Alabama’s 2019 abortion report was published online in February 2021. According to the report, abortions in the state declined from 2018.
Statistics and Changes in Alabama Abortions, 2018-2019
Abortion Totals and Trends
There were 6,009 abortions reported in Alabama in 2019, down seven percent from the previous year (Fig. 1). Conversely, chemical abortions increased by three percent to 2,089, making up 35 percent of the total in 2019. The Charlotte Lozier Institute (CLI) estimates that Alabama’s state abortion rate was 6.3 abortions per 1,000 women ages 15-44, a decrease of seven percent from 2018 (Fig. 2). As of August 2021, 39 states had released 2019 abortion statistics, including 21 that showed increases from the previous year.
Separately, Alabama reports the number of abortions performed on Alabama residents, both in Alabama and in other states, although not every state shares this information with Alabama. In 2019, Alabama was aware of 7,538 abortions performed on residents, up two percent from the year before.
State Report Summary
Abortions on Alabama Residents
Thirty percent of the abortions performed on Alabama residents were obtained by women ages 20 to 24, and another 30 percent were on women ages 25 to 29. Twenty-seven percent were on women in their thirties, and three percent were on women age 40 and above. Nine percent of the abortions were on girls under the age of 20.
Sixty-three percent of the abortions were performed on black women, even though black women compose just 31 percent of all Alabama women ages 15 to 44. Thirty-two percent of the abortions were performed on white women, and four percent were performed on women of other races. One percent of the abortions were on women whose race was unreported. Ten percent of the abortions were on married women, 89 percent on unmarried women, and one percent on women of unknown marital status.
Nearly two-thirds of Alabama resident abortions (65 percent) were on women who had already had live births. Twenty-nine percent were on women with one previous live birth, and 38 percent on women with two or more live births. Conversely, almost two-thirds of the abortions (66 percent) were performed on women with no previous abortions. Twenty-three percent of the abortions were on women with one prior abortion, and 11 percent were performed on women with more than one.
Six percent of the abortions were performed on women with less than a high school education. Forty percent of the women reported that twelfth grade was the highest completed, and 53 percent had finished 13 or more years of education. Education was not reported for one percent of the women undergoing abortions.
Twenty-seven percent of the abortions performed on Alabama residents occurred at six weeks of gestation or earlier. Over a third (34 percent) were performed between seven and eight weeks, and 18 percent were performed between nine and 10 weeks of gestation. Nine percent of the abortions occurred between 11 and 12 weeks, dropping to eight percent between 13 and 15 weeks and four percent between 16 and 19 weeks of gestation. One percent (81 abortions) occurred at 20 weeks of gestation or later.
All Abortions Occurring in Alabama
Separately, Alabama shares information on all abortions reported in the state, including those performed on nonresident women. In 2019, 30 percent of the abortions were performed on women ages 20 to 24 and another 30 percent were on women ages 25 to 29. Twenty-eight percent of the abortions were obtained by women in their thirties, three percent were on women age 40 or older, and nine percent were on girls under the age of 20.
In Alabama, before an abortion may be performed on a minor under the age of 18, the minor’s parent or guardian must provide written consent. Alternatively, the minor can petition a court for a waiver of the parental consent requirement, and consent is not required in medical emergencies. There were 153 abortions performed on minor girls in 2019. In 151 cases, the parent or guardian provided consent, and in two instances, the girls obtained court orders exempting them from the parental consent requirement. No medical emergencies were reported.
The majority of the abortions occurring in Alabama (62 percent) were performed on black women. Thirty-five percent were obtained by white women, and three percent were performed on women of other races.
Instead of reporting gestational age as it does for abortions performed on state residents, Alabama uses post-fertilization age for all abortions occurring in the state. Post-fertilization age is typically two weeks less than gestational age. Alabama limits abortion at 20 weeks post-fertilization (around 22 weeks of gestation) unless a woman’s life or a major bodily function is at risk. If an abortion after 20 weeks is necessary, the doctor must use the procedure most likely to protect the unborn baby’s life, unless doing so would put the mother at increased risk.
In 2019, 55 percent of the abortions were performed at six weeks post-fertilization or earlier. A fifth were performed between seven and eight weeks, and 10 percent were reported from nine to 10 weeks. Six percent of the abortions were performed between 11 and 12 weeks, five percent between 13 and 15 weeks, and three percent between 16 and 19 weeks post-fertilization. Two abortions were reported at 20 weeks post-fertilization or later. Post-fertilization age was reported as unknown for six abortions, even though the reporting forms indicated that post-fertilization age had been determined in advance of all 6,009 abortions. In every case, ultrasound was used to measure post-fertilization age.
One of the abortions after 20 weeks post-fertilization was performed due to severe or life-threatening chorioamnionitis or sepsis; the other was performed for another unspecified reason. Both abortions were performed using a procedure that would give the unborn baby the best chance of surviving.
Suction curettage was the most frequently reported procedure, used for 59 percent of the abortions occurring in Alabama. Thirty-five percent were chemical abortions, and six percent were performed via dilation and evacuation (dismemberment abortions). There were two induction abortions using prostaglandins, and 23 combined induction and dilation and evacuation procedures. One abortion was conducted using electrical vacuum aspiration. The type of procedure was not reported for five abortions. There were no cases in which an intra-fetal injection was used in an attempt to kill the baby before the abortion.
Alabama Abortion Centers
In 2021, Alabama Department of Public Health listed five licensed abortion or reproductive health centers – three independent centers and two Planned Parenthood centers. However, in 2019, only the three independent centers reported abortions. Planned Parenthood’s Mobile center was closed for renovations in 2019, and the Birmingham center moved to a new location.
West Alabama Women’s Center performed 47 percent of the total in 2019, followed by Alabama Women’s Center for Reproductive Alternatives with 32 percent and Reproductive Health Services of Montgomery with 21 percent. West Alabama Women’s Center reported zero abortions after 15 weeks post-fertilization, while Reproductive Health Services reported just one between 16 and 19 weeks. In 2019, almost all abortions after 15 weeks post-fertilization, including the two abortions performed at 20 or more weeks, were reported by Alabama Women’s Center for Reproductive Alternatives.
In 2020, West Alabama Women’s Center was purchased by the Yellowhammer Fund, a pro-abortion organization, and the center has announced that starting in 2021, it will perform abortions up to 21 weeks and 6 days of gestation.
In a 2016 CLI survey of abortion reporting across the United States, Alabama’s reporting was ranked at 12th best. As CLI has previously noted, Alabama could improve its reporting by including the state of residence for nonresident women who obtain abortions in Alabama. Alabama could also add more demographic information for all abortions occurring in the state, including those performed on nonresidents. Additionally, Alabama could collect and report data on abortion complications.
- The 2012 abortion report is the earliest with information on the types of abortion procedures performed in Alabama.
- Rates were calculated by CLI using the following formula: (total number of abortions performed in Alabama ÷ number of resident women ages 15-44) x 1,000. Rates may differ slightly from previous CLI articles due to revised population estimates. Population estimates were obtained from the CDC WONDER database.