Pre-Roe abortion services and trends in US

Investigators conducted a study to gather a baseline assessment of abortion incidence and service delivery prior to Roe v Wade being overturned earlier this year.

They collected data from all facilities known to have provided abortion services in the US in 2019 and 2020 and examined abortion incidence by state, region, and nationally and combined data on number of abortions with population data to estimate abortion rates. Additionally, they looked at the number of abortion clinics, trends in medication abortion and service disruptions and changes in abortion protocols due to COVID-19. They then compared their findings to the previous Abortion Provider Census from 2017.

As for their findings, they ultimately documented 930,160 abortions in 2020, which was an 8% increase from 2017. Abortion incidence, investigators found, increased in all 4 regions of the country and in majority of states between 2017 and 2020. The total number of clinics providing abortion care stayed stable nationally, but increased in the Midwest and West, declining in the Northeast and South. For medication abortions, investigators found a total of 492,210 in 2020, which was a 45% from 2017. They also found that a substantial minority of clinics adjusted protocols in response to COVID-19, most commonly adopting remote pre- and post-abortion counseling.

The investigators ultimately found that the long-term decline in abortion in the US has reversed. The number of abortions increased overall between 2017 and 2020 and the abortion rate increased 7%. They also found that the overwhelming majority of abortions (96%) were provided by abortion clinics, and they play an important role in access to care. According to investigators, while there were changes in clinic numbers for many states, they were not always in ways that suggested increased abortion.

Perhaps most interestingly, investigators found that medication abortions provided in a clinical setting increased substantially during the study period, and for the first time, accounted for the majority of abortions in 2020.

Reference

Jones RK, Kirstein M, Philbin J. Abortion incidence and service availability in the United States, 2020. Perspectives on Sexual and Reproductive Health. Published online November 20, 2022. doi:10.1363/psrh.12215