Abortion Reporting: Massachusetts (2023)

Recently, the Massachusetts Department of Public Health (MDPH) made all of their annual abortion reports from 1999 through 2023 available on their website. The state’s 2023 annual report was published in October 2024.1 Abortions in Massachusetts significantly increased 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 the total number of abortions obtained by Massachusetts residents out of state or 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 women who traveled to Massachusetts to obtain abortions and their states of residence as well as the number of abortions obtained by Massachusetts women in other states.

Statistics and Changes in Massachusetts Abortions, 2022-2023

Abortion Totals and Trends

In 2023, there were 24,355 abortions reported in Massachusetts, an increase of 37% from 2022, when there were 17,757 abortions. Drug-induced abortions composed 65% of the total, increasing from 9,276 in 2022 to 15,788 in 2023 (up 70%) (Fig. 1). CLI estimates that Massachusetts’ 2023 abortion rate was 17.3 abortions per 1,000 women ages 15 to 44, 37% higher than the 2022 abortion rate of 12.6 (Fig. 2).² As of November 2024, 21 states had released abortion statistics for 2023, with nine reporting that abortions had increased.

State Report Summary

Seven percent of the abortions were performed on girls ages 19 or younger. A quarter of abortions were performed on women ages 20 to 24 and 27% on women ages 25 to 29. Thirty-six percent of the abortions in Massachusetts were performed on women in their thirties, and 5% were on women ages 40 or above.

In 2023, 36% of Massachusetts abortions were performed on white women (Hispanic and non-Hispanic), and 20% were performed on black (Hispanic and non-Hispanic) women. Four percent of the abortions were performed on Asian women, 0.5% on American Indian and Alaskan Native women, and 0.3% on Native Hawaiian and Pacific Islander women. Women of other races obtained 5% of abortions in the state. Race was not specified for 23% of the abortions. CLI estimates that Massachusetts’ black abortion rate was 34 abortions per 1,000 women ages 15 to 44 and over four times the white abortion rate of 8.3. Nineteen percent of the abortions were obtained by Hispanic women, 58% by non-Hispanic women, and 23% by women of unknown ethnicity. Unlike in years past, the 2023 report did not include information on the number of abortions by educational status.

Fifty-two percent of the abortions were obtained by unmarried women, while 11% were performed on married women and 36% on women of unknown marital status. Thirty-three percent were performed on women with no previous abortions. Twenty-six percent were performed on women with one prior abortion, and 18% were performed on women with two or more previous abortions. Thirty-nine percent of the abortions were obtained by women with no previous live births, compared to 17% with one live birth and 22% with more than one. The number of prior abortions was not reported for 23% of the women who had abortions, and the number of previous live births was not reported for another 23% of the abortions.

Drug-induced abortions made up 65% of the total in 2023. For the first time since releasing their annual abortion reports, Massachusetts’ 2023 abortion report broke down the number of drug-induced abortions provided in-person (9,123) and via telehealth (6,665). Of the 6,665 drug-induced abortions performed via telehealth, 5,273 were provided to resident and nonresident women by online abortion drug providers that are licensed in Massachusetts and considered Massachusetts abortion providers. Another 942 drug-induced abortions were provided by Massachusetts brick and mortar abortion providers that also mail drugs to women residing in and outside the state. Twenty-six percent of the abortions performed in Massachusetts were dilation and evacuation abortions and 8% were performed via suction curettage procedures. The number of dilation and evacuation abortions increased by 132% from 2022 to 2023 and the number of suction curettage abortions decreased by 63%. One percent of abortions were performed using sharp curettage procedures and 15 abortions were labor induction abortions. Forty-four abortions were performed via some other means.

Seventy-six percent of Massachusetts abortions were performed at eight weeks of gestation or earlier, and 17% occurred between nine and 12 weeks. Four percent of the abortions were reported between 13 and 18 weeks of gestation, and 2% were performed between 19 and 23 weeks. Eighty-four were performed at 24 weeks of gestation or later, compared to 41 in 2022 and 37 in 2021. All but four of the 84 abortions performed at 24 weeks of gestation or later were performed in Executive Office of Health and Human Services (EOHHS) Region 6, which represents the Boston area. EOHHS Region 6 contains five hospitals that perform abortions and two abortion centers (one Planned Parenthood center and one non-Planned Parenthood clinic).  Abortion is legal in Massachusetts through 23 weeks of gestation, but the exceptions to the law are so broad that they render the limit ineffective. However, it is important to note that Boston Medical Center Obstetrics and Gynecology (BEACON: Family Planning) performs abortions through 24 weeks and while the 2023 annual report details that this location performed 1,144 abortions in 2023, it did not detail at what gestational ages those abortions occurred.

Other new information reported in Massachusetts’ 2023 report include the methods of payment that women used to pay for their abortions as well as a breakdown of the number of women who used abortion funds to help pay for a portion or the entirety of their abortion. The state defines abortion funds as money given to women from nonprofit organizations to pay for their abortion. Twenty-one percent of women used private insurance to pay for their abortion while 36% used public insurance including MassHealth plans or other state-subsidized coverage plans. Thirty-eight percent of women paid for their abortion out of pocket and the payment type was not known for 5% of abortions. Sixteen percent of women who obtained abortions in Massachusetts in 2023 used abortion funds while 71% did not. It is not known for 13% of women if they used abortion funds.

Abortions by Region of Residence

In 2023, unlike past years, a significant portion of the abortions reported in Massachusetts (25%) were performed on nonresidents. Seventy-four percent were performed on state residents and one percent were performed on women whose state of residence was unknown. Three abortions were performed on women from another country. For the first time ever, Massachusetts’ report included general details about the states of residence for nonresident women who obtained abortions in Massachusetts. The report broke down the number of abortions by women’s region of residence:³

Abortions by Facility

Fifty-eight percent of Massachusetts 2023 abortions were performed in abortion centers. Fifteen percent were performed in hospitals and 4% were reported by physicians. One abortion was reported by a university center. Twenty-four percent of abortions were performed by online organizations that are licensed in Massachusetts to provide Massachusetts women and women living in other states with abortion drugs. Planned Parenthood’s three abortion centers accounted for 35% of all abortions reported in Massachusetts (34.3% in-person and 0.4% via telehealth) and 60% of the abortions performed in abortion centers. Five out of the 28 locations that performed abortions in Massachusetts in 2023 (the three Planned Parenthood centers and four independent abortion centers) accounted for 50% of the state’s total abortions, with one Planned Parenthood center (Greater Boston Health Center) accounting for the highest percentage of abortions for a single location in the state (19.8%).

Because of the increased detail with which the state reported its 2023 abortion data, the report included the online organizations who qualified as Massachusetts telehealth abortion providers. Ishani Village was responsible for 18% of the abortions that occurred in Massachusetts because the organization is licensed in Massachusetts. However, both women living in Massachusetts and those living in other states received the abortion drugs via the mail sent out by these online organizations. Carafem was responsible for 4% of the abortions provided in Massachusetts while Abortion on Demand was responsible for 0.5%, Planned Parenthood for 0.4%, Hey Jane for 0.2%, and Sunny for 0.1%.

Telehealth Abortions Provided by Online Organizations vs. Surgical and Drug-Induced Abortions in Office Provided by Brick-and-Mortar Abortion Providers and by Region of Residence

As the table details, 1,821 abortions were obtained by nonresidents at brick-and-mortar facilities in Massachusetts versus 16,539 by Massachusetts residents. On the other hand, more nonresidents (4,294) obtained abortions via online organizations than did Massachusetts residents (1,397). Lastly, 251 women of unknown residencies obtained abortions at brick-and-mortar facilities while 53 obtained telehealth abortions from online organizations. Overall, the increase in the number of abortions occurring in Massachusetts in 2023 was due to the moderate increase in resident abortions and the much larger increase in nonresidents obtaining telehealth abortions via online organizations.

Guttmacher Data⁴

In 2023, Guttmacher estimated that 21,610 abortions occurred in Massachusetts while the state reported 24,355 occurred in the state.  An estimated 340 abortions were obtained by women who traveled to Massachusetts to get an abortion in 2023. However, it is important to mention, that Massachusetts’ report noted that 6,112 abortions were obtained by nonresident women. The discrepancy between the two reporting entities could be caused by the fact that Massachusetts’ report total was counting the number of nonresident women who obtained abortion drugs via the mail as prescribed by Massachusetts licensed abortion providers and those who physically traveled to the state to obtain an abortion. Guttmacher’s estimate only includes the number of women who physically traveled to the state. The 340 abortions are included within Guttmacher’s total estimate of 21,610 abortions occurring in the state. To see the number of abortions obtained in Massachusetts by women from various states, see below:

Lastly, Guttmacher estimated that 570 abortions were obtained by Massachusetts residents who traveled to other states to obtain an abortion. To see the number of abortions obtained by Massachusetts women in various states, see below:

State Ranking

In 2024, CLI published a paper reevaluating abortion reporting across the country, with Massachusetts ranking as tied for 23^rd place. However, that paper was published before Massachusetts released its improved 2023 report that was published online and included several new categories of data on telehealth abortions. Massachusetts could still improve its reporting by collecting and reporting information on complications caused by abortion and reinclude information on the educational status of the women who obtain abortions in Massachusetts.

1. The MDPH originally released their 2023 abortion report in October 2024. The original report included a breakdown of abortions by the online abortion providers licensed in the state to ship abortion drugs to Massachusetts residents and nonresidents. However, in November 2024 the MDPH removed the original report from its website and replaced it with a report that contained all the same statistical information but excluded data breaking down the number of abortions performed by specific online providers. The updated report can be found here.
2. National rates were calculated by the Guttmacher Institute. Massachusetts rates were calculated by CLI using the following formula: (total number of abortions performed in Massachusetts ÷ 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.
3. The definitions of the regions used by the MDPH are as follows:

• • New England – Connecticut, Maine, New Hampshire, Rhode Island, and Vermont
  • Mid-Atlantic – Delaware, District of Columbia, Maryland, New Jersey, New York, Pennsylvania, Virginia, and West Virginia
  • Southeast – Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee
  • Midwest – Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin
  • Gulf Coast – Arkansas, Louisiana, New Mexico, Oklahoma, and Texas
  • Plains – Iowa, Kansas, Missouri, and Nebraska
  • Rocky Mountains – Colorado, Montana, North Dakota, South Dakota, Utah, and Wyoming
  • Pacific – Arizona, California, Hawaii, and Nevada
  • Northwest – Alaska, Idaho, Oregon, and Washington
  • Other U.S. – American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Marshall Islands, Puerto Rico, Republic of Palau, and the Virgin Islands

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.

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