In response to the overturning of Roe v. Wade, the Guttmacher Institute has launched a new research initiative to track monthly estimates of medication and procedural abortions provided within the formal US health care system. The Monthly Abortion Provision Study interactive resource currently shows monthly data from January–June 2023 and is designed to help measure the impacts of abortion policies on state-level abortion incidence and trends. The interactive graphics also provide comparisons to 2020 abortion levels. A summary of key findings is below, and a policy analysis released along with the new data offers a detailed discussion of how the findings can help inform policymaking around abortion.  

The Guttmacher Institute has a long history of tracking abortion incidence in the United States and globally. Every three years since 1974, the Guttmacher Institute has conducted the Abortion Provider Census (APC) of all known facilities providing abortion in the United States to collect information about service provision, including total number of abortions. With the Monthly Abortion Provision Study initiative, Guttmacher will be releasing state abortion estimates monthly, as well as continually updating prior estimates. Next month’s release (October) will cover the period from January through July 2023, including the first data on the impact of North Carolina’s 12-week abortion ban, which went into effect on July 1, 2023. This release will also show data on interstate travel for abortion care. Subsequent to the October release, the study will include data on gestational age.  

“The post-Dobbs era has dramatically altered the abortion landscape in the United States, and all of us committed to protect access must do more to understand the real impact of abortion bans and restrictions,” says Dr. Herminia Palacio, president and CEO of Guttmacher. “With the Monthly Abortion Provision Study, our scientists are using virtually real-time data to document state-by-state access. Sadly, initial findings confirm a hierarchy of access to clinical care, based upon where a person lives and whether they have the resources to overcome geographical barriers.” 

“We designed this study to try to specifically accommodate the post-Roe reality of rapidly changing state policies, overburdened clinics, and heightened security risks for patients and providers,” says Guttmacher data scientist and Monthly Abortion Provision Study project lead, lsaac Maddow-Zimet. “Our aim is to sustainably produce accurate and transparent data that can provide nearly real-time information to advocates, policymakers and fellow researchers as they navigate a chaotic and evolving abortion landscape.” 

“The new Monthly Abortion Provision Study data are critical to our state policy team’s work to gauge the impact that both restrictive and protective state policies have on abortion access,” says Kelly Baden, vice president of public policy at the Guttmacher Institute. “For instance, we now have baseline data for the number of monthly abortions we would expect to see in North Carolina in 2023, which we can use to help estimate the impact of the 12-week ban that went into effect July 1.” 

Initial Findings  

Initial data from the study show dramatic state-level changes in abortion provision compared with 2020, underscoring how rapidly the landscape of US abortion access has changed since the Dobbs decision. With abortion banned or unavailable in 14 states during the study period, researchers found a substantial increase in abortion in many states neighboring ban states and in some states that have enacted protective policies after Roe was overturned. Guttmacher’s APC data for 2017–2020 documented that the number of US abortions had increased for the first time in decades, and Monthly Abortion Provision Study data show a much sharper increase in many states, particularly in states boarding ban states and those that have protected abortion access.  

• Increases in states that protected abortion access: In states that enacted protective policies post-Roe, such as Colorado, Connecticut, Illinois and Washington, new estimates show an increase in abortion numbers as compared with data from Guttmacher’s 2020 Abortion Provider Census. See analysis for data on specific states. 

• Increases in states bordering ban states: Many states that border or are in close proximity to states that banned abortion also saw an increase in monthly abortion counts, including Kansas, New Mexico and South Carolina. Increases in these states are likely due in large part to out-of-state patients who had to travel for abortion care. See analysis for data on specific states. 

• Decreases in states that banned abortion: During the January–June 2023 timeframe, abortion was banned or unavailable in 14 states. In 2020, there were 113,630 abortions in these 14 states. With almost no abortion care available within the formal health care system, individuals in these states are now forced to travel for care, self-manage their abortion, or remain pregnant when they don't want to be. 

• No clear national-level trend: While the data emphasize critical state-level trends, they do not yet support a clearcut narrative on national abortion trends. More research, including efforts to estimate abortions provided outside the formal US health care system, are needed. 

Monthly Abortion Provision Study Resources 

• Interactive graphics displaying state-level data for January 2023 through June 2023 and comparisons to 2020 abortion levels, as well as background information on the study 

• A detailed policy analysis highlighting key findings and main policy implications 

• Our interactive map tracking current state-by-state abortion policies 

About the Study  

The Monthly Abortion Provision Study produces monthly estimates of the number of abortions provided within the formal health care system in the United States. These include abortions provided at brick-and-mortar health facilities (such as clinics or doctor’s offices) as well as medication abortions provided via telehealth and virtual providers located in the United States. This study does not collect data on self-managed abortions, which we define as abortions occurring without in-person or virtual contact with the formal health care system.    

The study’s estimates are generated by a statistical model that combines data from samples of providers with historical data on the caseload of every US provider. As more data is collected each month, estimates for past months become more precise. Each estimate is expressed as an uncertainty interval which quantifies our confidence that the true value falls within a particular range. 

Acknowledgment

The Monthly Abortion Provision Study is supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development, the Office of Research on Women’s Health, and the Office of Behavioral and Social Sciences Research of the National Institutes of Health under award number R61HD112921. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.