Alabama’s 2023 abortion report was published online by the Alabama Department of Public Health in August 2024, showing that abortions decreased significantly from 2022.
Statistics and Changes in Alabama Abortions, 2022-2023
Planned Parenthood’s abortion market share reflects all abortions reported in Alabama.
Abortion Totals and Trends
In 2023, there were only seven abortions reported in Alabama, down 99.8% from the previous year. Drug-induced abortions also decreased by 99.8% in 2023, from 2,186 in 2022 to four in 2023 (Fig. 1). The Charlotte Lozier Institute (CLI) estimates that Alabama’s abortion rate decreased by 99.8% to 0.007 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 46% from 6,154 in 2022 to 3,307 in 2023. As of November 2024, 21 states have released 2023 statistics, with 12 showing that abortions had decreased from 2022.
State Report Summary
Abortions Performed on Alabama Residents
Six percent of Alabama resident abortions were performed on girls under the age of 20. Thirty percent of abortions were performed on women ages 20 to 24 and another 30% on women ages 25 to 29, while 31% of the abortions were obtained by women in their thirties. Two percent of the abortions were on women over the age of 40.
Sixty-nine percent of Alabama resident abortions were performed on black women. Twenty-five percent were obtained by white women, and 4% were on women of a different race. Race was not reported for 3% of the abortions. The black abortion rate, 7.5 abortions per 1,000 women ages 15 to 44, was six times the white abortion rate of 1.3. A majority of the abortions, 93%, were performed on unmarried women, compared to 7% on married women and not quite 1% (0.7%) on women of unknown marital status.
Over a third of the abortions performed on Alabama residents (36%) were obtained by women with no previous live births. Twenty-eight percent were obtained by women with one prior live birth, and 36% by women with two or more live births. Most abortions (69%) were performed on Alabama women with no previous abortions. Twenty percent were on women with one prior abortion, and 11% were obtained by women with two or more previous induced abortions.
Half of the abortions were performed on resident women who had completed at least some college. Forty-eight percent were on women who had completed 12th grade as their highest level of education. Less than 1% (0.5%) were on women with an 11th grade education or less, and education was not reported for 2% of abortions
Ninety-seven percent of the abortions performed on Alabama women occurred at six weeks of gestation or earlier. In contrast, only 43% of abortions performed on Alabama residents in 2022 were performed at six weeks of gestation or earlier. One percent of Alabama resident abortions in 2023 were performed between seven and eight weeks of gestation, and less than 1% (0.5%) between nine and 10 weeks. Seven abortions were performed between 11 and 12 weeks, while five were performed between 13 and 14 weeks and six between 15 and 19 weeks. Seven abortions were performed at 20 weeks or later. Two abortions were performed at unknown gestational ages.
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 seven abortions reported in Alabama in 2023.
One abortion occurring in Alabama (14%) was performed on a girl under the age of 20 and another one was performed on a woman between ages 25 and 29. Five abortions (71%) were performed on women in their thirties.
Alabama requires that parental consent be provided before an abortion is performed on a minor under the age of 18 (Ala. Code § 26-21-3). In 2023, there was one abortion for which parental consent was required. Parental consent was not provided in the one required case because of an unspecified medical emergency.
Three abortions were performed on white women and two abortions each were performed on black women and women of other races. One abortion was performed via suction curettage, four via abortion drugs, and two via induction abortions using other, unspecified means. It was unknown in one case if an intra-fetal injection was used to kill the unborn baby while an intra-fetal injection was not used with the six other abortions.
Alabama reports all abortions occurring in the state using probable post-fertilization age (pfa), rather than gestational age, which the state uses to report abortions performed on resident women. Post-fertilization age dates pregnancy from fertilization. In 2023, one abortion was performed between 11 and 12 weeks pfa, five between 15 and 19 weeks pfa, and one at 20 weeks postfertilization or later. The reason for this post-20-week abortion was not reported. For six of the seven abortions performed in Alabama it was unknown whether the method of abortion was one that provided the best opportunity for the unborn child to survive.
The astronomical decrease in the number of abortions performed in Alabama and on Alabama residents in Alabama or other states can be attributed to the state’s life at conception law going into effect on June 24, 2022, with the overturning of Roe v. Wade. Surrounding states (Mississippi and Tennessee) also had life at conception laws go into effect after Roe was overturned and other surrounding states (Georgia and Florida) had other gestational limits go into effect. These legislative changes in Alabama and the states that border it greatly contributed to the decrease in both resident abortions and abortions occurring in the state.
Alabama Abortion Centers
In 2023, there were two operational abortion centers in Alabama: one operated by Planned Parenthood and one independent center. Unlike in previous years, Planned Parenthood of Alabama, Reproductive Health Services of Montgomery, and West Alabama Women’s Center did not provide abortions in 2023. Alabama Women’s Center for Reproductive Alternatives performed six abortions (86%) and Planned Parenthood of Mobile, one (14%). As of 2024, Planned Parenthood of Mobile appears to be closed for business and while Alabama Women’s Center provided six abortions in 2023, its website says, “Due to the overturning of Roe v. Wade, as of June 24th we are unable to perform surgical and non-surgical abortions until further notice.”
Alabama Women’s Center performed four drug-induced abortions and two induction abortions while Planned Parenthood of Mobile performed one suction curettage abortion at 11 to 15 weeks post-fertilization. Alabama Women’s Center performed five abortions between 16 and 19 weeks postfertilization and one at 20 weeks postfertilization or later.
State Ranking
In CLI’s 2024 reevaluation of abortion reporting across the 50 states, the District of Columbia, and New York City, Alabama was tied for 12th best in the nation. 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 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. 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. Rates for 2023 were calculated using the Vintage 2022 postcensal estimates because 2023 population estimates have not yet been released by the CDC.
- The changes in total abortions and drug-induced abortions reflect all abortions reported in Alabama. Alabama first reported drug-induced abortions as a separate type of procedure in 2012.
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