The number of yearly abortions in the United States rose by 10 percent between 2020 and 2023, while medication abortions became more common than ever, according to a report published Tuesday by a research and advocacy group that favors abortion rights.
The Guttmacher Institute found that there were more than 1 million U.S. abortions last year, the first time since 2012 that the tally crossed that threshold. The group also reported that medication abortions made up 63 percent of those performed during that time, or about 642,700 procedures, up from 53 percent in 2020.
The rise in both numbers in the first full year since the U.S. Supreme Court overturned Roe v. Wade comes as more than a dozen states have largely banned abortion, and as the Supreme Court weighs whether it will restrict mifepristone, a key pill that is part of the two-drug regimen used in medication abortions. Oral arguments in that case are scheduled for March 26, further elevating the issue of abortion, which Democrats have seized on ahead of the 2024 election.
“This increase demonstrates that people continue to seek and obtain abortion care despite the drastic reduction in abortion access in many states,” wrote the report’s authors. They noted the estimates are likely an undercount since the numbers do not include abortions that took place outside the “formal health care system” or abortion pills mailed to people in states with total bans.
The report said the abortion rate for women and girls ages 15 to 44 increased to 15.7 abortions per 1,000 women, up from 14.4 per 1,000 in 2020.
Some of the largest increases in abortions were recorded in states that bordered those with the most restrictive antiabortion laws. For example, Illinois, which borders Indiana and Missouri, showed a 72 percent increase in abortions, while New Mexico, which borders Texas and Oklahoma, recorded 257 percent more procedures. More than 160,000 patients crossed state lines to seek care, the report found.
More broadly, states without total bans recorded a 25 percent increase in abortions last year relative to 2020.
Wider access to the drugs mifepristone and misoprostol likely contributed to the overall rise, as more providers used virtual appointments to prescribe the abortion medications via mail after the U.S. Food and Drug Administration loosened regulations in recent years for obtaining mifepristone. A large body of research shows mifepristone, which was first approved more than two decades ago, is safe and effective. Mifepristone and misoprostol are used together for a medication abortion.
Tessa Longbons Cox, a senior research associate at the Charlotte Lozier Institute, an antiabortion group that has criticized that FDA move, called the record number of medication abortions a “tragedy.”
“What we’re witnessing is a new abortion landscape that prioritizes putting women’s health and safety last,” Cox said in a statement.
Abortion providers and advocates say that if the Supreme Court restricts access to mifepristone, the second drug in the two-drug regimen, misoprostol, could still be used to terminate a pregnancy. That could cause more cramping and bleeding. Providers could also still perform surgical abortions.
The report found that the growth of financial support for abortions also helped account for the increase.
The number of abortions began rising in the United States in 2020 after a 30-year decline. It peaked in 1990 at 1.6 million and fell to 885,000 abortions in 2017.
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