28.5) 10,907 (19.0) 6,152 (10.7) 2,095 (3.7) 57,275 (100.0)
Utah 6 (0.2) 371 (12.7) 915 (31.3) 761 (26.0) 470 (16.1) 305 (10.4) 94 (3.2) 2,922 (100.0)
Vermont 108 (9.1) 305 (25.6) 322 (27.0) 247 (20.7) 153 (12.8) 1,191 (99.7)
Virginia 25 (0.2) 1,108 (7.1) 4,162 (26.7) 4,626 (29.7) 3,186 (20.4) 1,869 (12.0) 605 (3.9) 15,581 (99.9)
Washington 32 (0.2) 1,647 (9.6) 4,598 (26.7) 4,723 (27.4) 3,367 (19.5) 2,095 (12.2) 765 (4.4) 17,227 (99.8)
West Virginia 8 (0.7) 115 (9.7) 377 (31.9) 320 (27.0) 194 (16.4) 136 (11.5) 33 (2.8) 1,183 (100.0)
Wisconsin 17 (0.3) 690 (10.6) 1,917 (29.4) 1,806 (27.7) 1,202 (18.5) 637 (9.8) 242 (3.7) 6,511 (100.0)
Wyoming 6 (19.4) 10 (32.3) 8 (25.8) 6 (19.4) 31 (100.0)
Total 1,410 (0.2) 53,049 (8.6) 171,043 (27.6) 181,052 (29.3) 121,279 (19.6) 67,835 (11.0) 23,121 (3.7) 618,789 (99.5)§§
Abortion rate¶¶ 0.4 6.0 19.0 18.6 13.0 7.4 2.7 NA
Abortion ratio*** 873 348 275 194 132 145 224 NA

Abbreviation: NA = not applicable.
* Data from 49 reporting areas; excludes three reporting areas (California, Maryland, and New Hampshire) that did not report, did not report by age, or did not meet reporting standards.
Percentages for the individual component categories might not add to 100% because of rounding.
§ Percentage is calculated as the number of abortions reported by known age divided by the sum of abortions reported by known and unknown age. Values ≥99.95% are rounded to 100.0%.
Cells with a value in the range of 1–4 or cells that would allow for calculation of these small values have been suppressed.
** Includes residents only.
†† Reporting to the central health agency is not required. Data are requested from hospitals and licensed ambulatory care facilities only.
§§ Percentage based on a total of 622,137 abortions reported among the areas that met reporting standards for age; reporting standards for age were applied to abortions for residents of Illinois only.
¶¶ Number of abortions obtained by women in a given age group per 1,000 women in that same age group. Adolescents aged 13–14 years were used as the denominator for the group of adolescents aged <15 years, and women aged 40–44 years were used as the denominator for the group of women aged ≥40 years. For the total abortion rate only, abortions for women of unknown age were distributed according to the distribution of abortions among women of known age.
*** Number of abortions obtained by women in a given age group per 1,000 live births to women in that same age group. For the total abortion ratio only, abortions for women of unknown age were distributed according to the distribution of abortions among women of known age.

TABLE 4. Percentage, rate,* and ratio of reported abortions, by known age group and year — selected reporting areas,§ United States, 2010–2019Return to your place in the text
Age group (yrs) Year % Change
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2010 to 2014 2015 to 2019 2018 to 2019 2010 to 2019
Reported abortions by known age (%)
<15 0.5 0.4 0.4 0.3 0.3 0.3 0.3 0.2 0.2 0.2 −40.0 −33.3 0.0 −60.0
15–19 14.6 13.5 12.2 11.4 10.4 9.8 9.4 9.1 8.8 8.7 −28.8 −11.2 −1.1 −40.4
20–24 32.9 32.9 32.8 32.7 32.1 31.1 30.0 29.3 28.5 27.8 −2.4 −10.6 −2.5 −15.5
25–29 24.5 24.9 25.4 25.9 26.8 27.6 28.5 29.0 29.4 29.3 9.4 6.2 −0.3 19.6
30–34 15.3 15.8 16.4 16.8 17.2 17.7 18.0 18.3 18.8 19.4 12.4 9.6 3.2 26.8
35–39 8.9 8.9 9.1 9.2 9.7 10.0 10.3 10.5 10.7 10.8 9.0 8.0 0.9 21.3
≥40 3.4 3.6 3.7 3.6 3.6 3.6 3.6 3.6 3.5 3.7 5.9 2.8 5.7 8.8
Abortion rate
<15 1.0 0.9 0.8 0.6 0.5 0.5 0.4 0.4 0.4 0.4 −50.0 −20.0 0.0 −60.0
15–19 11.7 10.5 9.2 8.2 7.3 6.7 6.2 5.9 5.8 5.8 −37.6 −13.4 0.0 −50.4
20–24 26.8 25.0 23.3 21.9 20.9 19.9 19.0 18.4 18.2 18.1 −22.0 −9.0 −0.5 −32.5
25–29 20.2 19.5 18.9 18.2 18.1 17.9 17.7 17.3 17.6 17.8 −10.4 −0.6 1.1 −11.9
30–34 13.2 12.7 12.4 11.8 11.7 11.7 11.6 11.5 11.9 12.3 −11.4 5.1 3.4 −6.8
35–39 7.6 7.5 7.3 7.0 7.1 7.0 6.9 6.7 6.8 7.0 −6.6 0.0 2.9 −7.9
≥40 2.8 2.8 2.8 2.5 2.5 2.5 2.5 2.5 2.5 2.6 −10.7 4.0 4.0 −7.1
Abortion ratio
<15 848 839 804 791 745 699 729 777 853 851 −12.1 21.7 −0.2 0.4
15–19 332 326 304 300 291 289 295 301 318 332 −12.3 14.9 4.4 0.0
20–24 291 284 272 262 256 250 249 249 256 260 −12.0 4.0 1.6 −10.7
25–29 184 178 174 169 167 167 169 171 178 183 −9.2 9.6 2.8 −0.5
30–34 138 132 128 122 116 115 113 114 119 124 −15.9 7.8 4.2 −10.1
35–39 171 165 158 148 145 140 136 134 135 137 −15.2 −2.1 1.5 −19.9
≥40 274 275 269 245 239 228 218 211 206 213 −12.8 −6.6 3.4 −22.3
Total (no.)¶,** 672,271 640,719 611,540 579,406 565,691 553,596 542,922 528,308 533,557 539,634 NA NA NA NA

Abbreviation: NA = not applicable.
* Number of abortions obtained by women in a given age group per 1,000 women in that same age group. Adolescents aged 13–14 years were used as the denominator for the group of adolescents aged <15 years, and women aged 40–44 years were used as the denominator for the group of women aged ≥40 years. Abortions for women of unknown age were distributed according to the distribution of abortions among women of known age.
Number of abortions obtained by women in a given age group per 1,000 live births to women in that same age group. Abortions for women of unknown age were distributed according to the distribution of abortions among women of known age.
§ Data from 44 reporting areas; excludes eight reporting areas (California, District of Columbia, Florida, Maine, Maryland, New Hampshire, Vermont, and Wyoming) that did not report, did not report by age, or did not meet reporting standards for ≥1 year.
By year, the total number of abortions represents 99.4%–99.7% of all abortions reported to CDC among the areas that met reporting standards for age during 2010–2019; reporting standards for age were applied to abortions for residents of Illinois only.
** The total number is different than previously reported because the totals by known age are presented and data for out-of-state residents were subsequently added for Wisconsin.

TABLE 5. Number of reported abortions among adolescents, by known age and reporting area of occurrence — selected reporting areas,* United States, 2019Return to your place in the text
State/Area Age group (yrs) Total no.
<15 15 16 17 18 19
No. (%) No. (%) No. (%) No. (%) No. (%) No. (%)
Alabama 23 (4.2) 23 (4.2) 43 (7.8) 65 (11.8) 171 (31.1) 224 (40.8) 549
Alaska § § § § § § §
Arizona 19 (1.6) 40 (3.4) 79 (6.7) 150 (12.7) 367 (31.0) 527 (44.6) 1,182
Arkansas 10 (3.3) 22 (7.2) 33 (10.9) 36 (11.8) 87 (28.6) 116 (38.2) 304
Colorado 27 (3.2) 39 (4.6) 62 (7.4) 130 (15.5) 259 (30.9) 322 (38.4) 839
Delaware 8 (3.2) 12 (4.8) 21 (8.5) 43 (17.3) 70 (28.2) 94 (37.9) 248
District of Columbia 10 (2.5) 19 (4.8) 35 (8.8) 74 (18.7) 99 (25.0) 159 (40.2) 396
Florida 118 (2.2) 199 (3.7) 402 (7.5) 689 (12.9) 1,585 (29.6) 2,356 (44.0) 5,349
Georgia 71 (2.4) 115 (4.0) 209 (7.2) 383 (13.2) 860 (29.6) 1,265 (43.6) 2,903
Hawaii 6 (3.1) 9 (4.6) 15 (7.7) 31 (15.8) 48 (24.5) 87 (44.4) 196
Idaho § § § § § § §
Indiana 18 (2.3) 35 (4.5) 67 (8.5) 103 (13.1) 234 (29.8) 329 (41.9) 786
Iowa 12 (3.3) 24 (6.5) 36 (9.8) 49 (13.3) 108 (29.3) 140 (37.9) 369
Kansas 12 (1.9) 28 (4.3) 46 (7.1) 75 (11.6) 216 (33.5) 267 (41.5) 644
Kentucky 11 (3.6) 16 (5.2) 24 (7.9) 33 (10.8) 82 (26.9) 139 (45.6) 305
Louisiana 26 (3.5) 54 (7.2) 74 (9.8) 134 (17.8) 200 (26.6) 264 (35.1) 752
Maine 5 (2.5) 14 (6.9) 16 (7.9) 33 (16.3) 54 (26.6) 81 (39.9) 203
Massachusetts 28 (2.1) 43 (3.2) 100 (7.5) 169 (12.7) 383 (28.7) 611 (45.8) 1,334
Michigan 51 (2.1) 134 (5.6) 191 (8.0) 318 (13.4) 658 (27.7) 1,027 (43.2) 2,379
Minnesota 26 (3.1) 43 (5.1) 68 (8.0) 122 (14.4) 255 (30.0) 335 (39.5) 849
Mississippi 7 (2.3) 26 (8.6) 24 (7.9) 44 (14.6) 90 (29.8) 111 (36.8) 302
Missouri 5 (3.4) 15 (10.3) 12 (8.2) 27 (18.5) 37 (25.3) 50 (34.2) 146
Montana 5 (3.1) 10 (6.2) 17 (10.5) 26 (16.0) 42 (25.9) 62 (38.3) 162
Nebraska 7 (3.6) 10 (5.2) 15 (7.7) 34 (17.5) 37 (19.1) 91 (46.9) 194
Nevada 19 (2.7) 37 (5.2) 62 (8.7) 101 (14.2) 219 (30.8) 272 (38.3) 710
New Jersey 50 (2.5) 84 (4.2) 206 (10.3) 344 (17.1) 539 (26.8) 785 (39.1) 2,008
New Mexico 22 (4.2) 34 (6.4) 65 (12.3) 93 (17.6) 120 (22.7) 195 (36.9) 529
New York 186 (2.6) 316 (4.4) 657 (9.2) 1,218 (17.1) 2,026 (28.5) 2,702 (38.0) 7,105
      New York City 109 (2.6) 192 (4.6) 406 (9.8) 735 (17.7) 1,170 (28.1) 1,549 (37.2) 4,161
      New York State 77 (2.6) 124 (4.2) 251 (8.5) 483 (16.4) 856 (29.1) 1,153 (39.2) 2,944
North Carolina 60 (2.6) 112 (4.8) 186 (8.0) 282 (12.2) 689 (29.8) 983 (42.5) 2,312
North Dakota 0 (—) 6 (5.0) 13 (10.7) 16 (13.2) 33 (27.3) 53 (43.8) 121
Ohio 63 (3.5) 89 (4.9) 147 (8.2) 239 (13.3) 516 (28.7) 746 (41.4) 1,800
Oklahoma 89 (16.8) 19 (3.6) 29 (5.5) 67 (12.7) 145 (27.4) 180 (34.0) 529
Oregon 19 (2.2) 35 (4.1) 76 (8.9) 136 (15.9) 218 (25.5) 372 (43.5) 856
Pennsylvania 71 (2.8) 116 (4.6) 224 (8.8) 346 (13.6) 736 (28.9) 1,052 (41.3) 2,545
Rhode Island § § § § § § §
South Carolina 10 (2.0) 16 (3.1) 42 (8.3) 115 (22.6) 138 (27.1) 188 (36.9) 509
South Dakota § § § § § § §
Tennessee 17 (2.0) 38 (4.5) 76 (9.0) 108 (12.8) 238 (28.1) 370 (43.7) 847
Texas 106 (2.1) 213 (4.1) 426 (8.3) 677 (13.2) 1,449 (28.2) 2,276 (44.2) 5,147
Utah 6 (1.6) 13 (3.4) 23 (6.1) 49 (13.0) 119 (31.6) 167 (44.3) 377
Vermont § § § § § § §
Virginia 25 (2.2) 57 (5.0) 82 (7.2) 138 (12.2) 325 (28.7) 506 (44.7) 1,133
Washington 32 (1.9) 74 (4.4) 145 (8.6) 277 (16.5) 477 (28.4) 674 (40.1) 1,679
West Virginia 8 (6.5) 5 (4.1) 7 (5.7) 19 (15.4) 35 (28.5) 49 (39.8) 123
Wisconsin** 17 (2.5) 27 (4.0) 73 (10.8) 77 (11.4) 195 (28.8) 289 (42.6) 678
Wyoming § § § § § § §
Total 1,315 (2.6) 2,248 (4.5) 4,175 (8.3) 7,148 (14.3) 14,378 (28.7) 20,791 (41.5) 50,055
Abortion rate†† 0.4 1.4 2.6 4.4 8.6 12.2 NA
Abortion ratio§§ 853 559 415 344 358 294 NA

Abbreviation: NA = not applicable.
* Data from 47 reporting areas; excludes five reporting areas (California, Connecticut, Illinois, Maryland, and New Hampshire) that did not report, did not report age among adolescents by individual year, or did not meet reporting standards.
Percentages for the individual component categories might not add to 100% because of rounding.
§ Cells with a value in the range of 1–4 or cells that would allow for calculation of these small values have been suppressed.
Reporting to the central health agency is not required. Data are requested from hospitals and licensed ambulatory care facilities only.
** Includes residents only.
†† Number of abortions obtained by women in a given age group per 1,000 women in that same age group. Adolescents aged 13–14 years were used as the denominator for the group of adolescents aged <15 years. For the total abortion rate only, abortions for women of unknown age were distributed according to the distribution of abortions among women of known age.
§§ Number of abortions obtained by women in a given age group per 1,000 live births to women in that same age group. For the total abortion ratio only, abortions for women of unknown age were distributed according to the distribution of abortions among women of known age.

TABLE 6. Number of reported abortions, by known race/ethnicity and reporting area of occurrence — selected reporting areas,* United States, 2019Return to your place in the text
State/Area Non-Hispanic Hispanic Total abortions reported by known race/ethnicity
White Black Other
No. (%) No. (%) No. (%) No. (%) No. (% of all reported abortions)§
Alabama 1,823 (30.4) 3,717 (61.9) 142 (2.4) 323 (5.4) 6,005 (99.9)
Alaska 584 (49.0) 85 (7.1) 470 (39.5) 52 (4.4) 1,191 (93.8)
Arizona 4,821 (38.4) 1,376 (10.9) 1,241 (9.9) 5,130 (40.8) 12,568 (96.0)
Arkansas 1,277 (44.0) 1,370 (47.2) 68 (2.3) 190 (6.5) 2,905 (98.0)
Connecticut 3,122 (37.4) 2,754 (33.0) 506 (6.1) 1,971 (23.6) 8,353 (90.8)
Delaware 863 (42.5) 850 (41.9) 72 (3.5) 244 (12.0) 2,029 (99.4)
District of Columbia 831 (18.8) 2,365 (53.4) 517 (11.7) 717 (16.2) 4,430 (97.3)
Florida 20,576 (30.9) 23,072 (34.6) 3,189 (4.8) 19,829 (29.7) 66,666 (92.7)
Georgia 7,102 (21.2) 21,709 (64.9) 1,724 (5.2) 2,924 (8.7) 33,459 (90.7)
Idaho 939 (67.5) 39 (2.8) 68 (4.9) 346 (24.9) 1,392 (92.0)
Indiana 3,919 (51.6) 2,404 (31.6) 583 (7.7) 691 (9.1) 7,597 (99.5)
Kansas 3,722 (54.0) 1,631 (23.7) 534 (7.8) 1,000 (14.5) 6,887 (99.9)
Kentucky 2,041 (55.7) 1,236 (33.7) 133 (3.6) 253 (6.9) 3,663 (100.0)
Michigan 10,578 (39.9) 13,687 (51.6) 1,201 (4.5) 1,041 (3.9) 26,507 (97.0)
Minnesota 4,310 (46.8) 2,569 (27.9) 1,392 (15.1) 937 (10.2) 9,208 (92.6)
Mississippi 619 (19.5) 2,352 (74.0) 114 (3.6) 95 (3.0) 3,180 (99.6)
Montana 1,293 (82.5) 142 (9.1) 1,568 (100.0)
Nevada 2,841 (37.0) 1,409 (18.4) 924 (12.0) 2,497 (32.6) 7,671 (91.2)
New Jersey** 5,133 (26.7) 7,453 (38.8) 3,206 (16.7) 3,427 (17.8) 19,219 (86.7)
New Mexico 930 (27.6) 160 (4.8) 380 (11.3) 1,897 (56.3) 3,367 (85.4)
North Carolina 8,096 (30.7) 12,968 (49.2) 1,990 (7.6) 3,298 (12.5) 26,352 (92.6)
South Carolina 2,481 (48.8) 1,986 (39.0) 232 (4.6) 390 (7.7) 5,089 (99.8)
South Dakota 259 (62.6) 46 (11.1) 69 (16.7) 40 (9.7) 414 (100.0)
Tennessee 3,688 (38.9) 4,842 (51.0) 363 (3.8) 595 (6.3) 9,488 (97.6)
Texas†† 15,066 (26.3) 15,921 (27.8) 3,989 (7.0) 22,217 (38.8) 57,193 (99.9)
Utah 1,721 (60.4) 133 (4.7) 214 (7.5) 779 (27.4) 2,847 (97.4)
Vermont 1,045 (89.7) 47 (4.0) 41 (3.5) 32 (2.7) 1,165 (97.5)
Virginia 4,802 (33.6) 6,515 (45.5) 1,512 (10.6) 1,476 (10.3) 14,305 (91.7)
West Virginia 987 (83.4) 153 (12.9) 1,183 (100.0)
Wyoming 17 (60.7) 8 (28.6) 28 (90.3)
Total 115,486 (33.4) 132,878 (38.4) 25,056 (7.2) 72,509 (21.0) 345,929 (94.5)§§
Abortion rate¶¶ 6.6 23.8 13.0 11.7 NA
Abortion ratio*** 117 386 236 170 NA

Abbreviation: NA = not applicable.
* Data from 30 reporting areas; excludes 22 reporting areas (California, Colorado, Hawaii, Illinois, Iowa, Louisiana, Maine, Maryland, Massachusetts, Missouri, Nebraska, New Hampshire, New York City, New York State, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Washington, and Wisconsin) that did not report, did not report by race/ethnicity, or did not meet reporting standards.
Percentages for the individual component categories might not add to 100% because of rounding.
§ Percentage is calculated as the number of abortions reported by known race/ethnicity divided by the sum of abortions reported by known and unknown race/ethnicity. Values ≥99.95% are rounded to 100.0%.
Cells with a value in the range of 1–4 or cells that would allow for calculation of these small values have been suppressed.
** Reporting to the central health agency is not required. Data are requested from hospitals and licensed ambulatory care facilities only.
†† Reporting form contains only one question for race/ethnicity; therefore, abortions reported for women of White, Black, and other races (Asian and Native American) are not explicitly identified as non-Hispanic.
§§ Percentage based on a total of 366,130 abortions reported among the areas that met reporting standards for race/ethnicity.
¶¶ Number of abortions obtained by women in a given racial/ethnic group per 1,000 women in that same racial/ethnic group. For the total abortion rate only, abortions for women of unknown race/ethnicity were distributed according to the distribution of abortions among women of known race/ethnicity.
*** Number of abortions obtained by women in a given racial/ethnic group per 1,000 live births to women in that same racial/ethnic group. For the total abortion ratio only, abortions for women of unknown race/ethnicity were distributed according to the distribution of abortions among women of known race/ethnicity.

TABLE 7. Number of reported abortions, by known marital status and reporting area of occurrence — selected reporting areas,* United States, 2019Return to your place in the text
State/Area Marital status Total abortions reported by known marital status
Married Unmarried
No. (%) No. (%) No. (% of all reported abortions)§
Alabama 663 (11.0) 5,342 (89.0) 6,005 (99.9)
Alaska 253 (21.1) 945 (78.9) 1,198 (94.3)
Arizona 1,878 (14.3) 11,219 (85.7) 13,097 (100.0)
Arkansas 376 (12.7) 2,575 (87.3) 2,951 (99.6)
Colorado 1,559 (19.1) 6,596 (80.9) 8,155 (90.6)
Connecticut 939 (11.5) 7,232 (88.5) 8,171 (88.8)
Delaware 224 (11.0) 1,818 (89.0) 2,042 (100.0)
Florida 10,136 (16.1) 52,629 (83.9) 62,765 (87.3)
Georgia 4,410 (12.8) 30,033 (87.2) 34,443 (93.3)
Idaho 302 (21.6) 1,094 (78.4) 1,396 (92.3)
Illinois 3,575 (9.5) 33,868 (90.5) 37,443 (96.6)
Indiana 1,094 (14.3) 6,543 (85.7) 7,637 (100.0)
Iowa 633 (17.8) 2,925 (82.2) 3,558 (99.8)
Kansas 1,063 (15.5) 5,811 (84.5) 6,874 (99.7)
Kentucky 525 (14.3) 3,139 (85.7) 3,664 (100.0)
Louisiana 828 (10.5) 7,063 (89.5) 7,891 (96.9)
Maine 308 (16.0) 1,612 (84.0) 1,920 (95.0)
Michigan 2,660 (10.3) 23,095 (89.7) 25,755 (94.2)
Minnesota 1,535 (16.2) 7,959 (83.8) 9,494 (95.5)
Mississippi 290 (9.1) 2,893 (90.9) 3,183 (99.7)
Missouri 224 (16.0) 1,179 (84.0) 1,403 (95.4)
Montana 286 (18.2) 1,282 (81.8) 1,568 (100.0)
Nebraska 306 (15.0) 1,732 (85.0) 2,038 (98.5)
New Jersey** 2,515 (11.5) 19,372 (88.5) 21,887 (98.7)
New Mexico 563 (15.3) 3,128 (84.7) 3,691 (93.6)
New York City 8,269 (18.5) 36,518 (81.5) 44,787 (90.0)
North Carolina 3,622 (14.4) 21,547 (85.6) 25,169 (88.5)
North Dakota 162 (14.5) 958 (85.5) 1,120 (99.9)
Ohio 2,603 (14.0) 16,027 (86.0) 18,630 (92.7)
Oklahoma 941 (18.9) 4,043 (81.1) 4,984 (99.8)
Oregon 1,573 (20.3) 6,193 (79.7) 7,766 (89.4)
Pennsylvania 3,766 (12.2) 27,221 (87.8) 30,987 (99.9)
Rhode Island 263 (12.9) 1,782 (87.1) 2,045 (97.4)
South Carolina 726 (14.4) 4,331 (85.6) 5,057 (99.1)
South Dakota 85 (20.5) 329 (79.5) 414 (100.0)
Tennessee 1,295 (14.0) 7,985 (86.0) 9,280 (95.5)
Texas 9,784 (17.1) 47,363 (82.9) 57,147 (99.8)
Utah 724 (24.9) 2,182 (75.1) 2,906 (99.5)
Vermont 216 (20.3) 847 (79.7) 1,063 (89.0)
Virginia†† 2,349 (15.1) 13,252 (84.9) 15,601 (100.0)
West Virginia 203 (17.2) 979 (82.8) 1,182 (99.9)
Wisconsin 852 (13.2) 5,615 (86.8) 6,467 (99.3)
Total 74,578 (14.5) 438,256 (85.5) 512,834 (94.5)§§
Abortion ratio¶¶ 46 394 NA

Abbreviation: NA = not applicable.
* Data from 42 reporting areas; excludes 10 reporting areas (California, District of Columbia, Hawaii, Maryland, Massachusetts, Nevada, New Hampshire, New York State, Washington, and Wyoming) that did not report, did not report by marital status, or did not meet reporting standards.
Percentages for the individual component categories might not add to 100% because of rounding.
§ Percentage is calculated as the number of abortions reported by known marital status divided by the sum of abortions reported by known and unknown marital status. Values ≥99.95% are rounded to 100.0%.
Includes residents only.
** Reporting to the central health agency is not required. Data are requested from hospitals and licensed ambulatory care facilities only.
†† Recorded as patient married or not married to father.
§§ Percentage based on a total of 542,479 abortions reported among the areas that met reporting standards for marital status; reporting standards for marital status were applied to abortions for residents of Illinois only.
¶¶ Number of abortions obtained by marital status per 1,000 live births to women of the same marital status. For the total abortion ratio only, abortions for women of unknown marital status were distributed according to the distribution of abortions among women of known marital status.

TABLE 8. Number of reported abortions, by known number of previous live births and reporting area of occurrence — selected reporting areas,* United States, 2019Return to your place in the text
State/Area No. of previous live births Total abortions reported by known number of previous live births
0 1 2 3 ≥4
No. (%) No. (%) No. (%) No. (%) No. (%) No. (% of all reported abortions)§
Alabama 2,030 (33.8) 1,660 (27.6) 1,369 (22.8) 602 (10.0) 348 (5.8) 6,009 (100.0)
Alaska 575 (45.3) 233 (18.4) 258 (20.3) 103 (8.1) 100 (7.9) 1,269 (99.9)
Arizona 5,707 (44.0) 2,784 (21.5) 2,426 (18.7) 1,195 (9.2) 846 (6.5) 12,958 (98.9)
Arkansas 1,042 (35.2) 771 (26.0) 650 (21.9) 295 (10.0) 205 (6.9) 2,963 (100.0)
Colorado 5,167 (57.7) 1,644 (18.3) 1,268 (14.1) 573 (6.4) 310 (3.5) 8,962 (99.6)
Connecticut 3,731 (40.6) 2,319 (25.2) 1,833 (20.0) 839 (9.1) 465 (5.1) 9,187 (99.8)
Delaware 849 (42.1) 501 (24.8) 390 (19.3) 159 (7.9) 118 (5.9) 2,017 (98.8)
Florida 27,510 (38.3) 18,129 (25.2) 14,878 (20.7) 6,660 (9.3) 4,737 (6.6) 71,914 (100.0)
Georgia 14,313 (38.8) 9,116 (24.7) 7,405 (20.1) 3,646 (9.9) 2,425 (6.6) 36,905 (100.0)
Hawaii 1,096 (54.8) 338 (16.9) 313 (15.7) 160 (8.0) 92 (4.6) 1,999 (99.8)
Idaho 694 (46.3) 316 (21.1) 277 (18.5) 130 (8.7) 83 (5.5) 1,500 (99.1)
Indiana 3,045 (39.9) 1,831 (24.0) 1,558 (20.4) 780 (10.2) 423 (5.5) 7,637 (100.0)
Iowa 1,430 (40.4) 781 (22.1) 705 (19.9) 356 (10.1) 268 (7.6) 3,540 (99.3)
Kansas 2,795 (40.5) 1,686 (24.5) 1,327 (19.2) 681 (9.9) 405 (5.9) 6,894 (100.0)
Kentucky 1,300 (35.5) 934 (25.5) 871 (23.8) 338 (9.2) 221 (6.0) 3,664 (100.0)
Louisiana 2,627 (32.3) 2,231 (27.5) 1,807 (22.2) 894 (11.0) 564 (6.9) 8,123 (99.7)
Maine 1,002 (49.7) 431 (21.4) 362 (18.0) 148 (7.3) 73 (3.6) 2,016 (99.8)
Massachusetts 7,765 (46.2) 3,910 (23.3) 3,147 (18.7) 1,324 (7.9) 645 (3.8) 16,791 (90.3)
Michigan 9,472 (34.7) 7,075 (25.9) 6,209 (22.7) 2,827 (10.3) 1,748 (6.4) 27,331 (100.0)
Minnesota 3,954 (40.1) 2,265 (23.0) 1,944 (19.7) 964 (9.8) 730 (7.4) 9,857 (99.2)
Mississippi 996 (31.2) 924 (28.9) 714 (22.4) 342 (10.7) 218 (6.8) 3,194 (100.0)
Missouri 561 (38.1) 353 (24.0) 301 (20.5) 146 (9.9) 110 (7.5) 1,471 (100.0)
Montana 746 (47.6) 357 (22.8) 260 (16.6) 129 (8.2) 76 (4.8) 1,568 (100.0)
Nebraska 819 (39.6) 445 (21.5) 429 (20.8) 216 (10.4) 158 (7.6) 2,067 (100.0)
Nevada 3,606 (42.9) 1,954 (23.2) 1,496 (17.8) 790 (9.4) 567 (6.7) 8,413 (100.0)
New Jersey** 8,148 (36.9) 6,140 (27.8) 4,303 (19.5) 2,105 (9.5) 1,411 (6.4) 22,107 (99.7)
New Mexico 1,502 (42.6) 801 (22.7) 621 (17.6) 357 (10.1) 248 (7.0) 3,529 (89.5)
New York City 20,793 (45.8) 11,596 (25.5) 8,380 (18.4) 2,987 (6.6) 1,680 (3.7) 45,436 (91.3)
North Carolina 9,498 (37.4) 6,067 (23.9) 5,016 (19.8) 2,660 (10.5) 2,154 (8.5) 25,395 (89.3)
North Dakota 452 (40.3) 243 (21.7) 223 (19.9) 118 (10.5) 85 (7.6) 1,121 (100.0)
Ohio†† 7,074 (36.1) 4,963 (25.3) 4,176 (21.3) 2,049 (10.4) 1,360 (6.9) 19,622 (97.6)
Oklahoma 1,890 (37.9) 1,208 (24.2) 1,055 (21.1) 507 (10.2) 332 (6.7) 4,992 (99.9)
Oregon 4,366 (50.6) 1,759 (20.4) 1,501 (17.4) 590 (6.8) 407 (4.7) 8,623 (99.3)
Pennsylvania 11,760 (37.9) 7,926 (25.6) 6,367 (20.5) 3,046 (9.8) 1,919 (6.2) 31,018 (100.0)
Rhode Island 963 (45.9) 506 (24.1) 393 (18.7) 144 (6.9) 92 (4.4) 2,098 (100.0)
South Carolina 2,129 (41.7) 1,294 (25.4) 1,027 (20.1) 409 (8.0) 242 (4.7) 5,101 (100.0)
South Dakota 165 (39.9) 72 (17.4) 94 (22.7) §§ §§ 414 (100.0)
Tennessee 3,484 (36.3) 2,498 (26.0) 1,974 (20.6) 940 (9.8) 695 (7.2) 9,591 (98.7)
Texas 22,862 (39.9) 13,628 (23.8) 11,985 (20.9) 5,483 (9.6) 3,317 (5.8) 57,275 (100.0)
Utah 1,496 (51.2) 555 (19.0) 470 (16.1) 230 (7.9) 171 (5.9) 2,922 (100.0)
Vermont 597 (50.0) 235 (19.7) 231 (19.3) 88 (7.4) 43 (3.6) 1,194 (99.9)
Virginia 5,531 (35.5) 4,095 (26.2) 3,326 (21.3) 1,646 (10.6) 1,003 (6.4) 15,601 (100.0)
Washington 8,035 (46.7) 3,845 (22.3) 3,163 (18.4) 1,370 (8.0) 805 (4.7) 17,218 (99.7)
West Virginia 421 (35.6) 347 (29.4) 255 (21.6) 97 (8.2) 62 (5.2) 1,182 (99.9)
Wyoming 17 (54.8) 5 (16.1) 7 (22.6) §§ §§ 31 (100.0)
Total 214,015 (40.2) 130,771 (24.5) 106,764 (20.0) 49,178 (9.2) 31,991 (6.0) 532,719 (98.0)¶¶

* Data from 45 reporting areas; excludes seven reporting areas (California, District of Columbia, Illinois, Maryland, New Hampshire, New York State, and Wisconsin) that did not report, did not report by number of previous live births, or did not meet reporting standards.
Percentages for the individual component categories might not add to 100% because of rounding.
§ Percentage is calculated as the number of abortions reported by known number of previous live births divided by the sum of abortions reported by known and unknown number of previous live births. Values ≥99.95% are rounded to 100.0%.
Recorded as the number of previous pregnancies carried to term.
** Reporting to the central health agency is not required. Data are requested from hospitals and licensed ambulatory care facilities only.
†† Recorded as the number of living children.
§§ Cells with a value in the range of 1–4 or cells that would allow for calculation of these small values have been suppressed.
¶¶ Percentage based on a total of 543,515 abortions reported among the areas that met reporting standards for the number of previous live births.

TABLE 9. Number of reported abortions, by known number of previous induced abortions and reporting area of occurrence — selected reporting areas,* United States, 2019Return to your place in the text
State/Area No. of previous induced abortions Total abortions reported by known number of previous induced abortions
0 1 2 ≥3
No. (%) No. (%) No. (%) No. (%) No. (% of all reported abortions)§
Alabama 4,008 (66.7) 1,332 (22.2) 443 (7.4) 226 (3.8) 6,009 (100.0)
Alaska 819 (64.5) 271 (21.4) 109 (8.6) 70 (5.5) 1,269 (99.9)
Arizona 8,472 (65.6) 3,047 (23.6) 955 (7.4) 445 (3.4) 12,919 (98.6)
Arkansas 1,915 (64.6) 587 (19.8) 233 (7.9) 228 (7.7) 2,963 (100.0)
Colorado 6,287 (69.9) 1,852 (20.6) 601 (6.7) 251 (2.8) 8,991 (99.9)
Connecticut 4,883 (53.2) 2,163 (23.5) 1,123 (12.2) 1,018 (11.1) 9,187 (99.8)
Delaware 1,244 (61.5) 472 (23.3) 197 (9.7) 109 (5.4) 2,022 (99.0)
Florida 41,693 (58.0) 17,171 (23.9) 7,405 (10.3) 5,645 (7.8) 71,914 (100.0)
Georgia 22,534 (61.1) 8,778 (23.8) 3,605 (9.8) 1,990 (5.4) 36,907 (100.0)
Hawaii 1,244 (62.2) 452 (22.6) 178 (8.9) 125 (6.3) 1,999 (99.8)
Idaho 1,228 (81.8) 209 (13.9) 44 (2.9) 21 (1.4) 1,502 (99.3)
Indiana 5,160 (67.6) 1,712 (22.4) 539 (7.1) 226 (3.0) 7,637 (100.0)
Iowa 2,675 (75.6) 565 (16.0) 186 (5.3) 114 (3.2) 3,540 (99.3)
Kansas 4,647 (67.4) 1,467 (21.3) 499 (7.2) 281 (4.1) 6,894 (100.0)
Kentucky 2,324 (63.4) 866 (23.6) 293 (8.0) 181 (4.9) 3,664 (100.0)
Louisiana 5,098 (62.7) 2,006 (24.7) 732 (9.0) 291 (3.6) 8,127 (99.8)
Maine 1,314 (65.1) 455 (22.6) 153 (7.6) 95 (4.7) 2,017 (99.8)
Massachusetts 9,507 (52.6) 4,868 (26.9) 2,240 (12.4) 1,466 (8.1) 18,081 (97.2)
Michigan 14,134 (51.7) 6,797 (24.9) 3,684 (13.5) 2,712 (9.9) 27,327 (100.0)
Minnesota 6,030 (61.1) 2,197 (22.3) 937 (9.5) 708 (7.2) 9,872 (99.3)
Mississippi 2,159 (67.6) 685 (21.4) 249 (7.8) 101 (3.2) 3,194 (100.0)
Missouri 882 (60.0) 367 (24.9) 141 (9.6) 81 (5.5) 1,471 (100.0)
Montana 643 (41.0) 622 (39.7) 199 (12.7) 104 (6.6) 1,568 (100.0)
Nebraska 1,429 (69.1) 430 (20.8) 142 (6.9) 67 (3.2) 2,068 (100.0)
Nevada 5,281 (62.8) 1,874 (22.3) 744 (8.8) 512 (6.1) 8,411 (100.0)
New Jersey 13,486 (60.9) 4,195 (18.9) 2,251 (10.2) 2,223 (10.0) 22,155 (99.9)
New York City 16,911 (37.9) 11,024 (24.7) 8,392 (18.8) 8,244 (18.5) 44,571 (89.5)
North Carolina 15,400 (61.4) 5,874 (23.4) 2,474 (9.9) 1,329 (5.3) 25,077 (88.1)
North Dakota 778 (70.7) 200 (18.2) 92 (8.4) 31 (2.8) 1,101 (98.2)
Ohio 11,689 (59.7) 4,727 (24.2) 1,915 (9.8) 1,242 (6.3) 19,573 (97.4)
Oklahoma 3,558 (71.3) 975 (19.5) 304 (6.1) 155 (3.1) 4,992 (99.9)
Oregon 5,182 (60.1) 2,064 (23.9) 809 (9.4) 574 (6.7) 8,629 (99.3)
Pennsylvania 16,327 (52.6) 7,699 (24.8) 3,829 (12.3) 3,163 (10.2) 31,018 (100.0)
Rhode Island 1,286 (61.4) 480 (22.9) 218 (10.4) 110 (5.3) 2,094 (99.8)
South Carolina 3,320 (65.1) 1,160 (22.7) 414 (8.1) 207 (4.1) 5,101 (100.0)
South Dakota 285 (68.8) 88 (21.3) —** —** 414 (100.0)
Tennessee 6,230 (64.7) 2,326 (24.2) 724 (7.5) 348 (3.6) 9,628 (99.1)
Texas 35,902 (62.7) 14,039 (24.5) 4,874 (8.5) 2,460 (4.3) 57,275 (100.0)
Utah 2,251 (77.0) 506 (17.3) 114 (3.9) 51 (1.7) 2,922 (100.0)
Vermont 746 (62.5) 266 (22.3) 111 (9.3) 70 (5.9) 1,193 (99.8)
Virginia 8,520 (54.6) 4,322 (27.7) 1,670 (10.7) 1,089 (7.0) 15,601 (100.0)
Washington 9,911 (57.6) 4,219 (24.5) 1,713 (10.0) 1,363 (7.9) 17,206 (99.7)
West Virginia 728 (61.5) 298 (25.2) 106 (9.0) 51 (4.3) 1,183 (100.0)
Wyoming 20 (64.5) 9 (29.0) —** —** 31 (100.0)
Total 308,140 (58.2) 125,716 (23.8) 55,669 (10.5) 39,792 (7.5) 529,317 (98.1)††

* Data from 44 reporting areas; excludes eight reporting areas (California, District of Columbia, Illinois, Maryland, New Hampshire, New Mexico, New York State, and Wisconsin) that did not report, did not report by number of previous induced abortions, or did not meet reporting standards.
Percentages for the individual component categories might not add to 100% because of rounding.
§ Percentage is calculated as the number of abortions reported by known number of previous induced abortions divided by the sum of abortions reported by known and unknown number of previous induced abortions. Values ≥99.95% are rounded to 100.0%.
Reporting to the central health agency is not required. Data are requested from hospitals and licensed ambulatory care facilities only.
** Cells with a value in the range of 1–4 or cells that would allow for calculation of these small values have been suppressed.
†† Percentage based on a total of 539,573 abortions reported among the areas that met reporting standards for the number of previous induced abortions.

TABLE 10. Number of reported abortions, by known weeks of gestation* and reporting area of occurrence — selected reporting areas, United States, 2019Return to your place in the text
State/Area Weeks of gestation Total abortions reported by known gestational age
≤6 7–9 10–13 14–15 16–17 18–20 ≥21
No. (%)§ No. (%) No. (%) No. (%) No. (%) No. (%) No. (%) No. (% of all reported abortions)
Alabama** 1,280 (21.3) 2,807 (46.8) 1,257 (20.9) 317 (5.3) 163 (2.7) 133 (2.2) 46 (0.8) 6,003 (99.9)
Alaska 292 (23.0) 639 (50.4) 271 (21.4) 64 (5.0) †† †† 0 (—) 1,269 (99.9)
Arizona 3,863 (29.5) 5,985 (45.7) 2,079 (15.9) 496 (3.8) 261 (2.0) 245 (1.9) 168 (1.3) 13,097 (100.0)
Arkansas** 479 (16.2) 1,265 (42.7) 862 (29.1) 150 (5.1) 82 (2.8) 97 (3.3) 28 (0.9) 2,963 (100.0)
Colorado 3,639 (40.4) 3,666 (40.7) 1,062 (11.8) 198 (2.2) 150 (1.7) 110 (1.2) 173 (1.9) 8,998 (100.0)
Connecticut 4,046 (45.7) 3,155 (35.7) 947 (10.7) 263 (3.0) 175 (2.0) 164 (1.9) 95 (1.1) 8,845 (96.1)
Delaware 536 (26.3) 1,071 (52.5) 328 (16.1) 73 (3.6) 16 (0.8) 6 (0.3) 9 (0.4) 2,039 (99.9)
Florida 52,850 (73.5) 11,641 (16.2) 4,843 (6.7) 973 (1.4) 691 (1.0) 699 (1.0) 217 (0.3) 71,914 (100.0)
Georgia 16,086 (43.6) 13,864 (37.6) 4,396 (11.9) 927 (2.5) 653 (1.8) 752 (2.0) 229 (0.6) 36,907 (100.0)
Hawaii 678 (33.9) 861 (43.0) 268 (13.4) 80 (4.0) 43 (2.1) 49 (2.4) 22 (1.1) 2,001 (99.9)
Idaho 493 (32.9) 707 (47.1) 257 (17.1) 37 (2.5) †† †† †† 1,500 (99.1)
Indiana 1,924 (25.2) 4,055 (53.1) 1,618 (21.2) 9 (0.1) 8 (0.1) 17 (0.2) 6 (0.1) 7,637 (100.0)
Iowa 1,652 (46.3) 1,305 (36.6) 412 (11.6) 68 (1.9) 58 (1.6) 54 (1.5) 17 (0.5) 3,566 (100.0)
Kansas 2,761 (40.0) 2,722 (39.5) 921 (13.4) 195 (2.8) 121 (1.8) 137 (2.0) 37 (0.5) 6,894 (100.0)
Kentucky 1,302 (35.5) 1,493 (40.7) 550 (15.0) 116 (3.2) 65 (1.8) 109 (3.0) 29 (0.8) 3,664 (100.0)
Louisiana 2,815 (34.6) 3,567 (43.8) 1,274 (15.7) 273 (3.4) 173 (2.1) 38 (0.5) 0 (—) 8,140 (100.0)
Maine 595 (29.5) 996 (49.3) 317 (15.7) 48 (2.4) 33 (1.6) 31 (1.5) 0 (—) 2,020 (100.0)
Michigan 9,016 (33.0) 11,496 (42.1) 4,055 (14.9) 1,110 (4.1) 667 (2.4) 584 (2.1) 353 (1.3) 27,281 (99.8)
Minnesota 3,597 (36.7) 3,845 (39.2) 1,381 (14.1) 379 (3.9) 194 (2.0) 216 (2.2) 187 (1.9) 9,799 (98.6)
Mississippi 1,117 (35.0) 1,421 (44.5) 468 (14.7) 171 (5.4) 16 (0.5) †† †† 3,194 (100.0)
Missouri 86 (5.8) 496 (33.7) 505 (34.3) 130 (8.8) 87 (5.9) 112 (7.6) 55 (3.7) 1,471 (100.0)
Montana 599 (38.2) 628 (40.1) 211 (13.5) 51 (3.3) 34 (2.2) 34 (2.2) 11 (0.7) 1,568 (100.0)
Nebraska 976 (47.2) 683 (33.0) 284 (13.7) 62 (3.0) 46 (2.2) 16 (0.8) 0 (—) 2,067 (100.0)
Nevada 3,214 (38.6) 3,510 (42.1) 1,078 (12.9) 250 (3.0) 142 (1.7) 89 (1.1) 52 (0.6) 8,335 (99.1)
New Jersey§§ 8,513 (39.3) 7,499 (34.6) 2,923 (13.5) 961 (4.4) 638 (2.9) 613 (2.8) 514 (2.4) 21,661 (97.7)
New Mexico 1,487 (42.7) 957 (27.5) 381 (10.9) 80 (2.3) 73 (2.1) 101 (2.9) 406 (11.6) 3,485 (88.4)
New York City 22,364 (44.9) 17,579 (35.3) 5,579 (11.2) 1,335 (2.7) 897 (1.8) 934 (1.9) 1,096 (2.2) 49,784 (100.0)
North Carolina 9,598 (33.9) 12,098 (42.8) 4,432 (15.7) 982 (3.5) 672 (2.4) 484 (1.7) 15 (0.1) 28,281 (99.4)
North Dakota 435 (38.8) 447 (39.9) 180 (16.1) 42 (3.7) 17 (1.5) 0 (—) 0 (—) 1,121 (100.0)
Ohio 5,523 (27.5) 9,070 (45.1) 3,558 (17.7) 848 (4.2) 531 (2.6) 477 (2.4) 95 (0.5) 20,102 (100.0)
Oklahoma 2,177 (43.6) 1,835 (36.8) 710 (14.2) 125 (2.5) 64 (1.3) 64 (1.3) 16 (0.3) 4,991 (99.9)
Oregon 4,064 (47.2) 2,924 (33.9) 949 (11.0) 241 (2.8) 129 (1.5) 149 (1.7) 160 (1.9) 8,616 (99.2)
Rhode Island 929 (44.4) 705 (33.7) 270 (12.9) 90 (4.3) 52 (2.5) 32 (1.5) 13 (0.6) 2,091 (99.6)
South Carolina** 1,063 (20.8) 1,970 (38.6) 1,740 (34.1) 298 (5.8) 8 (0.2) 13 (0.3) 9 (0.2) 5,101 (100.0)
South Dakota 64 (15.6) 224 (54.8) †† †† 0 (—) †† 7 (1.7) 409 (98.8)
Tennessee 1,836 (18.9) 4,939 (50.9) 2,188 (22.5) 436 (4.5) 176 (1.8) 119 (1.2) 9 (0.1) 9,703 (99.8)
Texas** 22,356 (39.0) 22,721 (39.7) 8,232 (14.4) 1,870 (3.3) 957 (1.7) 838 (1.5) 301 (0.5) 57,275 (100.0)
Utah 1,018 (34.8) 1,185 (40.6) 478 (16.4) 92 (3.1) 51 (1.7) 67 (2.3) 31 (1.1) 2,922 (100.0)
Vermont 550 (46.0) 423 (35.4) 129 (10.8) 32 (2.7) 21 (1.8) 22 (1.8) 18 (1.5) 1,195 (100.0)
Virginia 7,917 (50.8) 5,215 (33.5) 1,938 (12.4) 121 (0.8) 131 (0.8) 170 (1.1) 90 (0.6) 15,582 (99.9)
Washington 7,046 (41.0) 6,768 (39.4) 2,061 (12.0) 420 (2.4) 265 (1.5) 273 (1.6) 363 (2.1) 17,196 (99.6)
West Virginia 325 (27.5) 536 (45.3) 235 (19.9) 58 (4.9) 18 (1.5) †† †† 1,183 (100.0)
Wyoming 18 (58.1) 12 (38.7) †† †† 0 (—) 0 (—) 0 (—) 31 (100.0)
Total 211,179 (42.9) 178,985 (36.4) 65,739 (13.4) 14,471 (2.9) 8,581 (1.7) 8,064 (1.6) 4,882 (1.0) 491,901 (99.6)¶¶

* Gestational age based on clinician’s estimate (Alaska, Arizona, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Jersey, New Mexico, New York City, North Carolina, North Dakota, Ohio, Oregon, Rhode Island, South Dakota, Tennessee, Vermont, Washington, West Virginia, and Wyoming); gestational age calculated from the last normal menstrual period (Oklahoma and Utah); clinician’s estimate of gestation based on estimated date of conception (Virginia); probable postfertilization age (Alabama, Arkansas, South Carolina, and Texas).
Data from 43 reporting areas; excludes nine reporting areas (California, District of Columbia, Illinois, Maryland, Massachusetts, New Hampshire, New York State, Pennsylvania, and Wisconsin) that did not report, did not report by gestational age, or did not meet reporting standards.
§ Percentages for the individual component categories might not add to 100% because of rounding.
Percentage is calculated as the number of abortions reported by known gestational age divided by the sum of abortions reported by known and unknown gestational age. Values ≥99.95% are rounded to 100.0%.
** Two weeks were added to the probable postfertilization age to provide a corresponding measure to gestational age based on the clinician’s estimate.
†† Cells with a value in the range of 1–4 or cells that would allow for calculation of these small values have been suppressed.
§§ Reporting to the central health agency is not required. Data are requested from hospitals and licensed ambulatory care facilities only.
¶¶ Percentage based on a total of 493,904 abortions reported among the areas that met reporting standards for gestational age.

TABLE 11. Percentage of reported abortions, by known weeks of gestation and year — selected reporting areas,* United States, 2010–2019Return to your place in the text
Weeks of gestation Year % Change
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2010 to 2014 2015 to 2019 2018 to 2019 2010 to 2019
≤13 weeks’ gestation (%) 91.9 91.5 91.4 91.6 91.0 91.0 91.0 91.1 91.5 92.0 −1.0 1.1 0.5 0.1
≤6 34.7 34.3 35.1 34.7 33.8 34.3 34.2 35.1 36.2 37.5 −2.6 9.3 3.6 8.1
7–9 40.1 40.1 39.4 39.9 40.0 40.0 40.3 40.4 40.0 39.9 −0.2 −0.3 −0.3 −0.5
10–13 17.0 17.1 16.9 17.0 17.2 16.7 16.4 15.7 15.2 14.6 1.2 −12.6 −3.9 −14.1
>13 weeks’ gestation (%) 8.1 8.5 8.6 8.4 9.0 9.0 9.0 8.9 8.5 8.0 11.1 −11.1 −5.9 −1.2
14–15 3.3 3.4 3.5 3.4 3.5 3.5 3.6 3.4 3.4 3.2 6.1 −8.6 −5.9 −3.0
16–17 1.8 1.9 1.9 1.9 2.2 2.1 2.1 2.2 2.1 1.9 22.2 −9.5 −9.5 5.6
18–20 1.8 1.9 1.9 1.8 1.9 2.0 2.0 2.0 1.9 1.8 5.6 −10.0 −5.3 0.0
≥21 1.2 1.4 1.3 1.3 1.3 1.3 1.3 1.3 1.2 1.1 8.3 −15.4 −8.3 −8.3
Total (no.)§ 508,841 481,667 457,201 435,881 426,636 414,914 408,903 394,181 395,960 398,505 NA NA NA NA

Abbreviation: NA = not applicable.
* Data from 34 reporting areas; excludes 18 areas (California, Connecticut, Delaware, District of Columbia, Florida, Illinois, Maine, Maryland, Massachusetts, Mississippi, Nebraska, New Hampshire, New York State, Pennsylvania, Rhode Island, Vermont, Wisconsin, and Wyoming) that did not report, did not report by weeks of gestation, or did not meet reporting standards for ≥1 year.
Percentages for the individual component categories might not add to 100% because of rounding.
§ By year, the total number of abortions represents 74.6%–98.2% of all abortions reported to CDC among the areas that met reporting standards for gestational age during 2010–2019.

TABLE 12. Number of reported abortions, by known method type and reporting area of occurrence — selected reporting areas,* United States, 2019Return to your place in the text
State/Area Surgical Medical Intrauterine instillation§ Hysterectomy/
Hysterotomy
Total abortions reported by known method type
Surgical,
≤13 weeks’ gestation
Surgical,
>13 weeks’ gestation
Surgical, unknown gestational age Medical,
≤9 weeks’ gestation
Medical,
>9 weeks’ gestation
Medical, unknown gestational age
No. (%) No. (%) No. (%) No. (%) No. (%) No. (%) No. (%) No. (%) No. (% of all reported abortions)**
Alabama†† 3,257 (54.2) 653 (10.9) §§ 2,030 (33.8) 58 (1.0) §§ 0 (—) 0 (—) 6,004 (99.9)
Alaska 895 (70.5) 65 (5.1) 0 (—) 305 (24.0) §§ §§ §§ 0 (—) 1,269 (99.9)
Arizona 6,768 (51.7) 992 (7.6) 0 (—) 5,031 (38.4) 159 (1.2) 0 (—) 137 (1.0) 0 (—) 13,087 (99.9)
Arkansas†† 1,369 (46.2) 356 (12.0) 0 (—) 829 (28.0) 408 (13.8) 0 (—) 0 (—) 0 (—) 2,962 (100.0)
Colorado 2,989 (35.9) 400 (4.8) §§ 4,819 (57.8) 120 (1.4) 0 (—) §§ 0 (—) 8,334 (92.6)
Connecticut 3,747 (41.0) 687 (7.5) 136 (1.5) 4,367 (47.8) 25 (0.3) 173 (1.9) 0 (—) 0 (—) 9,135 (99.3)
Delaware 722 (36.0) 101 (5.0) §§ 1,136 (56.6) 46 (2.3) §§ 0 (—) 0 (—) 2,007 (98.3)
District of Columbia¶¶ 2,170 (47.7) 382 (8.4) 0 (—) NA NA 2,000 (43.9) 0 (—) 0 (—) 4,552 (100.0)
Florida 32,315 (47.1) 2,505 (3.7) 0 (—) 33,428 (48.7) 352 (0.5) 0 (—) 0 (—) 8 (0.0) 68,608 (95.4)
Georgia 15,801 (42.8) 2,555 (6.9) 0 (—) 18,240 (49.4) 309 (0.8) 0 (—) 0 (—) 0 (—) 36,905 (100.0)
Hawaii 1,030 (51.4) 194 (9.7) §§ 776 (38.8) §§ 0 (—) 0 (—) 0 (—) 2,002 (100.0)
Idaho 826 (54.7) 42 (2.8) 10 (0.7) 621 (41.1) 8 (0.5) §§ §§ 0 (—) 1,511 (99.9)
Indiana 4,241 (55.5) 36 (0.5) 0 (—) 3,297 (43.2) 62 (0.8) 0 (—) 0 (—) 0 (—) 7,636 (100.0)
Iowa 948 (26.8) 190 (5.4) 0 (—) 2,364 (66.7) 40 (1.1) 0 (—) 0 (—) 0 (—) 3,542 (99.3)
Kansas 1,959 (28.4) 486 (7.1) 0 (—) 4,364 (63.3) 82 (1.2) 0 (—) 0 (—) 0 (—) 6,891 (100.0)
Kentucky 1,512 (41.3) 306 (8.4) 0 (—) 1,828 (49.9) 18 (0.5) 0 (—) 0 (—) 0 (—) 3,664 (100.0)
Maine 888 (44.0) 106 (5.3) §§ 960 (47.6) 63 (3.1) §§ 0 (—) 0 (—) 2,018 (99.9)
Massachusetts*** NA NA 10,377 (56.4) NA NA 7,958 (43.2) 67 (0.4) 0 (—) 18,402 (99.0)
Michigan 12,984 (47.6) 2,649 (9.7) 42 (0.2) 11,213 (41.1) 386 (1.4) 10 (0.0) 0 (—) 0 (—) 27,284 (99.8)
Minnesota 5,187 (52.2) 958 (9.6) 54 (0.5) 3,589 (36.1) 61 (0.6) 87 (0.9) §§ §§ 9,940 (100.0)
Mississippi 725 (22.7) 186 (5.8) 0 (—) 2,228 (69.8) 55 (1.7) 0 (—) 0 (—) 0 (—) 3,194 (100.0)
Missouri 1,076 (73.5) 367 (25.1) 0 (—) 5 (0.3) 10 (0.7) 0 (—) §§ §§ 1,463 (99.5)
Montana 524 (33.4) 128 (8.2) 0 (—) 900 (57.4) 16 (1.0) 0 (—) 0 (—) 0 (—) 1,568 (100.0)
Nebraska 686 (33.2) 122 (5.9) 0 (—) 1,245 (60.2) 13 (0.6) §§ 0 (—) §§ 2,068 (100.0)
Nevada 4,599 (55.0) 527 (6.3) 38 (0.5) 3,113 (37.2) 51 (0.6) 37 (0.4) §§ §§ 8,367 (99.4)
New Jersey††† 12,938 (58.3) 2,692 (12.1) 481 (2.2) 5,896 (26.6) 134 (0.6) 35 (0.2) 0 (—) 0 (—) 22,176 (100.0)
New Mexico 1,394 (39.9) 301 (8.6) 58 (1.7) 1,332 (38.2) 338 (9.7) 65 (1.9) §§ §§ 3,490 (88.5)
New York 40,495 (52.9) 6,130 (8.0) 1,399 (1.8) 23,809 (31.1) 2,125 (2.8) 2,555 (3.3) 24 (0.0) 32 (0.0) 76,569 (97.4)
      New York City 29,516 (59.4) 4,113 (8.3) 0 (—) 15,505 (31.2) 525 (1.1) 0 (—) 9 (0.0) 32 (0.1) 49,700 (99.8)
      New York State 10,979 (40.9) 2,017 (7.5) 1,399 (5.2) 8,304 (30.9) 1,600 (6.0) 2,555 (9.5) 15 (0.1) 0 (—) 26,869 (93.3)
North Carolina 12,295 (45.9) 1,992 (7.4) 32 (0.1) 12,209 (45.6) 190 (0.7) 36 (0.1) 0 (—) 12 (0.0) 26,766 (94.1)
North Dakota 698 (62.3) 59 (5.3) §§ 361 (32.2) §§ 0 (—) 0 (—) 0 (—) 1,121 (100.0)
Ohio 10,350 (51.5) 1,937 (9.6) §§ 7,716 (38.4) 91 (0.5) 0 (—) 0 (—) §§ 20,097 (100.0)
Oklahoma 2,152 (43.8) 263 (5.4) §§ 2,460 (50.1) 33 (0.7) §§ §§ 0 (—) 4,914 (98.4)
Oregon 3,494 (40.2) 646 (7.4) 21 (0.2) 4,337 (49.9) 133 (1.5) 51 (0.6) §§ §§ 8,684 (100.0)
Pennsylvania§§§ NA NA 17,159 (55.3) NA NA 13,845 (44.6) §§ §§ 31,013 (100.0)
Rhode Island 1,010 (48.3) 179 (8.6) 7 (0.3) 884 (42.2) 12 (0.6) §§ §§ 0 (—) 2,093 (99.7)
South Carolina†† 1,676 (32.9) 319 (6.3) §§ 2,334 (45.8) 766 (15.0) 0 (—) 5 (0.1) §§ 5,101 (100.0)
South Dakota 272 (65.7) 0 (—) §§ 124 (30.0) 13 (3.1) §§ 0 (—) 0 (—) 414 (100.0)
Tennessee 4,034 (41.5) 716 (7.4) 8 (0.1) 4,765 (49.0) 183 (1.9) 8 (0.1) 0 (—) 5 (0.1) 9,719 (100.0)
Texas†† 30,824 (53.8) 3,906 (6.8) 0 (—) 22,234 (38.8) 305 (0.5) 0 (—) §§ §§ 57,272 (100.0)
Utah 1,455 (49.8) 229 (7.8) 0 (—) 1,223 (41.9) 11 (0.4) 0 (—) §§ §§ 2,921 (100.0)
Vermont 394 (33.1) 87 (7.3) §§ 683 (57.4) 25 (2.1) 0 (—) §§ 0 (—) 1,190 (99.6)
Virginia 9,252 (59.3) 500 (3.2) 15 (0.1) 5,744 (36.8) 74 (0.5) §§ §§ 0 (—) 15,589 (99.9)
Washington 7,491 (43.4) 1,317 (7.6) 30 (0.2) 8,320 (48.2) 56 (0.3) 36 (0.2) 0 (—) 0 (—) 17,250 (99.9)
West Virginia 617 (52.2) 77 (6.5) 0 (—) 454 (38.4) 35 (3.0) 0 (—) 0 (—) 0 (—) 1,183 (100.0)
Wisconsin***,¶¶¶ NA NA 4,207 (66.0) NA NA 2,165 (34.0) 0 (—) 0 (—) 6,372 (100.0)
Wyoming 0 (—) 0 (—) §§ 30 (96.8) §§ 0 (—) 0 (—) 0 (—) 31 (100.0)
Total 277,789 (49.0) 40,699 (7.2) —**** 239,770 (42.3) 7,787 (1.4) †††† 252 (0.0) 81 (0.0) 566,378 (98.5)§§§§

Abbreviation: NA = not available.
* Data from 47 reporting areas; excludes five reporting areas (California, Illinois, Louisiana, Maryland, and New Hampshire) that did not report, did not report by method type, or did not meet reporting standards. Areas reporting by method type with unknown gestational age or gestational age reported was not compatible with categorizations presented in this table are included.
Includes uterine aspiration (might also be called dilation and curettage, aspiration curettage, suction curettage, manual vacuum aspiration, menstrual extraction, sharp curettage) and dilation and evacuation procedures.
§ Intrauterine instillations reported at ≤12 weeks’ gestation were considered as unknown for method type.
Percentages for the individual component categories might not add to 100% because of rounding.
** Percentage is calculated as the number of abortions reported by known method type divided by the sum of abortions reported by known and unknown method type. Values ≥99.95% are rounded to 100.0%.
†† Two weeks were added to the probable postfertilization age to provide a corresponding measure to gestational age based on the clinician’s estimate.
§§ Cells with a value in the range of 1–4 or cells that would allow for calculation of these small values have been suppressed.
¶¶ Numbers for medical abortions at ≤9 weeks versus >9 weeks are not presented because gestational age reported was not compatible with these categorizations.
*** Numbers for surgical abortions at ≤13 weeks versus >13 weeks and for medical abortions at ≤9 weeks versus >9 weeks are not presented because gestational age data were not provided by method type.
††† Reporting to the central health agency is not required. Data are requested from hospitals and licensed ambulatory care facilities only.
§§§ Numbers for surgical abortions ≤13 weeks and >13 weeks and medical abortions ≤9 weeks versus >9 weeks are not presented as gestational age reported was not compatible with these categorizations.
¶¶¶ Includes residents only. Wisconsin reports as surgical, unspecified and does not differentiate surgical abortions from hysterectomy/hysterotomy. All abortions were reported as surgical or chemically induced. For this report, all surgical abortions were classified as surgical and all chemical abortions as medical.
**** For the total only, surgical abortions reported without a gestational age were distributed among the surgical abortion categories according to the distribution of surgical abortions at known gestational age.
†††† For the total only, medical abortions reported without a gestational age were distributed among the medical abortion categories according to the distribution of medical abortions at known gestational age.
§§§§ Percentage based on a total of 575,098 abortions reported among the areas that met reporting standards for method type.

TABLE 13. Number of reported abortions, by known weeks of gestation and method type — selected reporting areas,* United States, 2019Return to your place in the text
Method type Weeks of gestation Total
≤6 7–9 10–13 14–15 16–17 18–20 ≥21
No. (%) No. (%) No. (%) No. (%) No. (%) No. (%) No. (%) No. (%)
Surgical§
≤13 weeks’ gestation 84,850 (41.3) 90,714 (52.2) 59,346 (93.2) NA NA NA NA 234,910 (49.2)
>13 weeks’ gestation NA NA NA 13,965 (99.2) 8,199 (98.3) 7,686 (96.9) 4,094 (87.0) 33,944 (7.1)
Medical
≤9 weeks’ gestation 120,333 (58.6) 82,966 (47.8) NA NA NA NA NA 203,299 (42.6)
>9 weeks’ gestation NA NA 4,339 (6.8) 109 (0.8) 94 (1.1) 185 (2.3) 545 (11.6) 5,272 (1.1)
Intrauterine instillation —** —** 1 (0.0) 2 (0.0) 48 (0.6) 58 (0.7) 60 (1.3) 169 (0.0)
Hysterectomy/
Hysterotomy
19 (0.0) 28 (0.0) 5 (0.0) 4 (0.0) 3 (0.0) 6 (0.1) 7 (0.1) 72 (0.0)
Total 205,202 (100.0) 173,708 (100.0) 63,691 (100.0) 14,080 (100.0) 8,344 (100.0) 7,935 (100.0) 4,706 (100.0) 477,666 (100.0)

Abbreviation: NA = not applicable.
* Data from 42 reporting areas; excludes 10 reporting areas (California, District of Columbia, Illinois, Louisiana, Maryland, Massachusetts, New Hampshire, New York State, Pennsylvania, and Wisconsin) that did not report, did not report by weeks of gestation, did not meet reporting standards, or did not have medical abortion as a specific category on their reporting form.
For each gestational age category, percentages of all method types might not add to 100% because of rounding.
§ Includes uterine aspiration (might also be called dilation and curettage, aspiration curettage, suction curettage, manual vacuum aspiration, menstrual extraction, sharp curettage) and dilation and evacuation procedures.
The administration of medication or medications to induce an abortion; at ≤9 weeks’ gestation, typically involves the use of mifepristone and misoprostol, and at >9 weeks’ gestation, typically involves the use of vaginal prostaglandins.
** Intrauterine instillations reported at ≤12 weeks’ gestation have not been included with known values.

TABLE 14. Number of reported abortions, by known weeks of gestation, age group, and race/ethnicity — selected reporting areas, United States, 2019Return to your place in the text
Characteristic Weeks of gestation Total
≤6 7–9 10–13 14–15 16–17 18–20 ≥21
No. (%) No. (%) No. (%) No. (%) No. (%) No. (%) No. (%) No. (%)
Age group (yrs)*,†
<15 306 (27.2) 384 (34.1) 214 (19.0) 73 (6.5) 53 (4.7) 47 (4.2) 50 (4.4) 1,127 (100.0)
15–19 14,886 (35.7) 15,785 (37.9) 7,007 (16.8) 1,536 (3.7) 948 (2.3) 962 (2.3) 561 (1.3) 41,685 (100.0)
20–24 56,003 (41.3) 50,599 (37.3) 19,052 (14.1) 4,179 (3.1) 2,398 (1.8) 2,142 (1.6) 1,226 (0.9) 135,599 (100.0)
25–29 61,791 (43.3) 52,298 (36.7) 18,882 (13.2) 3,925 (2.8) 2,294 (1.6) 2,189 (1.5) 1,242 (0.9) 142,621 (100.0)
30–34 43,257 (45.1) 34,165 (35.6) 11,747 (12.3) 2,654 (2.8) 1,523 (1.6) 1,473 (1.5) 1,022 (1.1) 95,841 (100.0)
35–39 24,816 (46.1) 18,652 (34.7) 6,425 (11.9) 1,501 (2.8) 960 (1.8) 880 (1.6) 588 (1.1) 53,822 (100.0)
≥40 9,053 (49.4) 5,919 (32.3) 1,990 (10.9) 523 (2.9) 344 (1.9) 334 (1.8) 165 (0.9) 18,328 (100.0)
Total 210,112 (43.0) 177,802 (36.4) 65,317 (13.4) 14,391 (2.9) 8,520 (1.7) 8,027 (1.6) 4,854 (1.0) 489,023 (100.0)
Race/Ethnicity*
Non-Hispanic
      White 51,748 (45.4) 40,580 (35.6) 14,205 (12.5) 2,978 (2.6) 1,741 (1.5) 1,767 (1.6) 963 (0.8) 113,982 (100.0)
      Black 49,644 (38.1) 49,659 (38.1) 20,818 (16.0) 4,464 (3.4) 2,543 (2.0) 2,190 (1.7) 903 (0.7) 130,221 (100.0)
      Other 11,606 (47.6) 8,047 (33.0) 2,861 (11.7) 697 (2.9) 409 (1.7) 477 (2.0) 279 (1.1) 24,376 (100.0)
Hispanic 35,358 (49.5) 23,471 (32.9) 8,211 (11.5) 1,897 (2.7) 1,020 (1.4) 962 (1.3) 499 (0.7) 71,418 (100.0)
Total 148,356 (43.6) 121,757 (35.8) 46,095 (13.6) 10,036 (3.0) 5,713 (1.7) 5,396 (1.6) 2,644 (0.8) 339,997 (100.0)

* Percentages for the individual component categories might not add to 100% because of rounding.
Data from 43 reporting areas; excludes nine reporting areas (California, District of Columbia, Illinois, Maryland, Massachusetts, New Hampshire, New York State, Pennsylvania, and Wisconsin) that did not report, did not report weeks of gestation by age, or did not meet reporting standards.
§ Data from 29 reporting areas; excludes 23 reporting areas (California, Colorado, District of Columbia, Hawaii, Illinois, Iowa, Louisiana, Maine, Maryland, Massachusetts, Missouri, Nebraska, New Hampshire, New York City, New York State, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Washington, and Wisconsin) that did not report, did not report weeks of gestation by race/ethnicity, or did not meet reporting standards.

TABLE 15. Number of deaths and case-fatality rates* for abortion-related deaths reported to CDC, by type of abortion — United States, 1973–2018 Return to your place in the text
Year Type of abortion CFR per 100,000 legal abortions
Induced Unknown** Total
Legal§ Illegal
1973–1977 2.09
1973 25 19 3 47
1974 26 6 1 33
1975 29 4 1 34
1976 11 2 1 14
1977 17 4 0 21
1978–1982 0.78
1978 9 7 0 16
1979 22 0 0 22
1980 9 1 2 12
1981 8 1 0 9
1982 11 1 0 12
1983–1987 0.66
1983 11 1 0 12
1984 12 0 0 12
1985 11 1 1 13
1986 11 0 2 13
1987 7 2 0 9
1988–1992 0.74
1988 16 0 0 16
1989 12 1 0 13
1990 9 0 0 9
1991 11 1 0 12
1992 10 0 0 10
1993–1997 0.52
1993 6 1 2 9
1994 10 2 0 12
1995 4 0 0 4
1996 9 0 0 9
1997 7 0 0 7
1998–2002 0.63
1998 9 0 0 9
1999 4 0 0 4
2000 11 0 0 11
2001 7 1 0 8
2002 10 0 0 10
2003–2007 0.60
2003 10 0 0 10
2004 7 1 0 8
2005 7 0 0 7
2006 7 0 0 7
2007 6 0 0 6
2008–2012 0.65
2008 12 0 0 12
2009 8 0 0 8
2010 10 0 0 10
2011 2 0 0 2
2012 4 0 0 4
2013–2018 0.41
2013 4 0 0 4
2014 6 0 0 6
2015 2 0 1 3
2016 6 1 1 8
2017 2 0 0 2
2018 2 0 0 2

Abbreviation: CFR = case-fatality rate.
* Number of legal induced abortion-related deaths per 100,000 reported legal induced abortions. Because a substantial number of legal induced abortions occurred outside reporting areas that provided data to CDC, national CFRs (i.e., number of legal induced abortion-related deaths per 100,000 reported legal induced abortions in the United States) were calculated with denominator data from the Guttmacher Institute’s national survey of abortion-providing facilities; for 2018, the CFR was calculated using denominator data for 2017, the most recent year for which data are available. Case-fatality rates were computed for consecutive 5-year periods during 1973–2012 and then for a consecutive 6-year period during 2013–2018 because rates based on <20 cases might be unstable.
Certain numbers might differ from those in reports published previously because additional information has been supplied to CDC subsequent to publication.
§ An abortion is defined as legal if it was performed by a licensed clinician within the limits of state law.
An abortion is defined as illegal if it was performed by any person other than a licensed clinician.
** Unknown whether abortion was induced or spontaneous.


Suggested citation for this article: Kortsmit K, Mandel MG, Reeves JA, et al. Abortion Surveillance — United States, 2019. MMWR Surveill Summ 2021;70(No. SS-9):1–29. DOI: http://dx.doi.org/10.15585/mmwr.ss7009a1external icon.

MMWR and Morbidity and Mortality Weekly Report are service marks of the U.S. Department of Health and Human Services.
Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.
References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.

All HTML versions of MMWR articles are generated from final proofs through an automated process. This conversion might result in character translation or format errors in the HTML version. Users are referred to the electronic PDF version (https://www.cdc.gov/mmwr) and/or the original MMWR paper copy for printable versions of official text, figures, and tables.

Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.

View Page In:pdf icon PDF [613K]
Page last reviewed: November 24, 2021