Iowa’s 2021 vital statistics report, which includes the state’s abortion statistics, was published online by the Iowa Department of Public Health in April 2023.
Statistics and Changes in Iowa Abortions, 2020-2021
The report does not include information on Planned Parenthood’s Iowa abortion market share.
Abortion Totals and Trends
There were 3,761 abortions reported in Iowa in 2021, down seven percent from 2020 (Fig. 1). Chemical abortions also decreased by seven percent but still composed 80 percent of the total in 2021, similar to 2020 when chemical abortions made up 79 percent of the total. The Charlotte Lozier Institute (CLI) estimates that Iowa’s abortion rate decreased by eight percent to 6.2 abortions per 1,000 women ages 15 to 44 (Fig. 2). As of June 2023, 31 states had released 2021 abortion reports, with eight states showing decreases in abortion totals from the previous year.
State Report Summary
Eighty-four percent of Iowa abortions were performed on resident women, while 16 percent were obtained by nonresidents. Eleven percent of the abortions were performed on girls younger than 20, including four percent on girls under the age of 18 and seven percent on girls between the ages of 18 and 19. Thirty-one percent of Iowa abortions were performed on women ages 20 to 24, and 27 percent were performed on women ages 25 to 29. Twenty-eight percent occurred to women in their thirties, and four percent were performed on women ages 40 and older.
A majority of Iowa abortions, 68 percent, were obtained by white women. Twenty percent were performed on African American women, and three percent were on Asian women. One percent of the abortions were performed on Native American women and 11 abortions were on Native Hawaiian or Pacific Islander women, while four percent were on women of other or unknown races and another four percent on women of multiple races. CLI estimates that Iowa’s black abortion rate was 23.7 abortions per 1,000 women ages 15-44 and five times higher than the white abortion rate of 4.8 abortions per 1,000 women.
Over half of Iowa abortions (55 percent) were performed on women who had completed at least some college, and 43 percent were on women with nine to 12 years of education. One percent of the abortions were obtained by women with fewer than nine years of education, while education status was not reported for one percent of the abortions. A little over 85 percent of Iowa abortions were on unmarried women, while not quite 15 percent were on married women. Marital status was not reported for four abortions.
A large majority of Iowa abortions were chemically induced (80 percent). Twenty percent were surgical, and one abortion was performed using some other means. Ninety-five percent of the abortions reported in Iowa occurred in the first trimester at or before 13 weeks of gestation. Five percent of the abortions were performed between 14 and 28 weeks of gestation. Zero abortions were reported at 29 weeks or later. The month of March had the most abortions (420), while November had the fewest (251).
Legislative Changes
Iowa passed a heartbeat law in 2018 and it was set to go into effect on July 1, 2018. However, the courts placed a temporary injunction on its enforcement on June 1, 2018 and then a permanent injunction on its enforcement in January 2019. Following the overturning of both an Iowa Supreme Court decision finding that the state constitution conferred a right to an abortion and Roe v. Wade in June 2022, Iowa Governor Kim Reynolds asked that the state courts lift the injunction on the law. In December 2022, a state judge declined to lift the injunction. Governor Reynolds appealed the decision to the state Supreme Court and on April 11, 2023, the Iowa Supreme Court heard oral arguments regarding the constitutionality of the heartbeat law. While litigation continues and the Iowa Supreme Court decides on this case, abortion remains legal in Iowa until 22 weeks gestation.
State Ranking
In 2016, Iowa tied for 33rd best in CLI’s review of abortion reporting across the country. Iowa could report gestational age with more specificity instead of grouping together 14 weeks into one range, as CLI has previously recommended. Additionally, Iowa could collect and report abortion complication data, particularly from emergency rooms and other urgent care settings. Chemical abortions have higher rates of complications and emergency room visits than surgical abortions, and as chemical abortions make up a larger and larger share of Iowa abortions, chemical abortion-related ER visits are likely to increase.
- Rates were calculated by CLI using the following formula: (total number of abortions performed in Iowa ÷ 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. 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 2020-2021 are Vintage 2021 postcensal estimates of the July 1 resident population. Estimates were produced by the U.S. Census Bureau and the National Center for Health Statistics.
