Report

Pregnancies, Births and Abortions in the United States, 1973–2020: National and State Trends by Age
An image of four charts (bars, pie)
Doris W. Chiu
,
Isaac Maddow-Zimet
 and
Kathryn Kost

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The Guttmacher Institute calculates comprehensive historical statistics on the incidence of pregnancy, birth and abortion in the United States. Our most recent release includes national statistics covering the period from 1973 to 2020, the most recent year for which comparable data are available; state-level statistics are available for selected years from 1988 to 2020 (see note on historical estimates). We highlight a few patterns in these new demographic estimates and include a series of interactive figures for further data exploration. A brief discussion of the methods used to produce these estimates is available, as well as in an accompanying document (see Methodology Appendix).

Introduction

Documenting pregnancy, birth and abortion rates over time and by age-group helps broadly illustrate how people’s reproductive lives have changed over the past five decades. The complete data set of all estimates (along with accompanying documentation) is publicly available at https://osf.io/kthnf in a variety of formats. Select estimates are also incorporated into the Guttmacher Institute’s Data Center, where users can generate interactive visualizations and custom tables.

Highlights

The following interactive figures offer a selection of key measures that portray trends over time nationally and by state, as well as regionally. We describe notable patterns in each figure. Use the drop-down menu boxes in figure titles to change which data are displayed.

National levels and trends in pregnancy (Appendix Tables 1 and 2)

  • The total pregnancy rate reached its lowest recorded level in 2020 at 83 pregnancies per 1,000 women aged 15–44.
  • In 2020, pregnancy rates for women aged 24 or younger reached their lowest recorded levels, continuing a long-standing decline in pregnancy rates among this age-group that started in the late 1980s. In 2020, there were 11 pregnancies per 1,000 women aged 15–17 (down from a peak of 75 in 1989), 50 pregnancies per 1,000 women aged 18–19 (from a peak of 175 in 1991) and 103 pregnancies per 1,000 women aged 20–24 (from a peak of 202 in 1990).
  • By contrast, pregnancy rates among older age-groups have been increasing since 1973. The pregnancy rate for those aged 35–39 peaked in 2019 (at 73 pregnancies per 1,000 women), and the rate for those 40 or older reached a historic high in 2019 (at 19 pregnancies per 1,000 women). Both groups had slight declines in their pregnancy rates in 2020.

National levels and trends in birth and abortion (Appendix Tables 3–7)

  • Birth and abortion rates do not always move or change direction in tandem. The decline in the pregnancy rate among adolescents and young adults over the past three decades was reflected in declines in both birth and abortion rates. Among women aged 30–34, 35–39, and 40 or older, the rate of abortions has stayed relatively stable since the late 1970s, while birth rates have largely increased.
  • Among women younger than 15, women aged 15–17 and women aged 18–19, the beginning of the decline in the abortion rate in the late 1980s preceded the decline in the birth rate by several years. For example, among 15–17-year-olds, the birth rate peaked in 1991 (at 39 births per 1,000 women), and the abortion rate peaked three years earlier, in 1988 (at 31 abortions per 1,000 women).
  • Among women aged 15–44, the abortion rate has declined since its peak in 1980 and 1981 (at 29 abortions per 1,000 women) and reached a historic low in 2017 (at 14 abortions per 1,000 women). The abortion rate has increased slightly each year from 2017 to 2020, but remains at 14 abortions per 1,000 women when the rate is rounded. This increase in abortion is primarily driven by increases in the 25–29 and 30–34 age-groups. By contrast, the birth rate among women aged 15–44 has gone through alternating periods of decline and increase since 1973; in 2020, it reached its lowest level (at 56 births per 1,000 women).

State levels and trends in pregnancy, birth and abortion (Appendix Tables 8–40)

  • Trends in pregnancy, birth and abortion rates followed broadly similar patterns across states from 1988 to 2020, and they mostly reflect trends at the national level. In every state, pregnancy rates among women aged 15–17, 18–19 and 20–24 declined from 1988 to 2020.
  • During this same time period, pregnancy rates for those aged 30–34, 35–39, and 40 or older increased in every state, except three: California, Hawaii and New Mexico, all of which had small decreases in the pregnancy rate among 30–34-year-olds.
  • Among women aged 15–44, the pregnancy rate declined from 1988 to 2020 in every state.
  • In 2020, pregnancy rates among women aged 15–19 and 20–24 were generally highest in the South and Southwest. Among women aged 30–34, 35–39, and 40 or older, rates were generally highest in the Northeast.
  • Overall, pregnancy rates ranged from 64 to 102 per 1,000 women aged 15–44.

Summary

Pregnancy rates among women aged 24 or younger have been declining during the past three decades, while rates among those older than age 30 have been increasing during that time. These patterns reflect different underlying trends in birth and abortion rates: Pregnancy rate declines among young people have resulted from decreases in both birth and abortion rates, while the abortion rates among older age-groups have stayed mostly constant as birth rates have increased. Trends at the state level have generally mirrored national trends; however, there are strong geographic patterns. Pregnancy rates in 2020 were higher among younger people in the South and Southwest and for older age-groups in the Northeast, compared with the rates among those age-groups in other regions.

Methods

We count pregnancies by summing births, abortions and fetal losses (i.e., miscarriages and stillbirths). The National Center for Health Statistics provides annual counts of births in the United States, as compiled in the National Vital Statistics System from data derived from birth certificates. Counts of abortions come from the Guttmacher Institute’s periodic national Abortion Provider Census. Counts of fetal losses are estimated as a proportion of births and abortions. For additional information about methods, sources and citations, see the Methodology Appendix.

A demographic rate is the number of events (in this case, pregnancies, births or abortions) divided by the number of individuals who could experience the event. The accuracy of demographic rates depends on having accurate counts of both events and the population of people who are able to become pregnant. In reality, that population includes cisgender women, transgender men and people whose gender is nonbinary. To our knowledge, there are no comprehensive estimates of the number or proportion of the US population that is able to become pregnant. As a proxy, the population we use for calculation of rates is the number of women in a given age-group (the denominator), as reported by the Census Bureau. Consequently, throughout the text, we describe rates as being among women, although counts of events (the numerator: births, abortions, fetal losses or all pregnancies) include outcomes among all people able to become pregnant, regardless of their gender.

Note on historical estimates

The Guttmacher Institute has published periodic surveillance reports on adolescent and young-adult pregnancy statistics over the past four decades.1–8 This report presents pregnancy trends for a wide range of age-groups (younger than 15, 15–17, 18–19, 20–24, 25–29, 30–34, 35–39, and 40 or older) nationally and by state.

Estimates in this report differ from those in prior publications.1–10 As new data become available, we plan to continue making iterative improvements to our methodology (see the Methodology Appendix); future reports will also include recalculated estimates for all available years. Prior data releases are available at https://osf.io/kthnf for purposes of comparison and to maintain reproducibility of analyses that used earlier versions of the data.

Suggested Citation

Chiu DW, Maddow-Zimet I and Kost K, Pregnancies, Births and Abortions in the United States, 1973–2020: National and State Trends by Age, New York: Guttmacher Institute, 2024, https://www.guttmacher.org/report/pregnancies-births-abortions-in-unite….

DOI: https://doi.org/10.1363/2024.300581

Acknowledgments

This report was prepared by Doris W. Chiu, Isaac Maddow-Zimet and Kathryn Kost, all of the Guttmacher Institute. It was edited by Peter Ephross. Research support was provided by Ava Braccia. Haley Ball, Amy Friedrich-Karnik, Rachel Jones and Emma Stoskopf-Ehrlich provided comments and suggestions. 

References

1. Henshaw SK and Van Vort J, Teenage abortion, birth and pregnancy statistics: an update, Family Planning Perspectives, 1989, 21(2):85–88, doi:10.2307/2135559.

2. Henshaw SK, Teenage birth and statistics by state, 1988, Family Planning Perspectives, 1993, 25(3):122, doi:10.2307/2136160.

3. Henshaw SK, Teenage abortion and statistics by state, 1992, Family Planning Perspectives, 1997, 29(3):8, doi:10.2307/2953333.

4. Henshaw SK and Feivelson DJ, Teenage abortion and statistics by state, 1996, Family Planning Perspectives, 2000, 32(6):9, doi:10.2307/2648195.

5. Guttmacher Institute, U.S. Teenage Pregnancy Statistics: Overall Trends, Trends by Race and Ethnicity and State-by-State Information, New York: The Alan Guttmacher Institute, 2004, https://www.guttmacher.org/sites/default/files/pdfs/pubs/state_pregnanc….

6. Kost K and Henshaw SK, U.S. Teenage Pregnancies, Births and Abortions, 2008: National Trends by Age, Race and Ethnicity, New York: Guttmacher Institute, 2012, https://www.guttmacher.org/report/us-teenage-pregnancies-births-and-abo….

7. Kost K and Henshaw SK, U.S. Teenage Pregnancies, Births and Abortions, 2010: National and State Trends by Age, Race and Ethnicity, New York: Guttmacher Institute, 2014, https://www.guttmacher.org/report/us-teenage-pregnancies-births-and-abo….

8. Kost K, Maddow-Zimet I and Arpaia A, Pregnancies, Births and Abortions Among Adolescents and Young Women in the United States, 2013: National and State Trends by Age, Race and Ethnicity, New York: Guttmacher Institute, 2017, https://www.guttmacher.org/report/us-adolescent-pregnancy-trends-2013.

9. Maddow-Zimet I, Kost K and Finn S, Pregnancies, Births and Abortions in the United States, 1973–2016: National and State Trends by Age, 2020, New York: Guttmacher Institute, https://www.guttmacher.org/report/pregnancies-births-abortions-in-unite….

10. Maddow-Zimet I and Kost K, Pregnancies, Births and Abortions in the United States, 1973–2017: National and State Trends by Age, 2021, https://www.guttmacher.org/report/pregnancies-births-abortions-in-unite….

Topic

United States

Geography