Texas’ 2021 report was released by Texas Health and Human Services in September 2022, reporting a drop in abortions from 2020.
Statistics and Changes in Texas Abortions, 2020-2021
This report does not include information on Planned Parenthood’s Texas abortion market share.
Abortion Totals and Trends
In 2021, there were 53,572 abortions reported, a drop of five percent from 2020 (Fig. 1). Similarly, chemical abortion decreased by seven percent in 2021 (26,972) from 2020 (29,013). Chemical abortions made up half of Texas abortions in 2021. The Charlotte Lozier Institute (CLI) estimates that Texas’ abortion rate fell by six percent to 8.7 abortions per 1,000 women ages 15 to 44 (Fig. 2). As of 2022, 24 states had released 2021 abortion statistics, of which 17 reported that abortions had increased from 2020.
State Report Summary
Texas abortions include abortions performed in Texas on residents and nonresidents, as well as abortions performed on Texas residents in other states. In 2020, 95 percent of Texas abortions were performed on state residents in Texas, two percent were performed on nonresidents in Texas, and three percent were performed on Texas women in other states.
In 2021, eight percent of Texas abortions were performed on girls under the age of 20. Thirty percent of the abortions were obtained by women ages 20 to 24, and 29 percent were performed on women ages 25 to 29. Nineteen percent of the abortions were performed on women ages 30 to 34 and 10 percent on women ages 35 to 39. Three percent were performed on women ages 40 and older.
Hispanic women made up the largest group of women undergoing Texas abortions, comprising 35 percent of the total. Thirty-one percent of the abortions were on black women, and 27 percent were on white women. Five percent of Texas abortions were performed on Asian women, 0.3 percent were on Native American women, and less than one percent were on women of other races. Race was not reported for one percent of the abortions. CLI estimates that Texas’ black abortion rate was 20.2 abortions per 1,000 women ages 15 to 44, three times the white rate of 6.5, while the Hispanic abortion rate was 7.0.
Half of Texas abortions were chemical. Forty-five percent were suction curettage procedures, and four percent were conducted via dilation and evacuation. There were 47 sharp curettage abortions (0.09 percent) and three hysterectomy or hysterotomy abortions. The type of procedure was not reported for 0.7 percent of the abortions.
A majority of Texas abortions, 85 percent, occurred before nine weeks post-fertilization (approximately 11 weeks of gestation). Six percent were performed between nine and 10 weeks post-fertilization, and four percent were reported between 11 and 12 weeks. Two percent of Texas abortions occurred between 13 and 14 weeks post-fertilization, one percent between 15 and 16 weeks, and another one percent from 17 to 20 weeks. There were 14 abortions reported between 21 and 24 weeks post-fertilization (23 to 26 weeks of gestation) and two abortions were reported at 25 weeks post-fertilization or later. The post-fertilization age was not reported for two abortions.
More than half of Texas abortions (53 percent) were performed in licensed abortion facilities and 44 percent were reported by ambulatory surgery centers. There were 70 abortions performed in hospitals (0.1 percent), while zero abortions were reported to have occurred in physicians’ offices. Three percent of Texas abortions occurred out of state.
Texas’ 2021 abortion report was the fourth to include information collected under the state’s new complication reporting law.1 Both physicians who treat complications and the facilities where complications are treated are required to file reports, and these complications are displayed in two separate tables in the abortion report. As part of its publication process, Texas Health and Human Services removes duplicate reports within each table. Because physicians and the facilities in which they operate are both required to report complications, the same complication could be reported across both tables.
In 2021, Texas received 237 complication reports from facilities, including 12 duplicate forms.1 Multiple complications can be reported on each form, and multiple forms could potentially be submitted for a single patient or complication. There were 235 unduplicated complications reported by facilities. The most frequent complication was incomplete abortion, which occurred 106 times. There were 19 cases of hemorrhage, eight infections, and three uterine perforations, and four cervical lacerations. One baby was reported to be born alive during an abortion in 2021, though there is no further information reported on the baby’s outcome. There were no abortion-related maternal deaths reported in 2021.
Some of the tables in the report contain information for abortions performed on Texas residents only; abortions performed in Texas on nonresident women are not included. In 2021, 85 percent of the abortions obtained by Texas residents were performed on unmarried women, while 15 percent were performed on married women. Forty percent of Texas resident abortions were performed on women with no previous live births. Twenty-three percent were on women with one prior live birth, and 37 percent were on women with two or more previous births. Sixty-two percent of Texas resident abortions were obtained by women who reported no previous abortions, 25 percent were performed on women with one prior abortion, and 13 percent were obtained by women with more than one previous abortion.
Because not every state shares abortion data with Texas, some abortions performed on Texas residents in other states are not included in the Texas abortion report. Research analyzing abortions performed on Texas residents in other states in the months immediately following the enactment of the heartbeat law found that out-of-state Texas resident abortions increased. Even with this increase, though, Texas’ abortion total was still lower in September 2021-February 2022 compared to those months in the previous year.
Legislative Changes
Texas’ Heartbeat Act, which was passed in 2020, went into effect in September 2021. This act limits abortion after the unborn baby’s heartbeat can be detected, which usually occurs around six weeks of gestation. An initial survey from the Texas Policy Evaluation Project (TxPEP) suggested that the Heartbeat Act ultimately could prevent 84 percent of Texas abortions, while Texas abortion providers asserted that 85 to 90 percent of all abortions could be averted. A follow-up report from TxPEP predicted that abortions would immediately drop by 50 percent, with even greater declines the longer the law remains in effect. However, after June 2022, when the Roe v. Wade (1973) decision was overturned by the United States Supreme Court, Texas’ pre-Roe trigger law went into effect (30 days after Roe was overturned). This law effectively prohibits all abortions except in cases where a mother’s life is endangered or a bodily function faces substantial impairment.
Using the data from Texas’ 2021 abortion report, the number of abortions that occurred after nine weeks post-fertilization (approximately 11 weeks of gestation or later) from September 2021 through December 2021 (14 abortions), after the Heartbeat Law was enacted, decreased by 99.3 percent compared to September to December of 2020, when 2,324 abortions at or after nine weeks post-fertilization occurred. In addition, an analysis of newly available Texas birth data shows the number of births to resident women increased by more than 5,000 from March to July 2022 when compared to the same time period from previous years.
State Ranking
In CLI’s 2016 paper evaluating abortion reporting across the country, Texas’ reporting tied for 15th best. To improve its reporting, Texas could report post-fertilization age with more precision, allowing Texans to determine how many abortions occurred at six weeks of gestation or later, whereas currently all abortions earlier than nine weeks post-fertilization are reported as one total. Texas could also report the states from which it did or did not receive data on abortions performed on Texas women.
- 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 Texas ÷ 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. 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.
