Abortions in United States Rise to Highest in Over a Decade

Oral medication accounted for 63 percent of all pregnancy terminations last year.

A woman views information about abortion pill mifepristone on a computer in Arlington, Va., on May, 8, 2020. Olivier Douliery/AFP via Getty Images

Abortion rates jumped by 10 percent between 2020 and 2023 despite several states enacting strict laws against such terminations following the reversal of Roe v. Wade.

There were an estimated 1.02 million abortions in the formal healthcare system in the United States in 2023, the first full calendar year after the U.S. Supreme Court overturned Roe V. Wade, according to the Monthly Abortion Provision study from the left-leaning Guttmacher Institute.

“This represents a rate of 15.7 abortions per 1,000 women of reproductive age and is a 10 percent increase since 2020, the last year for which comprehensive estimates are available. It is also the highest number and rate measured in the United States in over a decade,” said a March 19 press release.

“The last time there were over a million abortions provided in the formal health care system in the United States was in 2012. This increase demonstrates that people continue to seek and obtain abortion care despite the drastic reduction in abortion access in many states.”

Since the Supreme Court decision, 14 U.S. states have either banned or instituted limited exceptions for abortions. In seven states, laws restrict access to abortion based on gestational duration.

“While access has decreased dramatically in states with bans, almost all other states have experienced substantial increases in the number of abortions provided. As a result, the United States continues to face a fractured abortion landscape, with access varying widely based on where people live and what resources they have,” Guttmacher said.

States bordering other states that have instituted abortion bans saw a 37 percent jump in abortions, with “particularly sharp increases” in Illinois, New Mexico, Virginia, and North Carolina.

“Illinois, for example, provided abortion care to an estimated 25,660 more patients from out of state, accounting for 68 percent of its overall increase.”

In 1990, abortions in the country peaked at 1.6 million, after which a “sustained decline” was seen over 30 years, culminating in 885,000 abortions in 2017. But that year, this trend began to reverse, with abortions jumping 8 percent from 2017 to 2020.

Out of the 1.02 million abortions, 642,700 were medication abortions, representing 63 percent of all abortions. Medication abortions have risen from 53 percent in 2020.

“As abortion restrictions proliferate post-Dobbs, medication abortion may be the most viable option—or the only option—for some people, even if they would have preferred in-person procedural care,” said Rachel Jones, Guttmacher principal research scientist.

Supreme Court Case on Abortion Pills

The report comes as the U.S. Supreme Court is set to hear oral arguments next week in a case on the abortion drug mifepristone.

Medical abortion in the country is done using two pills—mifepristone and misoprostol. Mifepristone was approved by the U.S. Food and Drug Administration (FDA) in 2000.

The FDA made two changes related to mifepristone.

Back in 2016, the agency extended the drug cutoff date from 49 days of gestation to 70. The agency allowed the drug to be prescribed to women after just a single in-patient visit while blocking the report of nonfatal adverse events related to the medication.

In 2021, the FDA allowed mifepristone to be sent by mail.

Two cases were filed against the changes, one against Danco Laboratories, which manufactures mifepristone, and the second against the FDA. The Supreme Court consolidated the cases and will hear arguments on March 26.

Opponents point out that FDA changes in 2016 and 2021 removed key safety protocols that protected women. The consolidated case will deal only with these arguments and not tackle the FDA approval granted in 2000.

Attorney Erik Baptist of the Alliance for Defending Freedom, who is representing abortion opponents in the case, told The Epoch Times in January that he expects a positive outcome.

“Every judge who has looked at it so far, and every court has agreed that what the FDA did is so egregious and unlawful that it’s well within the realm of the court’s jurisdiction to strike down those agency actions to take away those common-sense safety standards,” he said.

A decision in the case is expected to be issued by June.

Last year, U.S. District Judge Matthew Kacsmaryk of Texas, a Trump appointee, ruled that the FDA was wrong in approving the drug and that the agency improperly lifted safety restrictions.

He issued a preliminary injunction blocking the FDA approval, which the Supreme Court lifted.

While supporters of medical abortion claim that the drugs are safe, research indicates otherwise. A 2021 study found that women who took the pills experienced “serious complications.”

“The major complaint at presentation was excessive bleeding (78 percent). Out of 100 patients, 66 percent of cases were diagnosed as incomplete abortion, 6 percent as missed abortion, and 6 percent as unaffected pregnancy,” the study said.

“Ectopic pregnancy was detected in 12 percent of cases.” Ectopic pregnancy requires surgical intervention.

“Restriction of the over-the-counter dispensation of abortion pills needs to be strictly implemented and knowledge of women regarding the unfavorable outcome of MTP (medical termination of pregnancy) pill intake without proper consultation needs to be improved,” the study recommended.

A 2022 study of mifepristone found that users suffered from severe reactions including fetal death, toxic epidermal necrolysis—a skin condition that can be life-threatening—and anaphylactic or allergic reactions.