Abortion Reporting: Alabama (2020)
Alabama’s 2020 abortion report was published online by the Alabama Department of Public Health in December 2021, showing that abortions reported in Alabama declined from 2019.
Statistics and Changes in Alabama Abortions, 2019-2020
The changes in total abortions, chemical abortions, and the abortion rate, as well as Planned Parenthood’s abortion market share, reflect all abortions reported in Alabama.
Abortion Totals and Trends
In 2020, there were 5,713 abortions reported in Alabama, down five percent from the previous year (Fig. 1). However, chemical abortions increased by 20 percent, composing 44 percent of the total. The Charlotte Lozier Institute (CLI) estimates that Alabama’s abortion rate declined by five percent to 6.0 abortions per 1,000 women ages 15-44 (Fig. 2). Alabama separately reports the number of abortions performed on state residents, both in Alabama and in other states, although not all states share abortion data with Alabama. Abortions known to have been performed on Alabama residents decreased by one percent from 2019. As of June 2022, 29 states had released 2020 abortion statistics, with 19 states reporting that abortions had decreased from the previous year.
State Report Summary
Abortions Performed on Alabama Residents
Eight percent of Alabama resident abortions were performed on girls under the age of 20; the youngest girl to undergo an abortion was 11. Thirty-one percent each were performed on women ages 20 to 24 and 25 to 29, while 27 percent of the abortions were on women in their thirties, and two percent were on women over the age of 40.
Two-thirds of Alabama resident abortions were performed on black women. Twenty-nine percent were obtained by white women, and three percent were on women of a different race. Race was not reported for one percent of the abortions. A majority of the abortions, over 88 percent, were performed on unmarried women, compared to nine percent on married women and two percent on women of unknown marital status.
Nearly a third of the abortions performed on Alabama residents (32 percent) were obtained by women with no previous live births. Twenty-eight percent were performed on women with one prior live birth, and 39 percent were on women with two or more live births. The majority of the abortions (65 percent) were performed on Alabama women with no previous abortions. Twenty-three percent were on women with one prior abortion, and 12 percent were obtained by women with two or more previous abortions.
Just over half of Alabama resident abortions, 51 percent, were performed on women with at least some college. Forty percent were on women who had completed 12th grade as their highest level of education, and five percent were on women with an 11th-grade education or less. Education was not reported for four percent of the abortions.
Thirty percent of the abortions performed on Alabama women occurred at six weeks of gestation or earlier. Thirty-five percent were performed between seven and eight weeks, dropping to 17 percent between nine and 10 weeks of gestation. Seven percent were performed between 11 and 12 weeks, while five percent each occurred between 13 to 14 and 15 to 19 weeks of gestation. One percent (75 abortions) were performed at 20 weeks of gestation or later.
Abortions Performed in Alabama
Separately, Alabama reports on all abortions that occurred in the state, including those performed on both resident and nonresident women. There were 5,713 abortions reported in Alabama in 2020.
Nine percent of the abortions occurring in Alabama were performed on girls under the age of 20. Thirty-one percent were on women ages 20 to 24, and another 31 percent were obtained by women ages 25 to 29. Twenty-seven percent were performed on women in their thirties, and two percent were performed on women ages 40 and older.
Alabama requires that parental consent be provided before an abortion is performed on a minor girl under the age of 18. In 2020, there were 155 abortions for which parental consent was required, and one abortion for which it was not reported whether parental consent was required. Parental consent was provided in 151 cases. In one instance, a court order waived the consent requirement. For four of the abortions, it was not reported whether parental consent was obtained.
Two-thirds of the abortions were performed on black women, even though black women compose just 31 percent of Alabama’s population of women ages 15 to 44. Thirty percent of the abortions were obtained by white women, and three percent were performed on women of other races. CLI estimates that Alabama’s black abortion rate was 12.8 abortions per 1,000 women ages 15 to 44, nearly five times the white rate of 2.8.
Forty-nine percent of the abortions reported in Alabama were conducted using suction curettage. Forty-four percent were chemical abortions, and five percent were dilation and evacuation procedures. One percent (57 abortions) were performed using electric vacuum aspiration, and three abortions were manual vacuum aspiration procedures. There were four sharp curettage abortions and one abortion performed with a combination of dilation and evacuation and induction. The method of abortion was not reported in nine cases. In one case, an intra-fetal injection was used to kill the unborn baby.
Alabama reports all abortions occurring in the state using probable post-fertilization age, rather than gestational age, which it uses to report abortions performed on resident women. Post-fertilization age dates pregnancy from fertilization and is typically two weeks less than gestational age, which dates pregnancy from the woman’s last menstrual period. Alabama limits abortion at 20 weeks post-fertilization. In 2020, 60 percent of the abortions reported in the state occurred at six weeks post-fertilization or earlier. Nineteen percent were performed between seven and eight weeks post-fertilization, and eight percent occurred between nine and 10 weeks. Six percent of the abortions were performed between 11 and 12 weeks post-fertilization, while three percent occurred between 13 and 14 weeks and four percent from 15 to 19 weeks post-fertilization. Zero abortions were reported at 20 weeks post-fertilization or later.
Alabama Abortion Centers
In 2019, Planned Parenthood reported zero abortions in Alabama. However, that changed in 2020 when Planned Parenthood opened a new abortion center in Birmingham and completed renovations of its Mobile center. The two centers did not begin performing abortions until partway through the year. In 2020, the Birmingham center reported 210 abortions and the Mobile center reported 21, together accounting for four percent of total Alabama abortions. Seventy-four percent of Planned Parenthood abortions were chemical, compared to 43 percent of the abortions reported by other abortion centers.
West Alabama was the highest-volume abortion center in 2020, performing 45 percent of the abortions. Thirty-five percent of the abortions occurred at Alabama Women’s Center for Reproductive Alternatives, and 16 percent were reported by Reproductive Health Services of Montgomery.
In CLI’s 2016 review of abortion reporting across the 50 states, Alabama was ranked at 12th best. To improve its reporting, Alabama could report demographic information for all abortions occurring in the state, as CLI has recommended in previous articles. Additionally, Alabama could report the states to which Alabama residents travel for abortions, as well as the states of residence of non-Alabama women who obtain abortions in Alabama. Alabama could report gestational age in addition to the post-fertilization age of abortions performed in the state. Alabama could also report abortion complication data and follow up with abortion providers when information is missing regarding the parental consent process.
- 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 CDC WONDER.
Percentages may not add to 100% due to rounding.