by Wm. Robert Johnston
last updated 25 November 2023
In 2022-2023 the Society for Family Planning (SFP) and Guttmacher Institute (Guttmacher or GI) have published estimates of monthly abortions for U.S. states with the stated objective of tracking changes resulting from post-Dobbs policy changes. These estimates are based on direct surveys of abortion providers combined with estimation methods and models. Limited descriptions of these surveys and estimation methods/models are provided. The SFP and Guttmacher estimates analyzed here are from the following releases:
The SFP estimates are based on periodic requests to all abortion providing facilities they have identified, of whom 83% responded to them for their most recent report. SFP requests monthly abortion counts and compensates participating facilities. SFP estimated figures for non-participating facilities and for missing months for participating facilities with approaches including estimates based on "state health department data, news articles, contacts known to the missing clinics, and knowledge of the abortion volumes by state", 2020 data from the Guttmacher Institute. In other cases clinic-level figures were estimated based on monthly trends for reporting facilities and based on figures from "similar" facilities. SFP has revised their methodology somewhat in successive reports. SFP has also provided for each state a range for the imputed (estimated) abortions versus those reported by facilities; notably, the revisions to estimated state-level numbers in successive releases have in some cases exceeded the reported imputation level (Norris et al., 2023c).
The Guttmacher estimates are based on monthly requests to all facilities that "play a particularly important or unique role in provision (e.g., because they border a state with an abortion ban or because they provide a large share of abortions in the state)" and a random sample from remaining larger facilities (with monthly caseloads requested for these retroactively for the current calendar year). Sampled facilities are restricted to those providing at least 50-300 abortions in either 2019 or 2020 (with threshold depending on facility type) and facilities beginning to perform abortions after 2020. For unsampled facilities meeting the threshold in abortion numbers, or for sampled facilities with missing data, estimates are produced from a model that incorporates observed trends and variability. Some model parameters are derived from in-state data, some from all states, and some from states grouped by whether or not they border on states with abortion bans. Planned Parenthood facilities and "virtual" clinics are "purposively sampled" separately. For excluded small facilities, estimates are modeled based on variability for similar facility types. (Maddow-Zimet et al., 2023b)
Here, I will compare the SFP and Guttmacher estimates to available state-reported data with the objective of assessing what can be concluded about recent abortion trends for each state. Summary of findings is forthcoming with some initial conclusions given here.
For each state the SFP has reported monthly estimates for each state starting for April 2022, shortly before the Dobbs decision returned abortion policy to the states in June 2022. In their four successive releases SFP has reported for a longer time period and updated prior figures, covering through June 2023 in the latest release. Guttmacher reported monthly estimates for January-June 2023 in their first release, with two updates so far updating prior figures and most recently covering through August 2023.
State-reported abortion data are usually a year or two behind the present, but is more or less current for some states. Of the 50 states, abortion data have not been reported for some years now for California, Maryland, and New Hampshire, while New Jersey recently stopped reporting. Monthly data are reported by 15 states, this number having recently increased with several state health departments likely opting to capture effects of post-Dobbs policy changes. The remaining 31 states and D.C. report annual data only.
Examination of past monthly abortion data shows very consistent seasonal trends in abortion (Johnston, 2023a). The figure below shows these seasonal trends for 14 states and DC, limited to data through 2021 (before post-Dobbs decision policy changes affected trends). For comparisons here, annual state data are shown with this seasonal trend applied to produce monthly estimates. The Guttmacher annual estimates for 2019-2020 also have this applied, plus the monthly Guttmacher estimates for 2020 are repeated for each following year to show what would be expected if abortion levels were unchanged from 2020.
The next figures explain how estimates are shown in the state and U.S. plots that follow (using Oregon as an example).
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The analyses for individual states are grouped based on changes in abortions levels from 2020-2021 to 2022-2023 according to the SFP and Guttmacher estimates. These state groups are shown in the map below. The groups are:
States dropping to near-zero abortions (14 states)
Alabama: Abortions fell to negligible numbers in July 2022 according to SFP figures and consistent with a low annual average for 2022 in state figures. Higher state figures and SFP figures for April-June 2022 suggest that abortions were about 20% higher than prior years just prior to the 2022 ban.
Arkansas: State-reported quarterly abortion figures are available for 2019-2020 (Altindag and Joyce, 2022) and show significant variability during 2019. Abortions fell to negligible numbers in July 2022 according to SFP figures and consistent with a low annual average for 2022 in state figures. State figures for 2021 were consistent with prior years. SFP reports a spike in abortion numbers in May 2022 about 15% above seasonal norms.
Idaho: Abortions fell to negligible numbers in September 2022 according to SFP figures, consistent with a low annual average for 2022 in state figures. State figures for 2021 are lower than 2020. SFP revised their estimates upward in their second data release, claiming a spike in abortion numbers in June 2022 about 50% above seasonal norms.
Kentucky: State-reported monthly data are available and are consistent with SFP data, both showing abortions falling to negligible numbers in August 2022. Both state and SFP figures also show a pre-ban spike in abortions in early 2022.
Louisiana: Abortions fell to negligible numbers in August 2022 according to SFP figures and consistent with a low annual average for 2022 in state figures. SFP figures imply a spike in abortion numbers in April-May 2022 to about 25% higher than seasonal norms; this appears compatible with the state reported total for 2022.
Mississippi: Abortions fell to negligible numbers in July 2022 according to SFP figures (state data for 2022 are not yet released). In-state abortions have been increasing in 2019-2021. SFP reports a spike in abortion numbers in June 2022 to about 30% above seasonal norms.
Missouri: Abortion restrictions came into effect early in Missouri, banning most abortions by 2020. State reported abortions in 2020-2022 were about 85% lower than 2019 (with 2019 already well below prior years). SFP figures report negligible abortions from July-August 2022 forward.
North Dakota: State-reported monthly data are available and are consistent with SFP data, showing abortions falling to negligible numbers in August or September 2022. State-reported monthly data show large variability month-to-month in 2019-2022 likely due to fluctuations for the small numbers occurring in North Dakota.
Oklahoma: State-reported monthly data are available but show a decline to negligible numbers in May 2022, a month prior to what SFP data report. Guttmacher annual abortion estimates for 2019 and 2020 were significantly higher than state-reported figures--by 60% in 2019 and 100% in 2020. State-reported data show higher abortions in 2021 than 2020 and in early 2022 over the prior year; this is known to include significant numbers of abortions obtained by Texas residents.
South Dakota: State-reported monthly data are available and are consistent with SFP data, both showing abortions falling to negligible numbers in July 2022. State-reported monthly data show large variability due to small numbers of abortions in South Dakota and also show few abortions occurring in April-September 2020 associated with travel restrictions limiting the ability of an out-of-state abortionist to perform abortions in the state (Longbons, 2022a).
Tennessee: Abortions fell to low numbers in July 2022 then to negligible numbers in September 2022 according to SFP figures (state data for 2022 are not yet released). SFP data imply a spike in abortion numbers in early 2022.
Texas: State-reported monthly data are available and are consistent with SFP data, both showing abortions falling to negligible numbers in July 2022. The monthly state-reported data show other policy-related impacts. Abortions dropped in early 2020 due to restrictions on non-essential surgeries from 22 March to 21 April 2020 (Longbons, 2022b). The Texas Heartbeat Act took effect on 1 September 2021, banning abortions once the preborn child's heartbeat is detectable except in medical emergency cases, and this is associated with a 46% drop in abortions.
West Virginia: State-reported monthly data are available and are consistent with SFP data, both showing abortions falling to negligible numbers in September-October 2022. The state-reported annual data for 2021 are 35% higher than 2020 and the state-reported monthly abortions were higher in early 2022 than seasonal norms, together suggesting a pre-ban increase in abortions. Monthly abortion numbers fluctuated significantly during their general decline in early-mid 2022.
Wisconsin: Abortions fell to negligible numbers in July 2022 according to SFP figures (state data for 2022 are not yet released). Prior to this the state-reported data show no year-to-year trend and the SFP figures prior to the ban are consistent with no pre-ban spike in numbers.
States reported with moderate drops in abortions (2 states)
Arizona: State-reported monthly data are available through 2021 and show large fluctuations in late 2020. State-reported abortions for December 2021 as well as SFP estimates for April-May 2022 are higher than prior norms which could reflect elevated levels in anticipation of abortion restrictions. Figures estimated by SFP for July-October 2022 average about 50% lower than prior norms, likely related to abortions restrictions briefly in effect before being blocked (Steupert and Longbons, 2023). In 2023 Guttmacher estimates are 17% below seasonal norms based on 2020 abortion levels, though with large uncertainties, while SFP estimates are similar to 2020 levels.
Georgia: SFP figures claim abortions in April-June 2022 were 30% above levels expected based on Guttmacher annual figures for 2020. SFP reports a drop of 50% in August 2022 with levels rising somewhat afterwards. Guttmacher estimates for early 2023 are 28% below levels expected based on 2020 levels though with uncertainties of 25%. The timing of SFP-estimated drops in late 2022 are consistent with implementation of a Hearbeat law on 20 July 2022 (briefly blocked 15-23 November 2022). State-reported annual figures for 2022 are similar to 2021 levels which are compatible with elevated levels in early 2022 and reduced levels in late 2022. Thus abortions appear to have dropped signficantly in Georgia though with large uncertainties. Note that in 2019-2020 Guttmacher annual figures were 10-15% higher than state-reported figures, indicating significant underreporting.
States reported with no change or ambiguous (7 states plus D.C.)
Indiana: Monthly state-reported abortion data are available and are consistent with SFP and Guttmacher figures. These indicate a rise in abortion numbers in March-August 2022 with a peak in July 2022 about 50% higher than seasonal norms. Abortion numbers in late 2022 and early 2023 have been consistent with 2019-2020 rates. Note that Indiana has reported monthly abortion data through June 2023, the most current monthly-level data from a state where abortion was largely unrestricted. This changed with a state abortion ban going into effect 21 August: Guttmacher reports (Maddow-Zimet et al., 2023c) that few if any abortions occurred in August in anticipation of the ban.
Iowa: State-reported monthly data are available and show large fluctuations in 2020-2021, some of which could related to COVID pandemic disruptions. The state-reported monthly data and SFP estimates for 2022 are consistent in showing abortions 35% higher than recent norms in early 2022, levels returning to normal in August-October 2022, then an increase at the end of 2022. Guttmacher estimates for 2023 are highly variable with levels above prior norms in January-March while similar to norms in April-June (the latter with large uncertainties). The future of abortion policy in Iowa has been uncertain in 2023 with legislation passed into law but blocked by the state supreme court. No recent clear trend can be confirmed for Iowa.
Nebraska: Monthly state-reported abortion data are available through December 2022 and are largely consistent with SFP-reported figures except for December 2022 where SFP figures are about 40% higher. State-reported data show more month-to-month fluctuation in 2022 than in prior years. SFP and Guttmacher data also show large fluctuations in 2022-2023 with Guttmacher reporting a 15% uncertainty for their early 2023 estimates. The state and SFP data for 2022 are consistent in showing abortion levels higher than prior years, but the SFP and Guttmacher data for 2023 are inconsistent and too uncertain to support conclusions for 2023.
New Jersey: In 2019-2020 Guttmacher annual abortion estimates were 100% higher than state-reported figures, a situation of underreporting that has long persisted in New Jersey. SFP figures have been signficantly revised in each release with the latest release reporting a 50% drop in abortions for November 2022. Guttmacher figures for 2023 are slightly higher than expected (9%) based on their 2020 estimates, but the stated uncertainty for 2023 is 15%. Consequently there is no confidence that abortion levels have changed in 2022-2023.
New York: In 2019-2020 Guttmacher annual abortion estimates were 30-60% higher than state-reported figures. SFP estimates for 2022-2023 were similar to levels in Guttmacher's 2020 annual estimate. The Guttmacher estimates for early 2023 are about 12% than levels based on Guttmacher's 2020 annual estimate, but the 2023 figures have stated uncertainties of 15% and the third round of Guttmacher estimates were significantly revised. Togther this yields no confidence in a 2022-2023 change in abortion levels.
Ohio: SFP figures report a 60% drop in abortions in July-September 2022 with a slow rise afterwards back to prior levels. This corresponds to the period between when a heartbeat law went into effect on 24 June 2022 and when it was blocked by a court on 14 September 2022. SFP figures for early 2023 are similar to seasonal norms while Guttmacher figures are slightly higher but with 5-10% uncertainties. No strong conclusions about overall recent trends can be drawn.
Wyoming: Prior to the Dobbs decision, Wyoming had the lowest levels of in-state abortions for any state according to Guttmacher estimates. Wyoming did not report figures for many years prior to 2018 and the increase in annual abortion numbers reported by the state from 2019-2022 likely reflects improvements in reporting rather than an actual increase. The SFP and Guttmacher figures are inconsistent by about a factor of two and the latter have large reported uncertainties. Uncertainties for all available Wyoming data are too large to support conclusions regarding recent trends.
District of Columbia: In 2019-2020 Guttmacher annual abortion estimates were 100% higher than district-reported figures, indicating significant underreporting. SFP estimates are 16% higher than expected based on Guttmacher estimates for 2020, while the Guttmacher estimates for 2023 are slightly lower than 2020-based expectations with uncertainties of 20%. Data for the District of Columbia are too uncertain to indicate possible recent trends.
States reported with moderate increases in abortions and not bordering restrictive states (9 states)
Alaska: SFP and Guttmacher estimates claim that abortions increased by 20-36% in late 2022 and early 2023 relative to levels in the Guttmacher annual estimates for 2019-2020, though with much month-to-month variability. This is very unlikely to represent increased abortions by non-residents given Alaska's isolation.
California: The state of California has not reported comprehensive abortion data since 1980 and the limited reporting of Medi-Cal state-funded abortions ended in 2014. The most recent annual Guttmacher estimates for 2020 report 17% of all U.S. abortions occurring in California. Thus any uncertainty in California abortion figures impact total estimates for the United States. The first SFP estimates for mid-2022 were 35% higher than levels expected based on Guttmacher annual estimates for 2019-2020. In their second release, SFP revised these figures down to levels consistent with the Guttmacher levels of 2019-2020. Both SFP and Guttmacher claim that abortions later rose 8-12% above the prior norms with SFP reporting the increase starting in November 2022. Since California is far from states with both post-Dobbs abortion restrictions and large populations (e.g. Texas), this increase may not be fully attributed to an increase in non-resident abortions.
Connecticut: SFP estimated abortions in 2022 were similar to levels expected based on Guttmacher annual figures for 2020. However, SFP and Guttmacher report higher abortion levels in 2023. Guttmacher figures for 2023 are 22% higher than expected based on 2020 estimates and are reported to have low uncertainties, though they are 10-15% higher than SFP figures. Notably, the Connecticut Department of Public Health has declined to release 2022 abortion data (Diocese of Norwich, 2022).
Hawaii: Guttmacher estimates claim that abortions increased by 11% in early 2023 relative to levels in the Guttmacher annual estimates for 2019-2020. This is very unlikely to represent increased abortions by non-residents given Hawaii's isolation. Note that Guttmacher annual figures for 2019-2020 were 50-60% higher than state-reported figures, indicating signficant underreporting; changes in underreporting could be a factor in the variation of state-reported annual figures in 2019-2021. SFP estimates for 2022-2023 are similar to expected levels based on Guttmacher's 2020 estimate.
Maine: State-reported annual abortions have generally increased from 2019 to 2022; Guttmacher annual figures for 2020 were higher than for 2019 and also implied state underreporting of 10%. SFP and Guttmacher monthly figures for 2022-2023 show large month-to-month variation. Compared to norms based on Guttmacher annual figures for 2020, SFP figures average 14% higher and Guttmacher figures 1% lower (though the initial Guttmacher estimates were 10% higher).
Massachusetts: State-reported annual abortions have been consistent from 2019 to 2022, and Guttmacher annual figures for 2019-2020 were very similar to state figures implying little underreporting. SFP and Guttmacher monthly figures for late 2022-early 2023 are about 13% higher than expected based on recent trends.
New Hampshire: New Hampshire has declined to report abortion figures since 1997. The SFP and Guttmacher figures for 2022-2023 are about 25% and 8% higher, respectively, than expected based on Guttmacher's 2020 annual estimate, with the SFP and Guttmacher figures for early 2023 disagreeing by up to 20%.
Rhode Island: State-reported annual figures showed an increase from 2019 to 2020 then a decrease in 2021. SFP and Guttmacher estimates for 2022-2023 are higher than state reported figures by about 50%, with large month-to-month variability.
Vermont: SFP estimated abortions for 2022 were about 50% higher than would be expected based on state-reported annual abortions for 2022. Guttmacher figures for 2023 are even higher. However, 2019-2020 state and Guttmacher annual figures are very similar, suggested little underreporting. State-reported figures have continued to drop since then even through the first half of 2023 (Mearhoff, 2023). Thus the SFP and Guttmacher estimates for 2022-2023 appear to be too high in addition to disagreeing with each other significantly.
States reported with moderate increases in abortions and bordering restrictive states (9 states)
Florida: State-reported annual figures for 2019-2023 show a trend of increasing abortions, about 4% per year. SFP estimates for 2022-2023 claim an increasing trend amounting to 20% year-over-year. The Guttmacher estimates for early 2023 are 12% lower than the SFP figures and are consistent with the state-reported figures for 2023, thus the Guttmacher estimates appear more plausible.
Michigan: State-reported annual figures for 2020-2022 are very similar. SFP estimates for 2022 are 20% higher than expected based on state-reported annual data. SFP and Guttmacher figures for 2023 are both about 11-15% higher than expected based on Guttmacher annual figures for 2020.
Minnesota: State-reported monthly data are available through 2022 and show an increase of 50% for late 2022 compared to late 2021. Guttmacher annual estimates for 2019-2020 are 12% higher than state figures implying notable underreporting. The SFP figures for 2022 are similarly higher than monthly state figures but consistent with this prior level of underreporting. The Guttmacher and SFP figures both claim a further increase in early 2023 to levels 60% higher than reported for 2021.
Montana: State-reported annual figures showed a 10% increase in abortions from 2019 to 2021. Compared to reported abortions for 2021, SFP figures for 2022-2023 are 20% higher and Guttmacher figures for early 2023 are 10% higher. The lower Guttmacher figures for 2023 would be consistent with recent year-to-year trends--apart from the new estimate for August 2023 which claims a 30% increase.
Nevada: State-reported annual figures for 2019-2020 are 10-20% lower than Guttmacher estimates, indicating signficant underreporting. Both SFP and Guttmacher estimates claim a large increase in abortions in 2022-2023 compared to 2020 levels, increases amounting to 51% and 44% in 2023, respectively.
North Carolina: State-reported annual abortions rose 15% from 2019 to 2021. Monthly SFP and Guttmacher estimates for 2022-2023 average 46% higher than reported abortion levels in 2021.
Oregon: State-reported monthly data are available through September 2023, though 2023 data are likely incomplete (particularly September data). State figures show decreasing monthly abortions from early 2019 to late 2020, then an increase to early 2023. SFP estimates for late 2022 are 60% higher than state figures, and Guttmacher and SFP estimates for early 2023 are 25% and 40% higher than state figures, respectively. These differences are large compared to the underreporting of 20% implied by Guttmacher and state annual figures for 2020. Current abortion levels in Oregon are thus uncertain.
Pennsylvania: State-reported annual figures for 2019-2021 showed a slow trend of increasing abortions. Preliminary state figures for 2022 show little change (PA Family, 2023). SFP and Guttmacher estimates for 2022-2023 are 9-12% higher than levels from Guttmacher's 2020 estimate.
Utah: State-reported monthly figures for 2019-2021 show a 50% decrease in abortions in late 2020 followed by a return to prior levels (these monthly figures only cover resident abortions, not non-resident abortions). SFP and Guttmacher monthly estimates for 2022-2023 show much month-to-month variability but average 29% higher than expected based on Guttmacher's 2020 annual estimate.
Washington: State-reported annual figures show a slow decline in abortions from 2019 to 2021. SFP and Guttmacher estimates for 2022-2023 are 26-31% higher than expected based on Guttmacher's 2020 annual estimate. The latest Guttmacher estimate claims a 16% increase in August 2023 relative to early 2023, at odds with expected seasonal trends.
States reported with large increases in abortions (9 states)
Colorado: State-reported annual figures show increases from 2019 to 2022, with 15% increases in 2020 and 2021 and 25% in 2022. Guttmacher annual estimates for 2019-2020 implied underreporting of about 20%. SFP estimates for 2022 are about 70% higher than implied by the state reported total for 2022. SFP and Guttmacher figures for early 2023 are 60% higher than would be expected based on state figures for 2022 even assuming 20% underreporting. The SFP and Guttmacher figures would require both very large increases in total abortions and large increases in underreporting.
Delaware: State-reported annual figures show an increase from 2019 to 2020 then a decrease in 2021. SFP monthly estimates claim very large increases during 2022 with some drop in 2023; for 2022 and 2023 these are 66% and 55% higher than levels based on Guttmacher's 2020 annual estimate. Guttmacher's monthly estimates for 2023 are even higher at 78% above levels from Guttmacher's 2020 estimate.
Illinois: State-reported annual figures for 2021 were 15% higher than levels in 2019 and 2020. SFP monthly estimates claim a very large increase during 2022 averaging 50% higher than levels based on Guttmacher's 2020 annual estimate. SFP and Guttmacher both claim even higher levels in 2023 at 71% and 62% higher, respectively, than levels based on Guttmacher's 2020 estimate.
Kansas: State-reported annual figures for 2019-2021 show an 8% year-to-year increase and are similar for 2019-2020 to Guttmacher annual estimates. The state-reported annual figure for 2022 is 60% higher than 2021 and is compatible with the SFP monthly estimates for 2022. Compared to SFP estimates for late 2022, the latest Guttmacher estimates for early 2023 are 15% higher and the SFP estimates for early 2023 are 30% higher. Though trends for 2023 are unclear, it appears that Kansas abortions have significantly increased due to increased non-resident abortions.
Maryland: Maryland has declined to report abortion figures since 2011. The Guttmacher annual estimates for 2019 and 2020 were similar and were consistent with the monthly SFP estimates for mid-2022. However, compared to expected levels based on the 2020 Guttmacher estimate, the SFP estimates for early 2023 are 29% higher while the latest Guttmacher estimates for early 2023 are 56% higher.
New Mexico: State-reported annual abortions increased in both 2020 and 2021 over the previous year, with an even larger increase in Guttmacher annual estimates from 2019 to 2020 implying an increase in underreporting. SFP and Guttmacher monthly figures for 2022-2023 claim a threefold increase in abortions occurring in New Mexico relative to the Guttmacher figure for 2020. While New Mexico has not released comprehensive figures for 2022 or 2023, state officials have provided some figures implying a doubling in abortions relative to 2020 (New Mexico Attorney General, 2023). Many other reports confirm a large increase in New Mexico abortions for non-residents. It appears likely that New Mexico is becoming a significant site of "abortion tourism".
South Carolina: State-reported annual figures show substantially increasing abortions from 2019 to 2022 with 2022 levels 40% higher than 2019. SFP monthly estimates for 2022 show extreme variability before finishing nearly double the levels of state-reported abortions in 2021, but together are compatible with the state-reported total for 2022. SFP and Guttmacher monthly estimates for 2023 are 112% higher than expected based on Guttmacher's 2020 estimate, or 70% higher than levels based on state-reported data for 2022.
Virginia: State-reported annual figures show a slow increase in abortions from 2019 to 2021, though Guttmacher's 2020 annual estimate is 15% higher than their 2019 estimate. Guttmacher's 2020 figure is also 15% higher than the state-reported figure for that year, implying significant underreporting. SFP monthly estimates for 2022 are 54% above levels expected based on Guttmacher's 2020 estimate. Compared to the Guttmacher 2020 estimate, for 2023 the SFP estimates are 89% higher and the Guttmacher figures are 53% higher, disagreeing significantly.
State-by-state comparisons: First, state-level trends are summarized as follows:
Note that the level of confidence in the Guttmacher and SFP estimates is highly variable. Degree of confidence may be qualitatively assessed by three indicators: level of agreement between SFP and Guttmacher estimates, Guttmacher-reported uncertainty in their estimates, and level of agreement between those estimates and trends in official figures (where available). The table below groups states by (1) degree of change in abortions from 2019-2020 to 2022-2023 based on SFP/Guttmacher estimates and (2) degree of confidence in the SFP/Guttmacher estimates for 2022-2023.
| reported change, 2019-20 to 2022-23 | high confidence | moderate confidence (within 10%) | low confidence (10-60% uncertain) |
|---|---|---|---|
| drop to near zero | Alabama, Arkansas, Kentucky, Louisiana, Missouri, North Dakota, Oklahoma, South Dakota, Texas, West Virginia, Wisconsin | Idaho, Mississippi, Tennessee | |
| some drop (~20%) | Arizona, Georgia | ||
| little change (<5%) | Indiana, Iowa, Ohio | Nebraska, New Jersey, New York, Wyoming, (District of Columbia) | |
| some rise (5-50%) | Florida, Massachusetts | Michigan, Minnesota, Oregon, Pennsylvania | Alaska, California, Connecticut, Hawaii, Maine, Montana, Nevada, New Hampshire, North Carolina, Rhode Island, Utah, Vermont, Washington |
| large rise (>50%) | South Carolina | Colorado, Delaware, Illinois, Kansas, Maryland, New Mexico, Virginia |
The next figure gives another look at the uncertainties and sizes of the estimated changes in abortions for each state. The horizontal axis shows change in the third Guttmacher estimates (Maddow-Zimet et al., 2023c) for Jan.-June 2023 relative to an estimate for Jan.-June based on the Guttmacher estimate for 2020 (using the average seasonal pattern). The vertical axis shows reported uncertainty based on the greater of (1) Guttmacher-stated uncertainty in their third release, (2) differences between the successive Guttmacher estimates, and (3) the difference between the most recent Guttmacher and SFP estimates. Note that this does not consider differences between Guttmacher estimates and recent state-reported data (hence the differences between uncertainties in the figure below and the table above). The 14 states with drops to near-zero abortions by Jan. 2023 are not shown, and Wyoming is not shown because its abortion numbers are too small to show statistically significant recent trends.
The five states with the largest numbers of estimated abortions in 2023 account for half of estimated abortions nationwide. These states are California, Florida, Illinois, New Jersey, and New York, and are shown with larger symbols. Of the 35 states (and D.C.) shown in the figure, 11 have reported uncertainties larger than or nearly as large as the amount of change estimated for 2023 relative to 2020 (highlighted area in figure).
Other state-specific results: A few states show impacts in 2020 on abortion numbers related to COVID restrictions (e.g., South Dakota, Texas) (Johnston, 2023a). Abortions in Texas dropped in early 2020 due to restrictions on non-essential surgeries from 22 March to 21 April 2020 (Longbons, 2022b), and mid-2020 drops in South Dakota abortions resulted from travel restrictions limiting the ability of an out-of-state abortionist to perform abortions in the state (Longbons, 2022a). COVID-related changes in abortions in other states are more difficult to confirm given the typical month-to-month variability in abortions.
For each state, preliminary estimates of 2021-2023 abortions (partial year for 2023) are available on these pages. These estimates (in the "abortions, merged" column) are based on state-reported data, the SFP and Guttmacher estimates, and supplementary data from media reports. Guttmacher estimates for the first half of 2023 are also shown (in the "abortions (AGI)--total in state" column) (Maddow-Zimet et al., 2023a).
Apparent issues with interpretation of Guttmacher and SFP estimates: Statements by media sources (citing the new SFP and Guttmacher estimates) regarding a net increase in nationwide U.S. abortions under post-Dobbs policies are not supported by the data given large uncertainties. Some of SFP/Guttmacher-based quantitative comparisons do not account for seasonal abortion trends (Johnston, 2023a) when examining partial year data. (Seasonal patterns are acknowledged in Maddow-Zimet et al., 2023c.) Queries of providers for monthly data might be prone to yield exaggerated figures (Bankole et al., 2015). Estimation methods by SFP for non-reporting facilities may be prone to exaggerate numbers, if non-reporting facilities are more likely to have low numbers than reporting facilities. In their first release, Guttmacher estimated an upward trend in May-June 2023 for monthly abortions for the U.S. in total and several individual states; this is likely an artifact of their model unduly relying on Indiana which was the only state-reported monthly data for the second quarter of 2023. The same issue occurred with the third Guttmacher release, where of the 35 states with non-zero abortions 32 showed an estimated increase from July to August; the median increase was 10%. The Guttmacher authors suggested this was a seasonal effect, but this is inconsistent with previously observed seasonal trends.
Total abortions for the United States: The figure below shows that SFP and Guttmacher estimates for 2022-2023 are slightly above the seasonal figures that would be expected based either on Guttmacher annual estimates for 2020 or on the seasonal trends derived for the U.S. (Johnston, 2023a). On average, the SFP and Guttmacher monthly figures are 6% higher than the 2020-derived figures. The stated uncertainties for the Guttmacher estimates average 4%. Note that Guttmacher states that their data "do not yet support a clearcut narrative on national abortion trends" (Guttmacher Institute, 2023).
Implications for suggested trends: At this point in time, official data are too incomplete to shed light on this uncertainty in nationwide trends. Based on comparisons of 2019-2020 state data and Guttmacher estimates, 25 states had underreporting levels less than 5%. Total abortions for these states showed a 2% increase from 2020 to 2021, and for the 20 states that have reported 2022 data total abortions dropped 16% from 2021 to 2022. However, these reporting states are disproportionately ones with new abortion bans (10 of the 20 states reporting, vs. 14 of 50 states overall). For most remaining states with reported data, most showed variable underreporting between 2019 and 2020 and thus recent figures may not be reliable for showing trends. Most importantly, of the one-third of abortions that went officially unreported in 2019-2020, 85% were from four states that have large scale underreporting/non-reporting issues: California, New York, Maryland, and New Jersey. The lack of reliable information for these states complicates attempts to discern recent trends, to say the least.
Thus, while a slight increase in U.S. abortions in 2022-2023 over previous years cannot be ruled out, there are sufficient uncertainties in SFP and Guttmacher estimates that such a claim is not yet established. U.S. total abortions have been trending downward from the late 1980s through 2017 but began increasing in 2018-2020, prior to post-Dobbs policy changes. Possible factors in this increase could include changing U.S. population and demographics. If the increasing trend indeed continued through 2022-2023, additional factors could include economic problems and the dramatic increase in abortion promotion by its advocates.
This last possibility, that increased abortion promotion has caused a net increase in many states, is concerning but plausible. For states with new abortion bans, analyses both pre- and post-Dobbs indicate it is unlikely for out-of-state abortions to reach numbers equal to the drops in abortions within those states. The increases in abortions claimed by SFP and Guttmacher in some states with pro-abortion policies are extremely difficult to fully explain in terms of out-of-state abortions by non-residents--particularly for states remote from those with new bans. On the contrary, officially reported abortions by residents occurring in the state of residence increased from 2020 to 2022 by 13% for Colorado and Georgia and by 7-8% for Florida, Maine, Minnesota, and Oregon, while they increased from 2020 to 2021 by 11% for Connecticut and Illinois (which have not yet reported 2022 data).
The Guttmacher Institute and SFP estimates of monthly state abortions are a unique effort to evaluate abortion number trends resulting from post-Dobbs policy changes. For a number of states the estimates are supported by available state data and affirm near zero abortions in the 30% of states that have implemented pro-life policies restricting abortion. However, more generally the uncertainties in estimates vary significantly from state to state, and collectively the uncertainties are too large to give confidence in national trends. The claimed large abortion increases in states with unrestricted abortion also vary in plausibility. For some states the increases are consistent both with expected increases in abortions by non-residents and with state-reported data. In other cases the validity of the estimated increases is unconfirmed. It remains to be seen whether these novel estimation methods are broadly reliable, or whether they are revealing increased abortions in some states for reasons not yet fully characterized.
© 2023 by Wm. Robert Johnston.
Last modified 25 November 2023.
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