Abortion Reporting: Kentucky (2023)

Kentucky’s 2023 abortion report was published by the Kentucky Cabinet for Health and Family Services in September 2024. In their 2023 report, the Cabinet published several new categories of data and discontinued the reporting of certain categories. Abortions occurring in Kentucky significantly decreased from 2022 to 2023. Charlotte Lozier Institute (CLI) is summarizing the information in the abortion report published by the state. This data does not include all of the abortions obtained by Kentucky residents out of state or the number of abortion drugs obtained or taken by Kentucky residents prescribed by licensed abortion providers in other states under their shield laws. Lastly, the Kentucky report does not include the number of self-managed abortions performed by women outside of the healthcare system. In a separate section, CLI will describe data provided by the Guttmacher Institute’s Monthly Abortion Provision Study that details the number of abortions obtained by Kentucky women in other states.

Statistics and Changes in Kentucky Abortions, 2022-2023

Abortion Totals and Trends

There were 23 abortions reported in Kentucky in 2023, a 99% decrease from the previous year (Fig. 1). Drug-induced abortions performed in the state also decreased by 99%, from 1,256 in 2022 to 10 in 2023. Drug-induced abortions composed 43% of the total in 2023. CLI estimates that Kentucky’s abortion rate was 0.03 abortions per 1,000 women of childbearing age (Fig. 2).¹ As of October 2024, 21 states have released 2023 abortion statistics, of which 12 showed that abortions decreased from the previous year.

State Report Summary

In 2023, all but one of the abortions reported in Kentucky were performed on state residents. One abortion was performed in Kentucky on an Illinois resident. One abortion was performed on a girl between the ages of 15-19 and, as the report notes, no abortions were performed on a minor in 2023. Four abortions were obtained by women ages 20 to 24 and eight were obtained by women ages 25 to 29. Eight abortions were performed on women in their thirties and two were performed on women whose age was unknown. For the first time, the 2023 abortion report detailed the number of abortions by the age of the father. Three abortions killed unborn babies whose father was between the ages of 25-29 and one was on a baby whose father was between the ages of 35 and 39. The age of the father was not known for 19 of the reported abortions.

Eleven of the abortions were performed on white women while four each were performed on black women and women of an unknown race. One abortion was obtained by an Asian woman and three were performed on women of another, unspecified race. Seven abortions were obtained by Hispanic women while 16 were obtained by non-Hispanic women.

Eleven of the abortions reported in Kentucky were obtained by women with no previous live births. Five were performed on women with one previous live birth and seven on women who had two or more previous live births. Similarly, 11 abortions were obtained by women who had never had a previous abortion and seven by women who had one previous abortion. Four abortions were performed on women who had two or more previous abortions and one on a woman whose previous abortion history was unknown. For the first time, the 2023 abortion report included information on the number of abortions by previous total pregnancies. Four abortions were obtained by women who had not previously been pregnant while six abortions were obtained by women who had one previous pregnancy. Thirteen abortions were performed on women who had two or more previous pregnancies.

Ten of the abortions reported in Kentucky were drug-induced. One abortion was performed via a dilation and evacuation procedure and another one via hysterectomy or hysterotomy. Three were performed using the suction curettage procedure. Eight abortions were performed by other means, including:

• 1 “medical non-surgical”
• 1 uterine wedge resection
• 1 laparoscopic ectopic resection
• 3 laparoscopic salpingectomies
• 2 salpingectomies

One abortion was performed at five weeks of gestation or earlier. Five were performed at six weeks of gestation and another five were performed between seven and eight weeks of gestation. One abortion was performed between nine and 10 weeks of gestation and three were performed between 13 and 15 weeks. Seven were performed between 16 and 19 weeks and one was performed at 21 weeks. The 2023 report was the first of Kentucky’s annual reports to describe what methods were used to confirm the gestational ages of the unborn babies killed by abortion. Ultrasound alone was used in 14 cases while a woman’s last menstrual period was on its own used in three cases. A combination of an ultrasound and a woman’s last menstrual period was used in two cases and another two cases used transvaginal ultrasounds. A transabdominal ultrasound was used in one case, and one case used an unknown method to determine the unborn baby’s gestational age.

Kentucky also collects data on abortions by post-fertilization age, which is around two weeks earlier than the unborn babies’ gestational age. Four abortions were performed at four weeks post-fertilization or earlier and four were performed between five and six weeks. Three abortions were performed between seven and eight weeks post-fertilization. One abortion was performed between 11 and 12 weeks and one between 13 and 14 weeks. There were four abortions performed between 15 and 17 weeks post-fertilization, two between 18 and 19 weeks, and one at 20 weeks or later. The post-fertilization age was unknown in three cases. Ultrasound alone was used to confirm the post-fertilization age of 13 aborted unborn babies. One case utilized a woman’s last menstrual period to confirm the post-fertilization age and a combination of both an ultrasound and a woman’s last menstrual period was used in three cases. A quantitative hCG test was used in two cases and the method of confirmation was unknown in four cases.

Kentucky’s 2023 abortion report was the fourth to include information on complications from abortions performed in the state.² In 2023, there were two reported complications. There was one reported case of heavy bleeding that caused symptoms of hypovolemia or the need for a blood transfusion and one reported case for another, unspecified complication that caused the woman to go to the emergency room for abdominal pain.

Unlike in years past and most likely due to Kentucky’s law prohibiting elective abortions, no abortions were performed at Planned Parenthood locations in Kentucky or at independent abortion centers. All 23 abortions were performed at hospitals. Four were performed at Baptist Health’s Lexington location and two were performed at Baptist Health’s Paducah location. Six abortions were performed at Norton Women’s and Children’s Hospital, and one was performed at The Medical Center (the exact location of this hospital was not included in the report). Nine abortions were performed at the University of Louisville, and one was performed at the University of Louisville Health Mary and Elizabeth Hospital.

To see how the state’s life at conception law impacted abortion totals in the state, see the abortion totals by month in 2021 when the state limited abortion at 22 weeks of gestation, 2022 when the state’s life at conception law went into effect halfway through the year after Roe v. Wade (1973) was overturned in June 2022, and 2023 when the law was in effect for the entire year:

Additional Information Included in the 2023 Abortion Report

In addition to some of the new data points described in previous sections of this report, Kentucky’s 2023 abortion report also included data points related to the exceptions to its pro-life law and other related data. While elective abortion is prohibited in the state, medical care (different from an elective abortion) is permitted in cases where the mother’s life or physical health is endangered.²

In fifteen cases, an abortion was performed on a woman who had a preexisting, unspecified medical condition, while eight women who obtained abortions in Kentucky did not have a preexisting medical condition. Women were tested for an STD in seven cases and were not tested in 16 cases. In five cases, women with Rh negative status were “provided with a Rh negative information fact sheet and treated with the prevailing medical standard of care to prevent harmful fetal or child outcomes or Rh incompatibility in future pregnancies.” In six cases, the fact sheet was not given to the woman obtaining an abortion and whether the fact sheet was given to the woman was unknown in 12 cases.

The heartbeat of 18 of the 23 unborn children aborted in Kentucky in 2023 was detected. A heartbeat was not detected in five of the unborn babies. Methods used to detect the heartbeat in 18 of the cases include ultrasounds, transvaginal ultrasounds, doppler transabdominal ultrasounds, and unknown methods. The unborn child was not viable in 22 cases and the viability was unknown in one case.

With all 23 abortions, the attending physician reported the abortion was necessary to save the mother’s life or physical health. The report goes into further detail when describing the medical reasons why the physicians considered the abortions necessary:

• There were 12 cases where the mother’s life was endangered. Three of the threats came from a combination of sepsis and Preterm Premature Rupture of Membranes (PPROM). Two of the threats to the mother’s life stemmed from a ruptured ectopic pregnancy and one from hemorrhage and sepsis.
• There were two cases of PPROM and one case of previable PPROM.
• There were five cases of an ectopic pregnancy, one case of a cornual ectopic pregnancy, and one case of an ectopic pregnancy that had implanted in a prior cesarean section scar.
• There was one case of a combination of severe preeclampsia, pulmonary edema, and liver failure at 18 weeks of gestation.³

A pathological examination was conducted on 13 of the unborn children, while an examination was not performed on nine of the unborn children. It is unknown in one case whether a pathological examination was performed. In 2023, no babies were born alive following an attempted abortion.

Guttmacher Data⁴

Guttmacher estimated the number of abortions that were obtained by Kentucky residents who traveled to other states to obtain an abortion. To see the number of abortions obtained by Kentucky women in various states according to Guttmacher, see below:

State Ranking

In CLI’s 2024 reevaluation of states’ abortion reporting requirements, Kentucky was tied for fourth best. The state has vastly improved their reporting since 2016 when CLI originally evaluated abortion reporting across the country and added several important categories of data in its 2023 abortion report. However, the completeness of Kentucky’s 2023 data was lacking because the state stopped reporting abortions by marital status, education status, if the unborn baby was given the best chance at survival during the abortion, and the breakdown of abortions by previous miscarriages. Kentucky could continue to make improvements by reporting the categories of data it left out of the 2023 report and by requiring all health care providers, including emergency room providers, to report abortion complications they treat.

1. National rates were calculated by the Guttmacher Institute. Kentucky rates were calculated by CLI using the following formula: (total number of abortions performed in Kentucky ÷ 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 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 2020-2022 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.
2. CLI is reporting on this information as it appeared in Kentucky’s abortion report. However, it is important to note that the cases described as exceptions to the state’s abortion law are not the same as induced abortions. They are descriptions of medical care allowed under the state’s law to save the life or physical health of the mother. The state law differentiates these medical procedures from an elective abortion which, when performed, has the sole intent of causing the death of an unborn baby.
3. Statistics on abortion complications reported here represent a minimal number of deaths and complications, as this data is collected in a non-systematic and non-verifiable way. As such, this data cannot be used to calculate either an accurate abortion mortality rate or an accurate abortion complication rate for the state.

4. The Guttmacher Institute notes that their monthly abortion totals by states are estimates and that each state’s estimate is within a range of uncertainty. Guttmacher also notes that their estimates do not reflect self-managed abortions or those obtained by women in pro-life states under shield laws.
5. Kentucky published reports for 2017 through 2023 online and provided CLI with reports for 2015 through 2018. Abortion totals for 2005 through 2014 were taken from the annual abortion surveillance reports published by CDC. Kentucky first reported drug-induced abortion data to CDC in 2008.

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