Abortion Surveillance

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

¹Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC; ²Oak Ridge Institute for Science and Education

References

1. Gamble SB, Strauss LT, Parker WY, Cook DA, Zane SB, Hamdan S; Centers for Disease Control and Prevention (CDC). Abortion surveillance—United States, 2005. MMWR Surveill Summ 2008;57(No. SS-13):1–32. PMID:19037196
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.0b013e3181a2af8f PMID:19407518
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):1–41. PMID:22108620
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/10.1363/4304111 PMID:21388504
5. Kortsmit K, Jatlaoui TC, Mandel MG, et al. Abortion surveillance—United States, 2018. MMWR Surveill Summ 2020;69(No. SS-7):1–29. https://doi.org/10.15585/mmwr.ss6907a1 PMID:33237897
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-2017
7. Kortsmit K, Mandel MG, Reeves JA, et al. Abortion surveillance—United States, 2019. MMWR Surveill Summ 2021;70(No. SS-9):1–29. https://doi.org/10.15585/mmwr.ss7009a1 PMID:34818321
8. Kortsmit K, Nguyen AT, Mandel MG, et al. Abortion surveillance—United States, 2020. MMWR Surveill Summ 2022;71(No. SS-10):1–27. https://doi.org/10.15585/mmwr.ss7110a1 PMID:36417304
9. 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/10.2307/2135791 PMID:3243346
10. 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/10.2307/3097821 PMID:12392215
11. 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.0b013e31821c405e PMID:21606746
12. 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. PMID:29048970
13. 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-1973-2017
14. Jones RK, Chiu DW. Characteristics of abortion patients in protected and restricted states accessing clinic-based care 12 months prior to the elimination of the federal constitutional right to abortion in the United States. Perspect Sex Reprod Health 2023;55:80–5. https://doi.org/10.1363/psrh.12224 PMID:37038835
15. Guttmacher Institute. Abortion reporting requirements. New York, NY: Guttmacher Institute; 2023. https://www.guttmacher.org/state-policy/explore/abortion-reporting-requirements
16. 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/10.2307/2991612 PMID:9782049
17. National Association for Public Health Statistics and Information Systems. Technical resources for reporting induced termination of pregnancy. Silver Spring, MD: National Association for Public Health Statistics and Information Systems; 2023. https://www.naphsis.org/impact/projects/technical-resources-for-reporting-induced-termination-of-pregnancy
18. 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; 2022. https://www.cdc.gov/nchs/data/dvs/GuidetoCompleteFacilityWks.pdf
19. Fritz MA, Speroff L. Clinical gynecologic endocrinology and infertility. Philadelphia, PA: Wolters Kluwer Health; 2012.
20. Mifeprex (mifepristone) [Package insert]. New York, NY: Danco Laboratories; 2016.
21. 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.
22. 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)90083-3 PMID:4442283
23. 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
24. 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
25. 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
26. 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
27. 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
28. 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
29. 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
30. 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
31. CDC. Postcensal estimates of the resident population of the United States as of July 1, 2020, by year, state and county, age, bridged race, sex, and Hispanic origin (Vintage 2020). [File pcen_v2020_y20.sas7bdat]. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2021. https://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#Vintage2020
32. Single-race population estimates 2020–2021 by state and single-year age request [Internet]. Atlanta, GA: US Department of Health and Human Services, CDC; 2022. https://wonder.cdc.gov/Single-Race-single-year-v2021.HTML
33. Natality files [Internet]. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics. https://wonder.cdc.gov/Natality.html
34. Osterman MJK, Hamilton BE, Martin JA, Driscoll AK, Valenzuela CP. Births: final data for 2021. Natl Vital Stat Rep 2023;72:1–53. PMID:36723449
35. CDC. Abortion surveillance, 1972. Atlanta, GA: US Department of Health, Education, and Welfare, Public Health Service, CDC; 1974.
36. CDC. Pregnancy Mortality Surveillance System. Atlanta, GA: US Department of Health and Human Services, CDC; 2022. https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm
37. Jones RK, Kirstein M, Philbin J. Abortion incidence and service availability in the United States, 2020. Perspect Sex Reprod Health 2022;54:128–41. https://doi.org/10.1363/psrh.12215 PMID:36404279
38. Hoyert DL. Maternal mortality and related concepts. Vital Health Stat 3 2007;33:1–13. PMID:17460868
39. 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.0b013e318273eb56 PMID:23168752
40. 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.2014.10.009 PMID:25465890
41. 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/10.1363/46e1714 PMID:24961366
42. Quast T, Gonzalez F, Ziemba R. Abortion facility closings and abortion rates in Texas. Inquiry 2017;54:46958017700944. https://doi.org/10.1177/0046958017700944 PMID:28351188
43. Venator J, Fletcher J. Undue burden beyond Texas: an analysis of abortion clinic closures, births, and abortions in Wisconsin. J Policy Anal Manage 2021;40:774–813. https://doi.org/10.1002/pam.22263
44. White K, Sierra G, Lerma K, et al. Association of Texas’ 2021 ban on abortion in early pregnancy with the number of facility-based abortions in Texas and surrounding states. JAMA 2022;328:2048–55. https://doi.org/10.1001/jama.2022.20423 PMID:36318197
45. 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/sites/default/files/pdfs/pubs/MandatoryCounseling.pdf
46. 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.2016.06.004 PMID:27502901
47. 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/hly039 PMID:30561624
48. 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/sites/default/files/pdfs/pubs/ParentalInvolvementLaws.pdf
49. 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.2015.11.004 PMID:26794433
50. 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.2014.07.006 PMID:25128413
51. 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.2016.17026 PMID:28114666
52. 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.0000000000003183 PMID:30870293
53. Joyce T. The supply-side economics of abortion. N Engl J Med 2011;365:1466–9. https://doi.org/10.1056/NEJMp1109889 PMID:22010912
54. 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.2017.12.003 PMID:29339010
55. Raifman S, Sierra G, Grossman D, et al. Border-state abortions increased for Texas residents after House Bill 2. Contraception 2021;104:314–8. https://doi.org/10.1016/j.contraception.2021.03.017 PMID:33762170
56. Upadhyay UD, Weitz TA, Jones RK, Barar RE, Foster DG. Denial of abortion because of provider gestational age limits in the United States. Am J Public Health 2014;104:1687–94. PMID:23948000
57. 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/sites/default/files/pdfs/pubs/RecessionFP.pdf
58. Rossen LM, Hamilton BE, Abma JC, et al. Updated methodology to estimate overall and unintended pregnancy rates in the United States. Hyattsville, MD: US Department of Health and Human Services, CDC, National Center for Health Statistics; 2023. https://www.cdc.gov/nchs/data/series/sr_02/sr02-201.pdf
59. 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.2009.08.022 PMID:20207237
60. 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):1–31. https://doi.org/10.15585/mmwr.ss6620a1 PMID:29073129
61. 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.2013.301339 PMID:23948010
62. 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)90582-4 PMID:4036997
63. Ferris LE, McMain-Klein M, Colodny N, Fellows GF, Lamont J. Factors associated with immediate abortion complications. CMAJ 1996;154:1677–85. PMID:8646655
64. 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.0000116260.81570.60 PMID:15051566
65. 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.2013.02.008 PMID:23574709
66. Foster DG, Kimport K. Who seeks abortions at or after 20 weeks? Perspect Sex Reprod Health 2013;45:210–8. https://doi.org/10.1363/4521013 PMID:24188634
67. 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.2011.10.012 PMID:22176796
68. 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.2009.12.021 PMID:20399953
69. 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.d0 PMID:16394050
70. 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.2006.04.010 PMID:16982236
71. 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.2020.06.007 PMID:32592799
72. 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.2013.11.009 PMID:24332434
73. Kaunitz AM, Rovira EZ, Grimes DA, Schulz KF. Abortions that fail. Obstet Gynecol 1985;66:533–7. PMID:4047543
74. Creinin MD, Edwards J. Early abortion: surgical and medical options. Curr Probl Obstet Gynecol Fertil 1997;20:1–32.
75. 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)70410-1 PMID:9166176
76. 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.2002.123898 PMID:12193934
77. 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.2020.04.004 PMID:32298713
78. 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.2017.09.006 PMID:28935220
79. 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.2018.11.002 PMID:30444970
80. 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.
81. 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.0b013e31826c315f PMID:23090524
82. National Abortion Federation. 2013 clinical policy guidelines. Washington, DC: National Abortion Federation; 2013. https://www.prochoice.org/pubs_research/publications/documents/2013NAFCPGsforweb.pdf
83. Creinin M, Grossman DA. Medical management of first-trimester abortion. Contraception 2014;89:148–61. https://doi.org/10.1016/j.contraception.2014.01.016 PMID:24795934
84. Food and Drug Administration. Information about mifepristone for medical termination of pregnancy through ten weeks gestation. Silver Spring, MD: US Department of Health and Human Services, Food and Drug Administration; 2021. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/mifeprex-mifepristone-information
85. 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.12024 PMID:28394463
86. Smith MH, Muzyczka Z, Chakraborty P, et al. Abortion travel within the United States: an observational study of cross-state movement to obtain abortion care in 2017. Lancet Reg Health Am 2022;10:100214. https://doi.org/10.1016/j.lana.2022.100214 PMID:36777689
87. Trussell J, Wynn LL. Reducing unintended pregnancy in the United States. Contraception 2008;77:1–5. https://doi.org/10.1016/j.contraception.2007.09.001 PMID:18082659
88. 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.0000000000001926 PMID:28277358
89. Secura GM, Allsworth JE, Madden T, Mullersman JL, Peipert JF. The Contraceptive CHOICE Project: reducing barriers to long-acting reversible contraception. Am J Obstet Gynecol 2010;203:115.e1–7. https://doi.org/10.1016/j.ajog.2010.04.017 PMID:20541171
90. 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.0000000000002361 PMID:29112661
91. Zapata LB, Pazol K, Dehlendorf C, et al. Contraceptive counseling in clinical settings: an updated systematic review. Am J Prev Med 2018;55:677–90. https://doi.org/10.1016/j.amepre.2018.07.006 PMID:30342631
92. 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.2016.03.039 PMID:27247239
93. 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.2016.02.017 PMID:26875950
94. 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:S878.e1–S878.e6. https://doi.org/10.1016/j.ajog.2019.11.1279 PMID:31809706
95. 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.0000000000000945 PMID:26241413

* Number of abortions per 1,000 women aged 15–44 years.
^† Number of abortions per 1,000 live births.
^§ For each specific year, excludes reporting areas that did not report that year’s abortion numbers to CDC: California (2012–2021), District of Columbia (2016), Maryland (2012–2021), New Hampshire (2012–2021), and New Jersey (2021).
^¶ For all years, excludes reporting areas that did not report abortion numbers every year during the analysis period: California, District of Columbia, Maryland, New Hampshire, and New Jersey.

FIGURE. Number, rate,* and ratio^† of abortions performed, by year — selected reporting areas,^§ United States, 2012–2021

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

See also

Black Health

CNET’s Wellness Editors Reveal Their Favorite Sleep Products

^† Number of abortions per 1,000 live births.

^§ Data are for 47 reporting areas; excludes California, District of Columbia, Maryland, New Hampshire, and New Jersey.

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 area of residence, are available at https://www.cdc.gov/reproductivehealth/data_stats/Abortion.htm.
^¶ Data from 48 reporting areas; excludes four reporting areas (California, Maryland, New Hampshire, and New Jersey) that did not report.
** The total abortions include those with known and unknown residence status.
^†† Residents of New York State who had abortions in New York City and residents of New York City who had abortions in New York State were excluded from the number and percentage of abortions obtained by out-of-area residents in New York.

Abbreviation: NA = not applicable.
* Data from 48 reporting areas; excludes four reporting areas (California, Maryland, New Hampshire, and New Jersey) that did not report.
^† 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 numerical value in the range of 1–4 and cells that would allow for calculation of these small values have been suppressed.
** Includes residents only.
^†† Percentage based on a total of 614,254 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 specific 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>^¶¶ Number of abortions obtained by women in a specific 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.

Abbreviation: NA = not applicable.
* Number of abortions obtained by women in a specific 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>^† Number of abortions obtained by women in a specific 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 43 reporting areas; excludes nine reporting areas (California, District of Columbia, Florida, Maine, Maryland, New Hampshire, New Jersey, Tennessee, 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 represent 99.5%–99.7% of all abortions reported to CDC among the areas that met reporting standards for age during 2012–2021; reporting standards for age were applied to abortions for residents of Illinois only during 2012–2019 and 2021.

Abbreviation: NA = not applicable.
* Data from 46 reporting areas; excludes six reporting areas (California, Connecticut, Illinois, Maryland, New Hampshire, and New Jersey) 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 numerical value in the range of 1–4 and cells that would allow for calculation of these small values have been suppressed.
^¶ Includes residents only.
** Number of abortions obtained by women in a specific 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>^†† Number of abortions obtained by women in a specific 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.

Abbreviation: NA = not applicable.
* Data from 33 reporting areas; excludes 19 reporting areas (California, Colorado, Hawaii, Illinois, Iowa, Louisiana, Maryland, Massachusetts, Nebraska, New Hampshire, New Jersey, New York State, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, Washington, and Wisconsin) that did not report, did not report by race and ethnicity, or did not meet reporting standards.
^† Including Alaska Native, American Indian, Asian (Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or other Asian), Native Hawaiian and other Pacific Islander (Native Hawaiian, Guamanian or Chamorro, Samoan, or other Pacific Islander), other races, and multiple races.
^§ 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 and ethnicity divided by the sum of abortions reported by known and unknown race and ethnicity. Values ≥99.95% are rounded to 100.0%.
** Cells with a numerical value in the range of 1–4 and cells that would allow for calculation of these small values have been suppressed.
^†† Reporting form contains only one question for race and ethnicity; therefore, abortions reported for women of White, Black, and other races (Asian and American Indian) are not explicitly identified as non-Hispanic.
^§§ Percentage based on a total of 415,791 abortions reported among the areas that met reporting standards for race and ethnicity.
^¶¶ Number of abortions obtained by women in a specific racial and ethnic group per 1,000 women aged 15–44 years in that same racial and ethnic group. For the total abortion rate only, abortions for women of unknown race and ethnicity were distributed according to the distribution of abortions among women of known race and ethnicity.
*** Number of abortions obtained by women in a specific racial and ethnic group per 1,000 live births to women in that same racial and ethnic group. For the total abortion ratio only, abortions for women of unknown race and ethnicity were distributed according to the distribution of abortions among women of known race and ethnicity.

Abbreviation: NA = not applicable.
* Data from 37 reporting areas excludes 15 reporting areas (Alaska, California, Connecticut, District of Columbia, Hawaii, Maryland, Massachusetts, Nevada, New Hampshire, New Jersey, New York City, New York State, Oregon, 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.
** Recorded as patient married or not married to father.
^†† Percentage based on a total of 484,203 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.

* Data from 42 reporting areas; excludes 10 reporting areas (California, Connecticut, District of Columbia, Illinois, Maryland, New Hampshire, New Jersey, New York State, Oklahoma, 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.
** Cells with a numerical value in the range of 1–4 and cells that would allow for calculation of these small values have been suppressed.
^†† Recorded as the number of living children.
^§§ Percentage based on a total of 520,625 abortions reported among the areas that met reporting standards for the number of previous live births.

* Data from 42 reporting areas; excludes 10 reporting areas (California, Connecticut, District of Columbia, Illinois, Maryland, New Hampshire, New Jersey, New York State, Oklahoma, 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%.
^¶ Cells with a numerical value in the range of 1–4 and cells that would allow for calculation of these small values have been suppressed.
** Percentage based on a total of 520,625 abortions reported among the areas that met reporting standards for the number of previous induced abortions.

* Gestational age based on clinician’s estimate (Alaska, Arizona, Colorado, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, 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); and probable postfertilization age (Alabama, Arkansas, South Carolina, and Texas).
^† Data from 41 reporting areas; excludes 11 reporting areas (California, Connecticut, District of Columbia, Illinois, Maryland, Massachusetts, New Hampshire, New Jersey, 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 numerical value in the range of 1–4 and cells that would allow for calculation of these small values have been suppressed.
^§§ Percentage based on a total of 477,911 abortions reported among the areas that met reporting standards for gestational age.

Abbreviation: NA = not applicable.
* Data from 35 reporting areas; excludes 17 areas (California, Connecticut, District of Columbia, Florida, Illinois, Maine, Maryland, Massachusetts, Nebraska, New Hampshire, New Jersey, New York State, Pennsylvania, Rhode Island, Tennessee, 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 represent 72.3%–91.1% of all abortions reported to CDC among the areas that met reporting standards for gestational age during 2012–2021.

Abbreviation: NA = not applicable.
* Data from 46 reporting areas; excludes six reporting areas (California, Illinois, Maryland, Missouri, New Hampshire, and New Jersey) 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 by method type where 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, or 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 numerical value in the range of 1–4 and cells that would allow for calculation of these small values have been suppressed.
^¶¶ Numbers for surgical abortions at ≤13 weeks and >13 weeks and medication abortions at ≤9 weeks versus >9 weeks are not presented as gestational age reported was not compatible with these categorizations.
*** Gestational age based on clinicians’ estimate. Numbers for medication 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 medication abortions at ≤9 weeks versus >9 weeks are not presented because gestational age data were not provided by method type
^§§§ Includes residents only. Wisconsin reports as surgical, unspecified and does not differentiate surgical abortions from hysterectomy or 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 medication.
^¶¶¶ 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, medication abortions reported without a gestational age were distributed among the medication abortion categories according to the distribution of medication abortions at known gestational age.
^†††† Percentage based on a total of 573,924 abortions reported among the areas that met reporting standards for method type.

Abbreviation: NA = not applicable.
* Data from 40 reporting areas; excludes 12 reporting areas (California, Connecticut, District of Columbia, Illinois, Maryland, Massachusetts, Missouri, New Hampshire, New Jersey, 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 medication 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; 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.

* Percentages for the individual component categories might not add to 100% because of rounding.
^† Data from 41 reporting areas; excludes 11 reporting areas (California, Connecticut, District of Columbia, Illinois, Maryland, Massachusetts, New Hampshire, New Jersey, 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 31 reporting areas; excludes 21 reporting areas (California, Colorado, Connecticut, District of Columbia, Hawaii, Illinois, Iowa, Louisiana, Maryland, Massachusetts, Nebraska, New Hampshire, New Jersey, New York State, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, Washington, and Wisconsin) that did not report, did not report weeks of gestation by race and ethnicity, or did not meet reporting standards.
^¶ Including Alaska Native, American Indian, Asian (Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, or other Asian), Native Hawaiian or other Pacific Islander (Native Hawaiian, Guamanian or Chamorro, Samoan, or other Pacific Islander), other races, and multiple races.

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. Case-fatality rates were computed for consecutive 5-year periods during 1973–2012 and then for a consecutive 8-year period during 2013–2020 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 or jurisdiction law.
^¶ Unknown whether abortion was induced or spontaneous.