Five Things We Don’t Know about Abortion in the U.S. (but Could with Better Reporting)

The U.S. Centers for Disease Control and Prevention (CDC) acknowledges that accurate abortion data is important for measuring unintended pregnancies, tracking changes in clinical practice, and counting all pregnancies in the United States. Now that the Supreme Court’s decision in Dobbs v. Jackson has restored the ability of legislators to enact policies that affect abortion rates, reliable abortion data is more critical than ever. However, the quality of U.S. abortion data is actually growing worse. Here are five things that everyone should know about abortion in the United States – but cannot because of the poor state of abortion reporting.

1. How many abortions are performed in the U.S. every year?

There is no comprehensive, universal repository of abortion data in the United States. The CDC compiles statistics from the states, but reporting is not mandatory, and some states do not participate, including California (the state estimated by others to have the highest abortion volume in the country), Maryland, and New Hampshire. Among states that do require abortion reporting, data quality varies widely.

Consequently, Americans are forced to rely on estimates that the Guttmacher Institute, which describes itself as opposing gestational limits “at any stage in pregnancy,” produces by surveying abortion facilities. Yet even Guttmacher acknowledges that its surveys are incomplete. In its most recent report, 16 percent of abortions were estimated by Guttmacher or based on state health department data, including approximately one-third of all abortions in New York and Florida. An even greater limitation is that Guttmacher does not capture abortions performed outside of a clinical setting; abortion pills mailed by groups like Aid Access, for example, are not included.

As a result, the official report from the CDC’s state-based data tallies 620,327 total abortions in the U.S. in 2020, and the Guttmacher Institute’s likewise incomplete data tallies 930,160 abortions – a notable discrepancy of 309,833 abortions, or 50 percent more than CDC’s total.

2. How many women are injured or killed by abortion?

U.S. maternal mortality data is deeply flawed, and abortion mortality data is worst of all. Compounding the problem, in 2016, the Food and Drug Administration (FDA) changed its regulations on the chemical abortion drug mifepristone to require its prescribers to report only deaths. Any complications other than death need not be reported. Even before this change, FDA was missing over half of all complications resulting from chemical abortion, with some estimates suggesting that as many as 95 percent of all complications were unreported.

As a result of this abysmal reporting, abortion advocates often claim that abortion is safer than childbirth. However, studies from countries with much better data show that women who undergo abortions have up to four times the death rate of women who give birth.

3. How many late-term abortions are performed every year?

Statistics from the CDC show that approximately 10,000 abortions a year are performed at 20 weeks or later in the United States, but no exact number is available. There is no information on the precise gestational ages at which these abortions occur or why they are performed. Some major late-term abortion hotspots do not report by gestational age, do not report consistently, or don’t report abortions at all. For instance, the District of Columbia allows abortion through all nine months of pregnancy, and a single D.C. abortion center reported aborting at least 338 babies at 24 weeks of gestation or later during a 17-month period. However, D.C.’s data is not included in CDC’s table of abortions by gestational age. Maryland also has a new abortion center that performs abortions throughout pregnancy, but the state collects no abortion data at all.

4. How many women undergo abortions using abortion pills that are sent through the mail?

Increasingly, abortion pills are sold online and then shipped through the mail. As more women choose this option, not even the abortion pill websites know how many abortions ultimately result. They can track the number of requests they receive and pills they ship, but they have no way of knowing who ends up taking the pills or whether they are effective. Some abortion advocacy groups have begun bulk ordering abortion pills and then redistributing them to women around the country, while other women report ordering abortion pills ahead of time in case they or “a friend” need them – a protocol promoted by abortion advocates. Even more concerning, there is no way of ensuring that these pills do not fall into the hands of abusive partners or traffickers who use them to force abortions without women’s knowledge or consent.

5. How many babies are born alive during abortions?

Babies who survive abortions are sometimes deemed a “myth” by the abortion industry, but peer-reviewed research demonstrates the existence of abortion survivors, and Canadian data shows that in an eight-year period more than 1,000 babies were born alive during abortions. In the United States, though, only eight states have reported the number of abortion survivors. Still, even this very limited state data shows that more than 100 babies were delivered alive during abortions in the U.S. in the past few years.

Conclusion

Now that the authority to enact abortion laws has been restored to elected leaders, not the courts, Americans need good abortion data to evaluate the impact of abortion policies. A 2016 analysis by the Lozier Institute found that reliable abortion statistics can be a bipartisan accomplishment. For example, Lozier found that Oklahoma (which is strongly protective of life) and Minnesota (which is permissive of abortion) were ranked one and two in the country, respectively, for the quality and timeliness of their state abortion reporting. The fact that national data on these five key statistics is unreliable or completely missing is not inevitable. Lack of data on abortion incidence and safety benefits only those seeking to promote abortion. Americans of all political persuasions should expect better.

Tessa Longbons is Senior Research Associate at Charlotte Lozier Institute. Mia Steupert, M.A. is Research Associate at Charlotte Lozier Institute.