Changes in Tennessee Abortions, 2018-2019
The change in total abortions and the abortion rate reflect all abortions occurring in Tennessee. Information on the number of chemical abortions performed in Tennessee and Planned Parenthood’s Tennessee abortion market share is not included in the abortion report.
Abortion Totals and Trends
In 2019, there were 9,719 abortions reported in Tennessee, down almost 11 percent from the previous year (Fig. 1). There were 8,727 abortions performed on Tennessee residents, both in Tennessee and in other states, a decrease of 13 percent from 2018. The report does not state the number of chemical abortions occurring in Tennessee. The Charlotte Lozier Institute (CLI) estimates that Tennessee’s state abortion rate fell by 11 percent in 2019 to 7.3 abortions per 1,000 women ages 15 to 44 (Fig. 2). Forty-eight reporting areas shared abortion data for 2018 and 2019 with the Centers for Disease Control and Prevention, with 23 indicating that abortions decreased in 2019.
State Report Summary
Eighty-one percent of the abortions occurring in Tennessee were performed on women who were Tennessee residents, while 19 percent were performed on residents of other states or Canada. However, the majority of the information in Tennessee’s abortion report relates to abortions performed on Tennessee residents only, both inside and outside Tennessee, rather than all abortions occurring in the state. Because not all states share abortion data with Tennessee, the report likely does not include all abortions performed on Tennessee residents. In 2019, 90 percent of the abortions known to have been performed on Tennessee residents took place in Tennessee.
Eight percent of the abortions performed on Tennessee residents in 2019 were on girls ages 19 and younger, including two percent on girls under the age of 18. Twenty-nine percent were performed on women in their early twenties, and 31 percent were on women in their later twenties. Twenty-eight percent of the abortions were obtained by women in their thirties, and three percent were performed on women in their early forties. Age was not reported for 38 abortions.
Forty-nine percent of Tennessee resident abortions were performed on black women, while 42 percent were on white women and eight percent on women of other or unknown races. Ninety-two percent of the abortions were obtained by non-Hispanic women, seven percent were on Hispanic women, and one percent were performed on women of unknown ethnicity.
Eighty-two percent of the abortions were performed on women who were unmarried. Fourteen percent were on married women, and four percent were on women of unknown marital status. A majority of the women undergoing abortions (64 percent) reported no prior abortions, while 24 percent of the abortions were performed on women with one previous abortion, and 11 percent were performed on women with two or more prior abortions. The number of previous abortions, if any, was not reported for 71 women.
Over half of Tennessee resident abortions (55 percent) occurred at eight weeks of gestation or earlier; 21 percent were performed before seven weeks, and 34 percent were reported between seven and eight weeks. Twenty-three percent of the abortions were performed between nine and 10 weeks, dropping to 10 percent between 11 and 12 weeks. Six percent occurred between 13 and 14 weeks. Two percent were performed between 15 and 16 weeks, and three percent were reported between 17 and 20 weeks of gestation. Sixty-three abortions occurred at unknown gestational ages.
The report includes abortion complications from the Tennessee Hospital Discharge Data System, although it does not include complications that were treated in facilities other than hospitals and emergency rooms.1 In 2019, there were 26 cases of “Failed attempted termination of pregnancy without complication.” There were 17 cases of delayed or excessive hemorrhage, and 15 cases of delayed or excessive hemorrhage following a failed abortion. There were 17 other, unspecified complications.
Tennessee’s report does not include the types of procedures used to perform abortions. However, Tennessee shared this data with the CDC to be included in the 2018 abortion surveillance report. In 2018, 52 percent of the abortions performed in Tennessee were surgical, while 47 percent were chemical.
Pro-Life Protections in Tennessee
In 2020, Tennessee enacted a law with multiple pro-life protections. The law requires that unless there is a medical emergency, an ultrasound must be performed and the results described to the woman undergoing the abortion. The woman must also be offered the opportunity to view the ultrasound and listen to her unborn baby’s heartbeat. The law also establishes a ladder of gestational limits, starting at six weeks of gestation if a heartbeat is present and limiting abortion at successive gestational ages, with each step of the ladder designed to remain in effect if earlier limits are overturned in court. Limits are set in place at six, eight, ten, twelve, fifteen, eighteen, twenty, twenty-one, twenty-two, twenty-three, and twenty-four weeks of gestation. Additionally, Tennessee’s law prohibits abortion based on the unborn baby’s sex, race, or likelihood of having Down syndrome. The law also requires that women undergoing chemical abortions be provided with information on abortion pill reversal.
The law was challenged in court and was initially blocked by a district court from being enforced. A panel of the 6th U.S. Circuit Court of Appeals upheld the lower court decision blocking the law, but the state appealed. The court has agreed to rehear the case en banc and has allowed the prohibition on abortions for sex, race, or Down Syndrome to go into effect.
In 2016, CLI ranked abortion reporting across the 50 states, the District of Columbia, and New York City, and Tennessee tied for 33rd best. To improve its reporting, Tennessee could include information on all abortions performed in the state and report on its state website the types of abortion procedures used. Tennessee could also require complication reporting from all medical facilities, including nonhospital facilities.
- 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.
- Rates were calculated by CLI using the following formula: (total number of abortions performed in Tennessee ÷ 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.