Alabama’s 2022 abortion report was published online by the Alabama Department of Public Health in October 2023, showing that abortions decreased significantly from 2021.
Statistics and Changes in Alabama Abortions, 2021-2022
Planned Parenthood’s abortion market share reflects all abortions reported in Alabama.
Abortion Totals and Trends
In 2022, there were 3,777 abortions reported in Alabama, down 42% from the previous year (Fig. 1). Chemical abortions also significantly decreased, from 3,653 in 2021 to 2,186 in 2022 (a decrease of 40%). The Charlotte Lozier Institute (CLI) estimates that Alabama’s abortion rate decreased by 42% to 3.8 abortions per 1,000 women ages 15 to 44 (Fig. 2).1 Alabama separately reports the number of abortions performed on state residents, both in Alabama and other states, although not all states share abortion data with Alabama. Abortions known to have been performed on Alabama residents decreased by 26% from 8,294 in 2021 to 6,154 in 2022. As of November 2023, 23 states have released 2022 statistics, with 10 reporting that abortions had decreased from 2021.
State Report Summary
Abortions Performed on Alabama Residents
Nine percent of Alabama resident abortions were performed on girls under the age of 20. Thirty-two percent of abortions were performed on women ages 20 to 24 and 30% on women ages 25 to 29, while 27% of the abortions were obtained by women in their thirties. Three percent of the abortions were on women over the age of 40.
Over two-thirds of Alabama resident abortions, 67%, were performed on black women. Twenty-seven percent were obtained by white women, and 3% were on women of a different race. Race was not reported for 3% of the abortions. The black abortion rate, 13.6 abortions per 1,000 women ages 15 to 44, was five times the white abortion rate of 2.6. A majority of the abortions, 89%, were performed on unmarried women, compared to 9% on married women and not quite 2% on women of unknown marital status.
Just over a third of the abortions performed on Alabama residents (34%) were obtained by women with no previous live births. Twenty-nine percent were obtained by women with one prior live birth, and 37%by women with two or more live births. Most abortions (63%) were performed on Alabama women with no previous abortions. Twenty-three percent were on women with one prior abortion, and 13% were obtained by women with two or more previous induced abortions.
Under half the abortions, 48%, were performed on resident women who had completed at least some college. Forty-three percent were on women who had completed 12th grade as their highest level of education. Four percent were on women with an 11th grade education or less, and education was not reported for 4% of the abortions.
Forty-three percent of the abortions performed on Alabama women occurred at six weeks of gestation or earlier. Twenty-seven percent were performed between seven and eight weeks of gestation, dropping to 15% between nine and 10 weeks. Six percent were performed between 11 and 12 weeks, while 4% each were performed between 13 and 14 weeks and 15 to 19 weeks. One percent (50 abortions) were performed at 20 weeks or later, with two being performed at 26 weeks or later.
Because zero abortions were reported to have occurred in Alabama after 20 weeks post-fertilization (22 weeks of gestation), it is likely that the two abortions that occurred at 26 weeks or later were performed on Alabama residents in other states. Until Roe v. Wade was overturned on June 24, 2022, Alabama limited abortion to 20 weeks post-fertilization (around 22 weeks of gestation) unless a woman’s life or major bodily function was at risk. On the day that Roe was overturned, the state started prohibiting abortion at any point in pregnancy except in the cases where the life of the mother was endangered or the unborn child had a “lethal fetal anomaly.”
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 3,777 abortions reported in Alabama in 2022.
Ten percent of the abortions occurring in Alabama were performed on girls under the age of 20. Thirty-three percent were on women ages 20 to 24, and 28% were obtained by women ages 25 to 29. Twenty-six percent were performed on women in their thirties, and 3% were performed on women ages 40 or older.
Alabama requires that parental consent be provided before an abortion is performed on a minor under the age of 18. In 2022, there were 105 abortions for which parental consent was required and two abortions on minors for which it was not required because both girls were married. Parental consent was provided in 104 cases. In one case, it was not reported whether parental consent was obtained.
Just under two-thirds of the abortions, 63%, were performed on black women, even though black women compose just 31% of Alabama’s female population ages 15 to 44. Thirty-three percent of the abortions were obtained by white women, and 3% were obtained by women of other races. Race was not reported for 2% of the abortions. CLI estimates that the black abortion rate for abortions occurring in Alabama was 7.9 abortions per 1,000 women ages 15 to 44, four times the white abortion rate of 1.9.
Thirty-five percent of the abortions reported in Alabama were conducted using suction curettage. Fifty-eight percent were chemical abortions, and 6% were dilation and evacuation procedures. One percent (42 abortions) were performed using electric vacuum aspiration. One sharp curettage abortion was performed. There were nine abortions performed via induction with prostaglandins. Three abortions were performed by other means. 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 the state uses to report abortions performed on resident women. Post-fertilization age dates pregnancy from fertilization. In 2022, 56% of the abortions reported in the state occurred at six weeks post-fertilization or earlier. Twenty-two percent were performed between seven and eight weeks post-fertilization, and 9% occurred between nine and 10 weeks. Six percent of the abortions were performed between 11 and 12 weeks post-fertilization, while 3% occurred between 13 and 14 weeks and 4% from 15 to 19 weeks post-fertilization. One abortion was reported at 20 weeks post-fertilization, with none occurring after that. The reason for this post-20-week abortion was not reported. Two abortions occurred at an unknown post-fertilization age.
Alabama Abortion Centers
In 2022, there were five operational abortion centers in Alabama: two operated by Planned Parenthood and three independent centers. That same year, the two Planned Parenthood locations accounted for 5% of the total number of abortions that occurred in Alabama. Planned Parenthood of Alabama in Birmingham performed 101 abortions and Planned Parenthood of Mobile, 82. The three independent centers were responsible for the remaining 95% of abortions that occurred in Alabama in 2022. Alabama Women’s Center for Reproductive Alternatives performed 1,328 abortions (35% of the total), Reproductive Health Services of Montgomery performed 860 abortions (23%), and West Alabama Women’s Center performed 1,406 abortions (37%).
Alabama Women’s Center performed the abortion that occurred at 20 weeks post-fertilization. The three independent centers performed 93% of the total number of chemical abortions that occurred in Alabama (2,186 abortions). Chemical abortions accounted for 72% of the total abortions that Planned Parenthood’s Birmingham center performed and all the abortions that Planned Parenthood of Mobile performed.
State Ranking
In CLI’s 2016 review of abortion reporting across the 50 states, the District of Columbia, and New York City, Alabama was ranked at 12th best. To improve its reporting, as CLI has previously recommended, Alabama could report demographic information for all abortions occurring in the state. Additionally, Alabama could report the states to which Alabama residents travel for abortions, as well as the states of residence for nonresidents who obtain abortions in Alabama. Lastly, Alabama could also report abortion complication data.
- National rates were calculated by the Guttmacher Institute. Alabama rates were calculated by CLI using the following formula: (total number of abortions performed in Alabama ÷ number of resident women ages 15-44 [based on most recent population estimates]) x 1,000. Rates may differ slightly from previous CLI articles due to revised population estimates. Rates reflect all abortions reported in Alabama. Population estimates were obtained from CDC WONDER. Estimates for 2005-2009 are intercensal estimates of the July 1 resident population. Estimates for 2010-2019 are Vintage 2020 postcensal estimates of the July 1 resident population. Estimates for 2020-2022 are Vintage 2022 postcensal estimates of the July 1 resident population. Estimates were produced by the U.S. Census Bureau and the National Center for Health Statistics.
- The changes in total abortions and chemical abortions reflect all abortions reported in Alabama. Alabama first reported chemical abortions as a separate type of procedure in 2012.
