North Carolina’s 2021 abortion statistics were published online by the North Carolina Department of Health and Human Services in May 2023.
Statistics and Changes in North Carolina Abortions, 2020-2021
*The change in total abortions and chemical abortions reflects abortions performed on North Carolina residents. The change in the abortion rate reflects all abortions reported in North Carolina, including nonresidents. The report does not include information on Planned Parenthood’s North Carolina abortion market share.
Abortion Totals and Trends
In 2021, there were 32,454 abortions reported in North Carolina, an increase of 8.2 percent from 2020. There were 27,305 abortions on North Carolina residents, up nine percent from the previous year (Fig. 1). Abortions on resident women composed 83 percent of all abortions reported in the state in 2021. Chemical abortions performed on state residents jumped dramatically by 21 percent from 2020 and represented 66 percent of resident abortions. The Charlotte Lozier Institute (CLI) estimates that North Carolina’s abortion rate increased by seven percent to 15.7 abortions per 1,000 women of childbearing age – surpassing the national abortion rate of 14.4 (Fig. 2). As of June 2023, 31 states have released 2021 abortion statistics, with 22 states reporting that abortions increased from 2020.
State Report Summary
The North Carolina report includes information on abortions performed on state residents both in North Carolina and in other states; most of the information in the report does not include abortions performed on nonresident women. In 2020, 1.2 percent of the resident abortions reported to the North Carolina Department of Health and Human Services were performed out-of-state, and 98.8 percent were performed in North Carolina.
Eight percent of North Carolina resident abortions were obtained by girls under the age of 20. Twenty-eight percent were on women in their early twenties, and 29 percent were obtained by women in their later twenties. A fifth were on women ages 30 to 34, and 13 percent were performed on women ages 35 and older. Age was not reported for two percent of the abortions.
Non-Hispanic black women composed the largest group of North Carolina residents undergoing abortions, making up 49 percent of the total even though non-Hispanic black women make up just 24 percent of North Carolina’s overall population of women of childbearing age. Twenty-seven percent of the abortions were on non-Hispanic white women. There is a large difference between the abortion rates of non-Hispanic black and white women of childbearing age in North Carolina. The black abortion rate in North Carolina in 2021 was 27.3, four times higher than the white abortion rate of 6.3. One percent of the abortions were on American Indian women. Three percent of North Carolina resident abortions were obtained by women of other races, and four percent were on women of multiple races. Fourteen percent of the abortions were performed on Hispanic women. Race was not reported for one percent of the abortions.
Well over half the abortions (59 percent) were obtained by women with 13 years of education or more. Thirty percent of the abortions were performed on women with 12 years of education, and seven percent were on women with fewer than 12 years of education. Eighty percent of the abortions were on unmarried women, while 13 percent were on married women and seven percent on women of unknown marital status.
Thirty-five percent of abortions performed on North Carolina residents were performed on women with no living children. A quarter were on women with one child, and 38 percent were obtained by women with two or more children. Over half (55 percent) of the abortions were on women with no previous abortions, compared to 21 percent with one abortion and 14 percent on women with two or more prior abortions. The number of living children was not reported for one percent of the women getting abortions, and the number of previous abortions was not reported for 10 percent.
The majority of North Carolina resident abortions (71 percent) occurred at eight weeks of gestation or earlier. Nineteen percent were performed between nine and 12 weeks of gestation, while four percent were reported between 13 and 15 weeks. Three percent of the abortions occurred between 16 and 20 weeks, with 691 abortions performed in North Carolina and three abortions performed in other states. There were 74 abortions at 21 weeks of gestation or later. Sixty of these were performed in North Carolina, and 14 abortions were performed on North Carolina women in other states. Gestational age was not reported for three percent of the abortions.
Legislative Changes
Following the reversal of Roe v. Wade in June 2022, North Carolina was able to enforce its 20-week abortion limit starting on August 17, 2022. The law, originally passed in 1973 and last amended in 2015, had been enjoined since 2019. However, after Roe was reversed a federal judge allowed the law to go back into effect. In May 2023, both chambers of the state legislature passed SB 20, a 12-week abortion limitation bill. North Carolina Governor Roy Cooper promptly vetoed the bill, but his veto was overridden by a supermajority in the state legislature on May 16, 2023. The law is set to take effect on July 1, 2023. A critical provision of this law is that doctors must perform a physical examination before administering chemical abortion drugs, and these drugs must be dispensed in person, which is intended to prevent complications from unsafe mail order abortions. This law could dramatically reduce the number of chemical abortions that occur in the state.
State Ranking
In a CLI study ranking abortion reporting across the country, North Carolina was ranked 29th best. Since then, North Carolina has improved its reporting, most recently in SB 20 by requiring healthcare providers to report abortion complications they treat. North Carolina could continue to improve its reporting by including information for all abortions occurring in the state, not just those performed on state residents. North Carolina could also identify the states that do or do not share data on North Carolina residents who travel out-of-state for abortions.
- The abortion reports caution that abortions were underreported in 2011-2014.
- Rates were calculated by CLI using the following formula: (total number of abortions performed in North Carolina ÷ 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 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 2020-2021 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.
