NRL News

CDC Updates Abortion figures show short term increase in 2018 but long term decline

by | Dec 11, 2020

By Randall K. O’Bannon, NRL Director of Education & Research

Editor’s note. This appears in the December digital edition of National Right to Life News. Please share this and the entire 51-page issue with your pro-life friends and family.

The afternoon before Thanksgiving, the U.S. Centers for Disease Control (CDC) released its latest abortion surveillance report, bringing its data up two years to 2018. 

In 2016 all the statistics measuring abortion—the raw number, the abortion rate, and the abortion ratio– reached historic lows.

Numbers for 2017 continued to offer encouraging all time lows in all three categories. For example, the number of abortions counted by the CDC decreased to 612,719. In 2018 the CDC found slight increases yet there were still fewer abortions than in 2016.

Looking at the big picture, if you compare the CDC abortion for 2008 (825,564) to the  CDC total for 2018 (619,591), the number has dropped by nearly 25 percent in a just a decade.

As always with CDC, we offer the important caveat that its numbers significantly underestimate the actual national totals.  There is no data from California, New Hampshire, and Maryland, which the CDC says would otherwise account for nearly one out of every five abortions performed in the U.S. 

Even where they do have data, the CDC relies on the reports of state health departments which miss a certain percentage of those abortions found by the Guttmacher Institute, which surveys abortion clinics directly. 

Consequently, while no one, including the CDC, thinks its numbers present a reliable national total, they still provide a regular benchmark and are very useful for tracking long term demographic trends.

Major CDC Abortion Measurements

The CDC had recorded 623,471 abortions in 2016 and saw that figure drop to 612,719 in 2017 before rising again to 619,591 for 2018. 

Other CDC measures of abortion show a similar trend.  For the CDC, the abortion rate measures the number per 1,000 women of reproductive age (15-44 years). 

The abortion ratio looks at the number of abortions for very thousand live births. Both those measures dropped for 2017 but rose for 2018.

The abortion rate for 2016 was 11.6 per thousand women of reproductive age. In 2017, the CDC obtained a reduced rate of 11.2. That figure ticked up to 11.3 abortions in 2018. 

Even with that slight increase, every abortion rate from 2011 onward has been lower than the rate of 14 per thousand women of reproductive age in 1973, the first year abortion was legalized throughout the United States.

The abortion ratio looks specifically at the outcomes with pregnant women.  That number dropped from 186 abortions for every thousand live births in 2016 to 185 in 2017. It increased by 2% in 2018, rising to 189 abortions for every thousand live births. Again, even with that increase, it is still lower than the 196.3 recorded in 1973, Roe’s first year.

Taken together, what these mean is, despite what may be the signal of what we hope is only a temporary stall we are still very close to the lowest points ever recorded by the CDC. 

Figures would be higher if data from California, New Hampshire, and Maryland were factored in.  Even so, they would still only be about half the figures recorded back in the 80s and 90s. (For example, in 1990, the CDC counted 1,429,247 abortions.  In 1980, the abortion rate was 25 per thousand women of reproductive age, according to the CDC.  In 1984, the CDC calculated that the abortion ratio 364.1 abortions for every 1,000 live births.)

Any way one looks at it, abortion has become a less common feature of American women’s lives. Though the size of the population has increased, fewer women are having abortions. The bottom line is that the likelihood of a pregnant woman choosing to abort her baby has dropped considerably. 

And that is an enormous tribute to the faithful work of the pro-life community.

A closer look at the demographics tells us not only more about those currently having abortions in the U.S. but also may give us an idea why they may have started to trend up.

Individual States Differ

One of the first things you notice when you look at CDC tables of abortion statistics is the wide variation in state abortion rates and ratios. Of course, the larger states report more abortions, but certain states, largely on the coasts, or with major metropolitan areas, or where there are more established clinics, also appear to have high abortion rates and abortion ratios.

While the national abortion rate was 11.3 abortions per thousand women of reproductive age, areas such New York City (26.8) and the District of Columbia (25.3) were reporting rates more than double that. Other notable states with rates considerably above the national average were Florida (18.1), Illinois (16.9), Georgia (15.7), Nevada (14.8), Michigan (14.2), Connecticut (13,9), New Jersey (13.6), New York State (13.5), North Carolina (13.5), Rhode Island (13.5) and Massachusetts (13.1).

Many of the same states show up with high abortion ratios. At noted above, that refers to the number of abortions for every 1,000 live births. 

While the national abortion ratio was 189 for 2018, several states still recorded more than 200 abortions for every 1,000 live births. Highest once more were the District of Columbia, with 518 abortions for every 1,000 live births, and New York City, with 457 for every 1,000 live births. 

Other states with high abortion ratios included Florida (317), Illinois (293), Georgia (269), Connecticut (268), Rhode Island (268), and Massachusetts (264). New Jersey (247), Michigan (243), New York State (236), North Carolina (232), New Mexico (227), Pennsylvania (224), Vermont (222), Oregon (207), and Washington State (201) complete the list of those with abortion ratios over 200.

Sometimes high abortion numbers are, at least in part, because of high numbers of women crossing the border; there may be an abortion clinic just across the state line. For example, nearly two-thirds (65.4%) of abortions in the District of Columbia were performed on women from other states. 

Kansas is another one of those states that had an abortion rate (12.4) and abortion ratio (192) above the national average. According to the CDC, 50.2% of the abortions performed there were obtained by out of state women. Notably, Planned Parenthood’s Overland Park clinic in Kansas is just about a mile from the Missouri state line.

Impact of Clinic Closures

The CDC does not tell us how many abortion clinics there are in each state. However, several of these states with higher abortion rates and ratios either have large numbers of clinics or large numbers of clinics relative to the size of their population. 

Data from Guttmacher helps flesh out the CDC state data.

Guttmacher identified California (not tracked by the CDC) as having the most abortion clinics–161 in 2017– followed by New York with 113, Florida with  65, and New Jersey with 41. There were also high numbers of abortion clinics in Washington State (40), Connecticut (26), Maryland (25), Michigan (21), and Texas (21).

Several of these show up in our earlier list of states with high abortion rates and ratios. Unsurprisingly, the concentration of clinics appears to impact both the state abortion numbers and overall totals reported by the CDC.

The number of hospitals, abortion clinics, and private physician’s offices performing abortion has fallen dramatically in the U.S., in many ways anticipating the drop in abortion numbers. After reaching a high of 2,918 in 1982,  the number of “abortion providers” began a steady fall. In 2017, Guttmacher reported just over half –1,587 – the number of original “providers.”

Not surprisingly, abortions measured by both Guttmacher and the CDC (even without California) dropped by almost half during this time.

Clinics have continued to close in many places, particularly older ones in economically depressed areas. But in recent years that decline has begun to slow. Many of those older clinics have often been replaced by shiny, new regional mega-centers, designed to handle and capable of performing high volumes of abortions (or managing high numbers of webcam chemical abortions).  

With some 74% of abortions being performed at centers with caseloads of a thousand or more a year (Guttmacher figures for 2017), the building of these abortion megaclinics comes with a potential to reduce or reverse these recent abortion declines. Perhaps some of that is reflected in the recent increase reported by the CDC.

Many private physicians have also added chemical abortions to their practice, which likely accounts for some of the recent slight increase in the number of abortions.

Most Demographics Fairly Constant

Other demographic data from the CDC are largely along the lines of previous reports. Most abortions are performed on women in their twenties (57.7%). These women  also have the higher abortion rates (19.1 for women ages 20-24, 18.5 for women 25-29).  

Younger women, teenagers, have lower abortion rates (6.0 for females 15-19, 0.4 for those under 15) but higher abortion ratios (334 abortions per 1,000 live births for teens 15-19 and 872 for those under 15). What this means is that they are much more likely to abort when they do become pregnant. 

More than 4.5 out of 5 (85.2%) of aborting women are unmarried, though 59.3% have already had at least one previous live birth. Just over four in ten (40.2%) reported having at least one prior abortion. About one in ten (9.9%) indicated having two past abortions, while 6.4% admitted to having had three or more.

All told, the CDC now says it expects that about fewer than one in five (18%) of all pregnancies end in abortion. It does not provide earlier estimates to give us a frame of reference in this report, but popular figures once put that figure at one in three or even one in four. 

Of course, all CDC data is somewhat compromised by the absence of  official statistics from California, Maryland, and New Hampshire. However, other specialized CDC datasets are also affected by differences even among states that do respond; some states report some demographic elements while others don’t. 

For example, not all states count or report the race or ethnicity of the aborting woman, and those that do may not report it in the same way (that is, reporting race but not ethnicity). CDC estimates of Black and Hispanic abortions are thus based on data from just thirty states and the District of Columbia. 

Racial and ethnic data is missing not only from California, which has a high minority population, but also from other major states like New York, Illinois, Pennsylvania, Georgia.

Still, based on the state data it does have, the CDC reports that Black American women accounted for 33.6% of the abortions the CDC measured in 2018. 

Where the CDC knew the ethnicity of the aborting woman in 2018,  Hispanic women represented about 20% of all abortions.

To put this in context, the U.S. Census bureau estimates that Blacks made up 13.4% of the nation’s population in 2019 and Hispanics 18.5%.  Even if adding to these the 2.8% of the population the census identified as from two or more races, it still leaves us with the two largest minorities accounting for just about a third of the population but more than half of the abortions performed in the U.S.

Abortion rates and ratios also reflect this racial disparity. Non-Hispanic black women have an abortion rate 3.4 times higher than white women and an abortion ratio 3 times higher than white women.  

Hispanic women had an abortion rate 1.7 times and an abortion ratio 1.4 times that of their white counterparts, according to the CDC.

Most of the demographic statistics cited so far are pretty much in line with what has been reported in the past, most abortions are to unmarried women in their twenties, many who have already had abortions or had previously given birth, an overrepresentation of minorities, etc. But data on gestational age and abortion method expose some concerning trends.

Growth in Chemical Abortions

The CDC says most abortions in 2018 were performed in the first trimester, as it has been the case for many years. In 2018, 92.2% of abortions reported to the CDC occurred at 13 weeks gestation or less. 

Of course, this leaves, even by the CDC minimal counts, tens of thousands of abortions performed on babies in the second or third trimesters. These are the later term abortions the media likes to pretend don’t exist.

There has been a shift, nevertheless, particularly in the past twenty years, to abortions performed earlier and earlier in the first trimester. Current figures for 2018 show more than three quarters (77.7%) of abortions were performed at nine weeks gestation or less. More than four in ten (40.2%) are performed at six weeks or earlier.

For comparison, in the CDC’s report from twenty years ago (1998 Abortion Surveillance), 75.7% of abortions were performed at ten weeks or less (the CDC grouped weeks together differently at that point). Just 18.8%, less than half the current 40.2%, were performed at six weeks gestation or less.

The explanation for this shift can be seen in another set of data from the CDC and a quick recounting of history.

The “abortion pill” RU-486, also known as mifepristone, was first approved for use in the United States in September of 2000. Originally, its use was supposed to be limited to women no more than seven weeks pregnant, measured from a woman’s last menstrual period. But bending to pressure from the abortion industry, President Obama’s FDA allowed its use up to ten weeks in March of 2016.

Though the number of chemical abortions began to rise slowly, the CDC now says that chemical abortions (or as it puts them, “medical” abortions) running up through nine weeks and 6 days account for 38.6% of all abortions where procedure was identified. 

They account for 54.9% of abortions performed at six weeks or less, which explains the CDC’s rising figure of early abortions mentioned earlier.  

The CDC says that the number of “early medical abortions” reported to them rose 120% from 2009 to 2018.

On top of that, the CDC says an additional 1.4% of “medical” abortions took place at some point greater than nine weeks.

That 1.4% likely reflects the fact that despite the official government protocol, abortionists have in the past prescribed their use past the recommended cutoff date. *

In any case, both the CDC’s abortion method and gestation data document a significant change in the timing of abortions and the way they have been performed over the past two decades. If the abortion industry continues to promote these and to press the government to further loosen distribution requirements to allow online sales and at-home use, these numbers might keep on keep on increasing.

It seems likely that this growth in chemical abortions amidst other long-term declines may be a dominant factor in the recent slight increase seen in abortions, abortion rates, and abortion ratios recorded by the CDC for 2018.

The Empire Strikes Back?

Anyone who thought that the abortion industry would stand idly by while their empire crumbled, while states were passing laws holding them in check, pro-life pregnancy centers were offering their potential clients better life preserving alternatives, and major abortion chains were being defunded, was probably overly optimistic.

Abortion advocates have seen this decline in abortions coming for several decades and have taken steps to shore up their industry. They have rebuilt their customer base, constructed new megaclinics, heavily promoted chemical abortions, and fought pro-life laws in the courts and legislatures.

The CDC’s latest data shows us both that years of pro-life education, legislation, outreach, and private assistance have had a long term impact, but also that counter efforts by the abortion industry may be starting to blunt or even reverse those trends.

Abortions, abortion rates and ratios are slightly up in their latest figures, but many moms and their babies have already been spared over the last three decades because of the tireless efforts of pro-lifers. 

But this recent report shows us that our work is far from over.

*Though, in theory, these could involve other drugs, chemical methods using urea, oxytocin, or prostaglandins would likely be counted as “intrauterine instillation” procedures, for which the CDC has a separate category.