The Guttmacher Institute has released new data from the Monthly Abortion Provision Study, an initiative launched in 2023 to provide monthly estimates of the number of abortions within the formal US health care system. The latest estimates cover the period January–October 2023, and reflect the number of facility-based procedural and medications abortions, as well as medication abortions provided via telehealth and virtual providers.
National Increase in Abortion
In the first 10 months of 2023, there were an estimated 878,000 abortions in the formal US health care system, 94% as many abortions as were provided in 2020 (930,000). Approximately 88,000 abortions have been provided in the formal health care system per month so far in 2023, so with two months of data yet to be published, it is very likely that the total number of abortions provided in 2023 will substantially exceed 2020 numbers. The actual increase in abortions is likely even larger than these numbers suggest because these counts do not include abortions occurring outside the formal health care system, which are likely to have increased substantially following the implementation of state bans and restrictions.
Many factors have contributed to more abortions in 2023, including the following:
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Abortions were already increasing in many US states prior to the Dobbs decision, as reported in Guttmacher’s 2020 Abortion Provider Census: Abortions increased by 8% from 2017 to 2020, reversing 30 years of a declining abortion rate.
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Interstate travel for abortion care has increased, largely facilitated by practical support networks (like abortion funds) that have helped patients navigate financial and logistical barriers.
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Access to abortion has increased in states that passed protective abortion policies following the fall of Roe v. Wade.
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Abortion provided via telehealth has become increasingly available.
“An increase in abortion numbers is a positive development if it means people are getting the health care they want and need,” says Isaac Maddow-Zimet, data scientist at Guttmacher and project lead. “However, despite an increase in abortions compared with 2020, we know that many people in 2023 had to overcome immense barriers to access care, often traveling across state lines to do so. We also know that not everyone has been able to access care, and as with all abortion bans and restrictions, the burdens imposed by Dobbs have been disproportionately shouldered by already marginalized communities, thus exacerbating longstanding inequalities in access to abortion care.”
Abortion Care Resumes in Wisconsin
After Roe was struck down in June 2022, Wisconsin providers were forced to stop providing abortions due to legal uncertainty around an 1849 law that could have led to providers facing prosecution. After a state court clarified how to interpret the law, Planned Parenthood of Wisconsin resumed performing abortions as of September 18, 2023. In October 2023, the first full month after Planned Parenthood resumed abortion services in the state, there were 270 abortions provided within the formal health care system.
Sustained Decrease in States that Enacted Bans in 2023
In 2023 new restrictive abortion laws went into effect in North Carolina, South Carolina and Indiana. Previous Monthly Abortion Provision releases captured the immediate impact that these policies had on abortion numbers in each state, and the latest data show that these restrictions continue to impede access to abortion care:
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A six-week ban went into effect on August 23 in South Carolina, resulting in a 71% decline in abortions provided in September; this decline was largely sustained through October.
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Following the implementation of a near-total ban in Indiana in August, there continue to be virtually no abortions provided within the state’s formal health care system.
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Abortions in North Carolina declined sharply in July, after a 12-week ban and a medically unnecessary requirement for state-mandated counseling that forced patients to make two in-clinic appointments went into effect. Abortions then increased in September and October after implementation of the South Carolina ban, likely reflecting an increase in South Carolinians traveling out of state for care.
Upcoming Releases
In 2024, Guttmacher will continue to release estimates from the Monthly Abortion Provision Study, including new data on state of residence of abortion patients who are traveling out of state for care and on gestational duration.
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 estimates cover abortions provided at brick-and-mortar health care facilities (such as clinics or doctor’s offices), as well as medication abortions provided via telehealth and virtual providers located in the United States. As of the January 2024 release, counts for all months include telehealth abortions provided under “shield laws” to patients in states where abortion is legal but telehealth provision of abortion is banned. 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, and does not estimate abortions in states with total bans.
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 are 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.
The Monthly Abortion Provision Study interactive resource includes monthly data on the number of abortions by state for January–October 2023 and is designed to help measure the impact of abortion policies on state-level abortion incidence and trends. The interactive graphics also show the estimated number and proportion of out-of-state abortion patients for every state in January–June 2023, and change in the proportion of abortions provided in each state to patients traveling from out of state between 2020 (six-month period) and January–June 2023.
About the Guttmacher Institute
The Guttmacher Institute is a leading research and policy organization committed to advancing sexual and reproductive health and rights worldwide. The 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 of all known facilities providing abortion in the United States to collect information about service provision, including total number of abortions.
Acknowledgments
The Monthly Abortion Provision Study is supported by the Eunice Kennedy Shriver National Institute of Child Health and 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 the sole responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.