Missouri’s 2021 abortion report was published online in July 2023, showing that Missouri’s reported abortions continued to decrease from 2020, reaching the lowest number ever recorded in the state. As of August 2023, 37 states have released 2021 abortion statistics, of which 10 (including Missouri) reported that abortions decreased.
Statistics and Changes in Missouri Abortions, 2020-2021
The report does not include information on Planned Parenthood’s Missouri abortion market share.
Abortion Totals and Trends
From 167 abortions in 2020 to 150 in 2021, the total number of abortions reported in Missouri fell by 10 percent, while chemical abortions increased by one abortion: from 22 in 2020 to 23 in 2021 (Fig. 1). The Charlotte Lozier Institute (CLI) estimates that Missouri’s 2021 abortion rate was 0.1 abortions per 1,000 women ages 15 to 44, and far below the 2020 national rate of 14.4 (Fig. 2).3
Separately, Missouri reports abortions performed on residents, both those occurring in Missouri and in other states that share data with Missouri, with residents who obtain abortions out of state primarily doing so in Kansas and Illinois. There were 3,653 abortions reported to have been performed on Missouri residents in 2021, although Missouri estimates that the true total was far higher. There was an eight percent increase in reported resident abortions in 2021 compared to 2020, when there were 3,391 abortions. Since 1984, Missouri’s highest volume year when 20,204 abortions were reported, abortion occurrence in Missouri has declined by 99 percent.
The data summarized below is broken down into data on Missouri residents, regardless of the location of their abortions, and data on all occurrences of abortion in Missouri, regardless of the residential status of those who obtained the abortions.
State Report Summary
Residence Data
Of the 3,653 abortions known to have been performed on Missouri women in 2021, the majority (58 percent) were performed on women in their twenties, with 30 percent on women ages 20 to 24 and 28 percent on women ages 25 to 29. Thirty percent were on women in their thirties, and three percent were on women aged 40 or older. Nine percent of the abortions were on girls under the age of 20, including three percent on girls under the age of 18.
Half of the abortions performed on Missouri residents were on non-Hispanic white women, and 37 percent were on non-Hispanic black women. Seven percent were on non-Hispanic women of other races, and just three abortions were on non-Hispanic women of unknown race. Six percent were performed on Hispanic women.
Six percent of the abortions were on women with fewer than 12 years of education. Forty-one percent of the abortions were performed on women with 12 years of education, 36 percent on women with 13 to 15 years, and 15 percent on women with 16 years of education or more. Level of education was not reported for two percent of abortions. The vast majority of Missouri resident abortions (88 percent) were on unmarried women. Eleven percent were on married women and one percent were on women of unknown marital status.
The majority of the Missouri women undergoing abortions, 61 percent, already had children. Twenty-four percent of the abortions were performed on women with one living child, and 37 percent were on women with two or more children, compared to 39 percent obtained by women with no children. Conversely, the majority of abortions (65 percent) were performed on women with no previous abortions. Twenty-two percent were on women with one prior abortion, and 13 percent on women with two or more previous abortions.
More than two-thirds of the abortions (69 percent) were performed earlier than nine weeks of gestation (approximately seven weeks post-fertilization), and the majority of them were chemical abortions. Fourteen percent occurred between nine and 10 weeks gestation, and seven percent were performed between 11 and 12 weeks, dropping to three percent between 13 and 14 weeks. Three percent were performed between 15 and 16 weeks, and two percent between 17 and 19 weeks. Less than one percent (0.7 percent) occurred at 20 weeks and one percent were reported at 21 weeks of gestation or later.
There were 2,503 (69 percent) chemical abortions reported to have been performed on Missouri residents, whether in Missouri or in other states that shared data with Missouri. This suggests that the vast majority occurred out-of-state, as only 23 chemical abortions were reported in Missouri in 2021. Twenty-three percent of the abortions performed on Missouri women were curettage abortions, and eight percent were laminaria dilation and evacuation procedures. Twenty-seven abortions were performed using other, unspecified methods, and one was performed using an unknown method.
Occurrence Data
Just over half of the abortions occurring in Missouri (51 percent) were performed on women in their twenties. Forty-one percent were on women in their thirties, two percent (three abortions) were on women in their forties or older, and five percent were on girls under the age of 20 (including two abortions on girls under the age of 18).
Just under half of the abortions (49 percent) were performed on non-Hispanic white women. Forty-two percent were on non-Hispanic black women, four percent on non-Hispanic women of other races, and three percent (four abortions) on Hispanic women. Three abortions were performed on non-Hispanic women of unknown race.
Unlike the abortions performed on Missouri residents, just 14 percent of the abortions reported in Missouri were performed before nine weeks of gestation. Eleven percent were performed between nine and 10 weeks, and 13 percent were between 11 and 12 weeks. While the actual numbers are small, a relatively large percentage of the abortions reported in Missouri occurred in the second trimester. Seven percent of the abortions were reported between 13 and 14 weeks of gestation, while nine percent occurred between 15 and 16 weeks and 12 percent between 17 and 19 weeks of gestation. Ten percent of the abortions were performed at 20 weeks and, alarmingly, 23 percent were performed at 21 weeks or later, for a total of 33 percent (50 abortions) at or after 20 weeks of gestation.
Thirty-nine percent of the abortions occurring in Missouri were curettage procedures, while just under one-third (30 percent) were laminaria dilation and evacuation abortions. There were 23 chemical abortions and one hysterectomy or hysterotomy abortion. Another 23 abortions were performed using other, unspecified procedures.
Abortion Complications
Missouri requires medical professionals who treat abortion complications to report them to the Missouri Department of Health and Senior Services (MDHSS), regardless of whether the abortion occurred in Missouri or in a different state. In 2021, MDHSS received 54 complication report forms with information on 79 complications, a 23 percent increase in submitted complication forms and a 32 percent increase in complications compared to the previous year.1
Fifty-four percent of the forms were submitted for surgical abortions, 43 percent for chemical abortions, and four percent for abortions of unknown type. The most common complication was hemorrhage, occurring 21 times, followed by 20 cases of retained products of conception, 15 instances of incomplete abortion, and nine cases of endometritis (inflammation of the uterine lining). There were two cases each of cervical laceration, failed abortion in which the pregnancy was undisturbed, and uterine perforation. There was one instance of pyrexia (fever) and seven unspecified complications. Twenty-five women were hospitalized.
Only three of the forms were submitted for abortions occurring in Missouri, which MDHSS used to calculate a Missouri complication rate of 2.0 complications per 100 abortions.1 However, many complications are caused by abortions performed outside of Missouri. Missouri does not receive abortion complication reports from other states, so the number of abortion complications suffered by Missouri residents but treated outside of Missouri is unknown.
Out-of-State Abortions
Most abortions performed on Missouri residents occur in other states, many of which then report the abortion data back to Missouri. There were 3,653 abortions performed on Missouri residents in Missouri or reported to Missouri by other states in 2021. However, not all states share individual record-level data with Missouri. In 2021, Illinois and Oklahoma provided estimates of Missouri resident abortions. Missouri reports that when totals from Illinois and Oklahoma are included, there were an estimated 11,185 Missouri resident abortions in 2021.
State Ranking
In 2016, CLI surveyed abortion reporting across the country, and Missouri’s reporting tied for 25th best. To improve its reporting, Missouri could add more context for its data by reporting the percentage of abortions performed in Missouri on nonresident women, as well as the states to which Missouri residents travel for abortions. Additionally, Missouri could report pregnancy history, level of education, and marital status for all women undergoing abortions in the state, as many other states do.
- Statistics on abortion complications reported here represent a minimal number of deaths and complications, and the state acknowledges that this data may be incomplete.
- Total abortions occurring in Missouri. Abortion totals for 2011 and 2014 were revised in later reports, but because chemical abortion totals were not revised, the original numbers provided by the 2011 and 2014 abortion reports have been used to allow for comparison between total and chemical abortions.
- Rates were calculated by CLI using population estimates from the United States Census Bureau. The rates were calculated using the following formula: (total number of abortions performed in Missouri ÷ 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. Estimates for 2005-2009 are intercensal estimates of the July 1 resident population. Estimates for 2010-2020 are Vintage 2020 postcensal estimates of the July 1 resident population. Estimates were produced by the U.S. Census Bureau and the National Center for Health Statistics.
