CDC reports decreasing abortion rates from 2013 to 2022

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Abortion rates have decreased across the United States between 2013 and 2022, according to recent data published by the Centers for Disease Control and Prevention (CDC).

The data was voluntarily provided to the CDC by agencies of 48 areas, including 46 states, New York City, and the District of Columbia. California, New Jersey, New Hampshire, and Maryland were excluded from the analysis.

This data about legal abortions has been collected by the CDC since 1969. A significant increase in the rate of abortions among women aged 15 to 44 years was reported after nationwide legalization in 1973. In the following years, variations have been observed in abortion incidence and practices over time, indicating a need for continued surveillance.

Data collection occurred through reports from hospitals, facilities, and physicians to a central health agency. The data from 2022 is up to date as of July 15, 2024. The CDC defined legal induced abortion as a procedure to terminate intrauterine pregnancy within the limits of the local law by a licensed clinician.

Aggregation of the data was performed based on age group, gestational age at abortion, race, method type, marital status, number of prior live births, number of prior induced abortions, and residence. The CDC requested abortion numbers for certain variables be cross-tabulated by a second variable.

When available, medical and surgical abortions were further categorized by gestational age. Early medication abortion was defined by the administration of abortion medication at 9 weeks’ gestation or sooner. Surgical abortions were reported as occurring at 13 weeks’ gestation or sooner, or later than 13 weeks’ gestation.

Abortion was reported through 4 measures: the number of abortions in a specific population, the percentage of abortions by selected characteristics, the abortion rate, and the abortion ratio. Adjustments based on the population size were made when needed.

While overall abortion rates were assessed in women aged 15 to 44 years, a denominator of girls aged 13 to 14 years was used for abortion rates in adolescents aged under 15 years. In patients aged 40 years or older, the denominator was women aged 40 to 44 years.

There were 613,383 reported abortions in 2022, 609,360 of which were from areas reporting abortion data every year between 2013 and 2022. The abortion rate in these areas was 11.2 abortions per 1000 reproductive-aged women and 199 per 1000 live births in 2022.

Between 2021 and 2022, a decrease in the number of abortions in areas reporting since 2013 of 2% was reported, alongside a decreased abortion rate of 3% and decreased abortion ratio of 2%. From 2013 to 2022, these changes were a decrease of 5%, a decrease of 10%, and an increase of 1%, respectively.

Variations in abortions rates between different areas was noted, from 0.1 abortions per 1000 reproductive-aged women in Missouri to 2.8 per 1000 in New Mexico. In 2022, 56.5% of abortions were among women aged 20 to 29 years, with 28.3% being those aged 20 to 24 years and 28.2% being those aged 25 to 29 years.

The lowest abortion rates were reported among women aged under 15 years or 40 years and older. However, adolescents aged under 15 years and those aged 15 to 19 years did not experience a change in abortion prevalence from 2021 to 2022, while rates decreased among women aged 20 years and older.

Abortions were more common among non-Hispanic White and non-Hispanic Black women vs Hispanic and non-Hispanic woman of another race, with rates of 31.9%, 39.5%, 21.2%, and 7.3%, respectively. However, White women had the lowest abortion rate and ratio, at 5.7 per 1000 reproductive-aged women and 106 per 1000 live births, respectively.

The highest abortion rate and ratio were reported among Black women, at 24.4 per 1000 reproductive-aged women and 429 per 1000 live births, respectively. In areas reporting marital status, 12.6% of abortions were among married women, while 87.7% were among unmarried women.

Of abortions in areas reporting prior live births, 40.6%, 24.1%, 19.5%, 9.4%, and 6.5% of abortions were among women with 0, 1, 2, 3, and 4 prior live births, respectively. For prior abortions, rates were 56.1%, 24.7%, 10.9%, and 8.2% for women with 0, 1, 2, and 3 or more previous abortions, respectively.

This data indicated decreasing abortion rates across multiple populations in the United States. Investigators concluded ongoing surveillance of abortion is vital for promoting equal contraception access, evaluating changes in clinical practice patterns over time, and determining rates of various public health outcomes.

Reference

Ramer S, Nguyen AT, Hollier LM, Rodenhizer J, Warner L, Whiteman MK. Abortion surveillance — United States, 2022. MMWR Surveill Summ. 2024;73(SS-7):1–28. doi:10.15585/mmwr.ss7307a1